Unsurprisingly it’s technical, but excellently explained:

I’ve tucked it below the fold, as it autostarts and that’s annoying.  Also, I’m not smart enough to keep it from autostarting…

Read the rest of this entry »

Woman arrested over ‘cyanide’ attack that left ex-boyfriend dead and his fiancée fighting for life | Mail Online

Cyanide.  That’d be hard to pick up in a patient brought in in full arrest (not involved in a fire).  Though I suspect if it’s advanced to the full-arrest stage recognizing it wouldn’t help much.

ER doctors sue state, say emergency room system near collapse | L.A. Now | Los Angeles Times
Emergency room doctors filed a lawsuit today against the state, saying that California’s overstressed emergency healthcare system is on the verge of collapse unless they receive additional funding.

…

Emergency room physicians say they have been particularly hard hit by the state’s fiscal problems. Unlike other doctors, who can choose not to accept Medi-Cal patients, emergency rooms cannot deny treatment. They provide care for these patients but are reimbursed at rates they say are half the cost of the treatment. California’s reimbursement rate ranks 43rd in the country, state officials said.

Hmm.  I understand their frustration but wonder what they think they’re going to get from a state that’s essentially insolvent.

richard[WINTERS]md: Concierge Emergency Department is a very interesting idea.

Every hospital I’ve been to treats every patient to the same experience, with the same care. Some people would gladly pay for the same care but a better experience (see above blog post). I know I would.

What say you, folks about the Concierge ED: good, bad, or indifferent?

On the same track, an ED in Silver Springs, MD had a good idea, the Seniors ED:

When Barbara Rayner, 78, came to the emergency room at Holy Cross Hospital in Silver Spring last month with severe lower back pain, she was expecting a long wait and harried staff. But within minutes she was whisked into a separate area, called the senior emergency center. It is one of the nation’s first ERs designed to serve a population 65 and older.

Seniors get a better experience, and the hospital gets to market to a payor group that’s nearly 100% covered by some kind of insurance.  Win/Win.

I was pleased to be Zippy’s caretaker when we went to the Bahamas for a medical conference (background on Zippy Here).

I’ve made a pictorial essay on the travels and travails of Zippy the Lobster:

Also, recall what Zippy’s trying to do, raise awareness (and coff money coff) for childrens’ brain cancer research.  So, if you feel the urge, go over there and give a little.

2008 Medical Weblog Awards Sponsored by Epocrates: Meet the Winners! – Medgadget – www.medgadget.com

I was away and missed this.  Congratulations to all the winners!

He’s on vacation, and has nothing to say at this time.

He will, later.

Zippy arrived today, from the bitterest cold of Michigan, having spent some crazy time with Crzegirl there.

Zippy doesn’t travel light,

or cheap, either,

and is leaving with me tomorrow on a very fun trip.  Stay tuned!

Read all about Zippy here; also, the Evil Genius behind Zippy.

The Leap Non-Severity Scale at edwinleap.com
My scoring system for critical illness:

The Leap Non-severity scale:

Profanity:

3 Unable to speak profanity or make profane gestures.

Follow the link, there’s more.  And it’s funny (because it’s true)!

Genius.  Sheer, unadulterated genius.

Life in the Fast Lane » Blog Archive » Is Twitter the essential Blogging nutrient?

Fun illustration, and good post.

Notorious Fort Worth madam finally gets a headstone | Fort Worth | Star-Telegram.com
A group of local historians placed a granite stone at the resting place of Mary Porter, Fort Worth’s most famous madam, who was buried more than a century ago alongside three other prostitutes in an unmarked plot at Oakwood Cemetery.

The Irish-born woman operated a downtown “female boardinghouse” — a brothel — on Rusk Street.

In his book Hell’s Half Acre, author Richard Selcer wrote that Porter probably knew most of the prominent businessmen in town on a first-name basis. From 1893 to 1897, she had 130 offenses on record with the county court but never spent one night in jail.

Never let it be said Fort Worth forgets its history.

Aggravated DocSurg: Four Horsemen of a Trauma Death

An excellent post on Trauma and why people dies traumatic deaths.

Suggested by an old friend: During a slow shift in an ED, try to find a chronic disease that doesn’t have an online support group.  He assures me it’s not winnable.

I haven’t tried it yet.

A couple of weeks ago a really dumb survey was published, which purported to show that a giant majority of EP’s thought police were using excessive force, and I agreed with California Medicine Man that it was at best ill-informed, and most likely wrong.

The original article didn’t go unnoticed by the Police:

Medical Diagnosis: We Suck! – Patrol Tactics Channel – POLICE Magazine
…
It appears to me that there’s a good number of doctors—say about 98% of those polled—out there who are in desperate need of some vertebrae transplants.

Physicians, heal thy selves.

Read the article, and the comments.  Interestingly, they assume it’s true (which I doubt), and the anecdotes about bad medicine flow.

Medicare’s mistake – Opinion – USATODAY.com

Kevin, MD (Dr. Pho) has yet another excellent op-ed in USA Today.  Why not Kevin, MD for Surgeon General over Dr. Gupta!