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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Peter Dierks who wrote (3554)	1/3/2008 9:33:15 AM
From: Pogeu Mahone	Read Replies (1) \| Respond to of 42652

Heart Attack rush to Casino forget ER`s-ng- ========================== A code blue for hospitals Study warns that defibrillators not effectively used By Thomas H. Maugh II, Los Angeles Times \| January 3, 2008 LOS ANGELES - People who suffer a life-threatening alteration in heart rhythms are more likely to survive if they are in a casino or airport than if they are in a hospital, researchers reported yesterday. Doctors already knew that more than half of those who suffer such attacks in airports and casinos survive. A new study in hospitals shows that only a third of victims there survive - primarily because many patients do not receive life-saving defibrillation within the recommended two minutes. Nearly 40 percent of hospitalized patients who received defibrillation within two minutes survived to leave the hospital, compared with only 22 percent of those for whom the response took longer, researchers reported in the New England Journal of Medicine. As many as 750,000 people suffer such attacks in hospitals every year in the United States and another quarter million outside hospitals. "It is probably fair to say that most patients assume - unfortunately, incorrectly - that a hospital would be the best place to survive a cardiac arrest," wrote Dr. Leslie Saxon, a cardiologist at the University of Southern California, in an editorial accompanying the report. People who suffer a heart attack in the middle of a crowded airport or casino - where defibrillators are widely available - are typically noticed immediately, whereas a lone patient suffering an attack in a hospital room might not be noticed for much of the crucial window of opportunity during which defibrillation is most effective. The odds of survival are even lower in small hospitals with fewer than 250 beds and on nights and weekends, according to the study by Dr. Paul S. Chan of Saint Luke's Mid-America Heart Institute in Kansas City, Mo., and Dr. Brahmajee K. Nallamothu of the University of Michigan. At least part of the apparent discrepancy arises because hospitalized patients are sicker to begin with, while those who suffer attacks in airports and casinos generally don't have underlying medical illnesses or symptoms, said Dr. Gregg C. Fonarow, a cardiologist at the University of California, Los Angeles, who was not involved in the study. Nonetheless, he said, hospitals can do more to shorten the time required to administer defibrillation. Defibrillation is used when patients suffer either ventricular fibrillation or ventricular tachycardia. In the first case, the heart beats abnormally or intermittently, while in the second it beats extremely rapidly. In both cases, the result is the same: an inability to effectively pump blood through the body. Applying a shock to the heart often restores normal heart rhythms. The devices found in public places, called automated external defibrillators, can be used by trained laymen to treat the condition rapidly. The lower rate of successful defibrillator use at hospitals might be understated, the researchers added, because only the best hospitals are likely to be participating in the registry. © Copyright 2008 The New York Times Company

To: Peter Dierks who wrote (3554)	1/3/2008 10:22:33 AM
From: Lady Lurksalot	Read Replies (2) \| Respond to of 42652

Peter, this is not news. For as long as I can remember and even before, people have shown up at emergency rooms with runny noses and skinned knees and the like. They have shown up at emergency rooms, having noncritical ailments, because they did not want to wait for an appointment with their own physicians, or they did not want to take time off from work to keep an appointment with their own physicians. They have shown up at emergency rooms with their kid because their kid was crying and keeping them awake. Non-emergent nursing home patients have been shipped--via ambulance--to emergency rooms at change of shift at the nursing home, for all kinds of hummer (read hmmmmm) reasons. Some, and not a just few, have shown up at emergency rooms because there was nothing good on TV but they had police and fire scanners broadcasting to them, telling them that the emergency room was where the real action could be found. Of course, that was never their presenting complaint, but we knew. I could go on. People of all flavors have shown up at emergency rooms in the dead of night, and all through the day and evening,for a variety of complaints--precious few of whom warrant emergent medical attention. The article is excruciatingly correct in stating that anyone who shows up at an emergency room must be treated and stabilized, regardless of their complaints or their ability to pay for service. Bad law. Hopping to the other side for a moment, I was on the scene, long ago and far away, for two genuine emergency patients who, at the time, made this law necessary. - Holly