Apr 6th, 15

Californians increasingly visiting hospital ERs for non-injury care

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Californians are increasingly likely to visit a hospital emergency room for complex medical problems rather than an injury, according to new research.

Although hospital emergency departments, or EDs, were once known as “accident rooms,” a review of all non-federal hospital emergency rooms in California from 2005 to 2011 found that injury-related visits have declined over that time period, according to a study published Monday in the journal Health Affairs.

Overall, emergency room visits due to injury fell nearly 1% while visits brought on by complex medical issues such as gastrointestinal disease and mental illness rose by more than 13%, the researchers found.

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Apr 4th, 15

Lessons from the battlefield are transforming emergency medicine in huge ways

Lessons from the battlefield are transforming emergency medicine in huge ways
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About 35 million people are treated in the United States each year for traumatic injuries, such as those cause by gunshots and car accidents. Trauma is the leading cause of death for Americans under 44, according to the Trauma Center Association of America.

The techniques brought home since the Sept. 11, 2001, attacks on the United States are a reflection of the historic low in combat deaths in Iraq and Afghanistan.

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Jun 15th, 12

Researchers Identify Risk Factors for Death from MRSA Bacteremia

A new study by Dr. Mina Pastagia et al. has identified risk factors for death from bacteremia due to MRSA. In a retrospective study of 699 cases of MRSA bacteremia in 603 patients, researchers noted that advanced age, residence in a nursing home, severe bacteremia, and organ impairment were independently associated with increased risk of death. Consultation with an infectious disease specialist was associated with a significantly decreased risk of mortality.

Overall mortality was 31.5%. More than 40% of the patients had had surgery within the previous 3 months, and in 43% of cases a central venous catheter was found to be the source of infection.

According to the lead author, “The consequences of MRSA bacteremia are clear — many patients will die or experience a decline from their baseline clinical condition. The adjusted risk difference enables clinicians to use a targeted approach, directed toward patients with the highest risk of death… These patients should be treated carefully and should possibly receive a consult from an infectious diseases specialist. What remains unclear is whether patients at increased risk for death should be treated with antimicrobial drugs other than vancomycin.”

These findings can help clinicians to estimate the risk that a patient with MRSA bacteremia will die and to determine the need for infectious disease consultation, thereby potentially improving the chances that the patient will survive.

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