ACEP News, November 2009

November 2009 ACEP News in full digital format
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Critical illness occurred in 6.5% of patients with pandemic A (H1N1) influenza who were admitted to hospitals in Mexico from March-June, with 41% of those patients dying from the infection, a retrospective review has confirmed.

In the wake of Massachusetts' ground-breaking move in 2006 to universal health coverage, nearly two-thirds of surveyed emergency physicians said more patients are seeking emergency care--and nearly two-thirds of surveyed state residents said waiting times in emergency departments have remained the same or risen.

It was January 2009 when the California Supreme Court prohibited emergency physicians from balance billing the several million patients covered under that state's HMOs and Blue Cross and Blue Shield PPOs. But now class action attorneys are moving in--both to file lawsuits against illegal balance billing that is still taking place and to have the state court's ruling applied retroactively.

Each month in my ED, we greet a group of fresh, smiling faces from the third-year medical school class.

With pandemic A(H1N1) influenza bearing down on already overcrowded emergency departments, the Agency for Healthcare Research and Quality is rolling out resources to help EDs prepare for the immediate impact--and funding research to improve ED patient flow and care coordination after the flu has faded.

The Centers for Disease Control and Prevention has updated its guidelines for using antiviral medications to treat the seasonal and pandemic influenza A(H1N1) viruses, according to the CDC Web site.

Intensive care units could become overwhelmed if the pandemic influenza A(H1N1) virus spreads as widely as feared and progresses as rapidly as observed in a March-July 2009 outbreak in Canada.

A greater emphasis on compressions and defibrillation--and less emphasis on the airway and breathing--are among the important concepts to consider when a medically crashing patient arrives in the emergency department.

The Food and Drug Administration is investigating reports of radiation overexposure during perfusion multislice CT imaging to aid in the diagnosis and treatment of stroke.

Emergency physicians commonly use anatomic landmarks to make an educated guess about where to inject regional anesthesia--and commonly end up frustrated when they find out 10-15 minutes later that the block failed. Up to 30% of anesthetic blocks are unsuccessful using this "landmarks" method, some studies suggest.

Dr. Karl Mangold died on June 3, 2009, and on Oct. 4, the ACEP Council adopted a memorial resolution honoring him.

Dr. Sandra M. Schneider was chosen president-elect during the annual ACEP Council Meeting last month in conjunction with the Scientific Assembly in Boston. Dr. Schneider, an emergency physician from Rochester, N.Y., will serve a 1-year term and will assume ACEP's presidency at next year's meeting in Las Vegas.

- 8/11/2011

Few diseases match malaria in historical and global mortality. Within the United States, though the vast majority of cases are in the armed forces, nearly all civilian cases of malaria enter the health care system through the emergency department.

For the second consecutive year, ACEP's Scientific Assembly set a new attendance record. More than 4,700 emergency medicine specialists registered for all 4 days this year. Total attendance, including 1-day registrations, was well over 5,600.

In the November issue of the Annals of Emergency Medicine, the American College of Emergency Physicians published a clinical policy focusing on critical issues in the emergency department management of adult patients presenting with community-acquired pneumonia (CAP).

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