ACEP News, July 2009

July 2009 ACEP News in full digital format
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Dr. James Rohack, president of the AMA, explains why his organization is backing health care reform legislation.

The House Energy and Commerce Committee approved an amendment that included  provisions ACEP has worked to include in the House health care reform package.

Summary from the 2009 Daniel Stern & Associates Emergency Medicine Compensation and Benefit Survey includes information from 624 staff physicians and 385 emergency department directors.

The emergency department wait time to see a physician for emergent patients--those who should be seen in 1-14 minutes--averaged 37 minutes in 2006. Half of such patients waited longer than recommended, the Government Accountability Office said in a report.

A bold Boston experiment has demonstrated that ambulance diversion can temporarily be eliminated in a major city without adverse impact on the efficiency of hospital and emergency medical services.

The routine emergency department practice of ordering whole-body computed tomography scans for level III blunt trauma patients provides virtually no diagnostic information, generates considerable expense, and exposes patients to potential harm from the radiation in the so-called pan scans.

The better I get at putting to rest patients' concerns, the happier they are and the more satisfied I am.

A simple clinical decision rule using prehospital vital signs may predict which trauma patients will need emergent surgical intervention upon arriving in the emergency department.

Nonsustained hypotension in emergency department patients with sepsis was associated with a threefold increased rate of in-hospital mortality in a large prospective study.

Many emergency physicians don't routinely test for STDs in women who present to the emergency department with gynecologic complaints during the first trimester of pregnancy--but a new study suggests they should.

A standardized pathway for assessing and managing patients who come to the emergency department with chest pain led to a "remarkable" reduction in patient deaths and readmissions during the first 4 years of use, based on a review of about 3,000 patients.

An 80-lead electrocardiographic body-surface mapping system significantly improved detection of acute myocardial infarction and unstable angina in the emergency department, compared with the standard 12-lead electrocardiogram.

Strokes in young patients and posterior-circulation strokes collectively make up less than 15% of all ischemic strokes but are a disproportionate cause of lawsuits against emergency physicians.

Hospital staff are aware of only a fraction of patients who may be bringing infectious diseases in from another hospital, because transfers between hospitals are often indirect.

The combination of oral dexamethasone and nebulized epinephrine appeared to reduce hospital admission, hasten discharge from the emergency department, and decrease the duration of symptoms in infants with bronchiolitis, according to a report in the New England Journal of Medicine.

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