Medical News: Medical Community Mobilizes in Shadows of California Wildfires – in Emergency Medicine, Emergency Medicine from MedPage Today

Medical News: Medical Community Mobilizes in Shadows of California Wildfires – in Emergency Medicine, Emergency Medicine from MedPage Today

SAN DIEGO, Oct. 25 — Despite the pervasive clouds of wind-blown smoke that enveloped southern California and displaced an estimated million persons, the emergency departments here did not face an exceptional strain.At the University of California San Diego Medical Center, elective operations and procedures were postponed. UC San Diego physicians were dispatched to triage duty at Qualcomm Stadium, where thousands of persons congregated after mandatory evacuations.

“So far we are only seeing very mild respiratory issues, some coughing or shortness of breath, but nothing serious,” said a spokesperson.

That’s good news.

No Charges for Dr. Anna Pou

NEW ORLEANS, Louisiana (AP) — A grand jury Tuesday declined to indict Dr. Anna Pou, the surgeon accused of killing four seriously ill patients in the aftermath of Hurricane Katrina.

The Orleans Parish grand jury had been investigating the charges since March.

Assistant District Attorney Michael Morales, who conducted the grand jury hearings, had asked the grand jurors to return one charge of second-degree murder and nine of murder conspiracy.

The grand jurors sat calmly while the judge read the possible charges and each response of “no true bill.”


Wife, 2 daughters dead after doctor’s family held hostage –

Wife, 2 daughters dead after doctor’s family held hostage –
CHESHIRE, Connecticut (AP) — At least two men broke into a prominent doctor’s home early Monday, kidnapped a female family member to withdraw money from a bank and then killed his wife and their two daughters, police said.

Utterly horrible.

45 Muslim doctors planned US Terror raids

Before you get too anxious, I’m pretty sure this is three years old, and got sexed up a bit due to the recent terror strikes in Great Britain by physicians. group of 45 Muslim doctors threatened to use car bombs and rocket grenades in terrorist attacks in the United States during discussions on an extremist internet chat site.

Police found details of the discussions on a site run by one of a three-strong “cyber-terrorist” gang.

They were discovered at the home of Younis Tsouli, 23, Woolwich Crown Court in south-east London heard.

One message read: “We are 45 doctors and we are determined to undertake jihad and take the battle inside America.

“The first target which will be penetrated by nine brothers is the naval base which gives shelter to the ship Kennedy.” This is thought to have been a reference to the USS John F Kennedy, which is often at Mayport Naval Base in Jacksonville, Florida.

The message discussed targets at the base, adding: “These are clubs for naked women which are opposite the First and Third units.”

It also referred to using six Chevrolet GT vehicles and three fishing boats and blowing up petrol tanks with rocket propelled grenades.

Investigators have found no link between the Tsouli chat room and the group of doctors and medics currently in custody over attempted car bomb attacks in London and Glasgow.

However, sources said it was “definitely spooky” that the use of doctors for terrorist purposes was being discussed in jihadi terrorist circles up to three years ago.

So, this was in an internet chat room run by would-be jihadists who would actually rather steal credit card numbers and defraud banks.  While it bears investigation, I’m not going to start sweating just yet.


Thanks to reader ‘Medic’ for the tip!

Two doctors held over bomb attacks | the Daily Mail


Two doctors held over bomb attacks | the Daily Mail
Two doctors were among five people being held as terror suspects last night after the bomb plots in London and Glasgow.

One was one of two men who tried to drive a blazing Jeep packed with petrol, gas canisters and nails into Glasgow Airport on Saturday.

Read the article, see the photos. How would a physician, one sworn to defend and protect life, come to this? I don’t want to know.

From my cursory glance, the surviving individual (from all accounts not worthy of being addressed as a physician) has third degree burns on at least 70% of the body. (In one picture he’s wearing clothing that covers the back of the torso, so it’s possibly less or un-burned). Still horribly disfiguring injuries, and hard to survive.

Things that make EMS and ED worry

Bizarre event in a world already on edge from terrorist attempts:

More suspects held in UK terror attacks –
LONDON, England (CNN) — Two people were arrested in Cheshire, England, in connection with terrorist incidents in England and Scotland, bringing the total number of people in custody to four, Scotland Yard said early Sunday.

On Saturday, a sport utility vehicle was driven into an entrance at Scotland’s Glasgow International Airport and burst into flames. On Friday, two explosives-laden cars were discovered at two locations in London.

Two men were immediately arrested at the airport. One was hospitalized with severe burns; early reports that he had died were erroneous.

A third suspect is believed to have died in the Jeep Cherokee that crashed at the airport terminal’s main entrance about 3:15 p.m. (10:15 a.m. ET). …

That ‘s bad, but not the part that has me worried. It’s this bit:

William Rae, chief constable of the Strathclyde Police, said part of the Royal Alexandria Hospital in Glasgow was evacuated after a suspicious device was found on the injured suspect. The device was safely taken away and is being examined, Rae said.

That’s not something I’ve ever trained for. I (and you, if you’re in this business) need to at least consider what we’re going to do when and if this happens.

Congressional Quarterly: ERs are “Biggest Crisis in American Healthcare”

Congress hears from those who prepared last June’s IOM report on the impending ED disaster:

June 22, 2007 – 7:24 p.m.

Emergency Rooms Labeled ‘Biggest Crisis in American Health Care’

Physicians told a House hearing Friday that the nation’s emergency medical care departments are overwhelmed, understaffed, underfunded and unready to take on the type of patient surge that could come with a major natural disaster or terrorist attack.

Despite numerous reports highlighting conditions such as patients being boarded in ER departments waiting for rooms elsewhere in the hospital or ambulances diverted to other facilities — creating treatment delays that have led to patients’ deaths — federal agencies charged with overseeing the nation’s emergency health care system have done little to ease the burden, witnesses told the House Oversight and Government Reform Committee.

“While the demands on emergency and trauma care have grown dramatically, the capacity to handle such demands has not kept pace,” said C. William Schwab, who heads the University of Pennsylvania Medical Center’s Trauma and Surgical Division. Schwab, who helped compile the Institute of Medicine’s report released last June detailing key problems with ER departments and recommendations to fix them, noted that there has been little response from Washington.

Read the whole article to get the flavor. The good news? At least one congressman is ticked at HHS for not acting strongly enough:

Committee member

Elijah E. Cummings, D-Md., who chaired the hearing, said the Department of Health and Human Services (HHS) “appears to be ignoring the mounting emergency care crisis” despite the billions of dollars Congress has appropriated for biodefense and pandemic preparedness. Witnesses said the funding had not relieved any of the burdens in their emergency care departments, and Cummings said HHS has “not made a serious effort to identify the scope of the problem and which communities are most affected.” Cummings was clearly irritated that Leslie Norwalk, acting administrator for the Centers for Medicare and Medicaid Services, did not accept the committee’s June 14 invitation to testify at the hearing. Of the 115 million emergency room visits in 2005, more than 40 percent were covered by CMS programs such as Medicare, Medicaid or the State Children’s Health Insurance Program.

Read the rest for the denoument (Warning: mentions Rep. Henry Waxman). So, Congress is awakening to the idea that the ED’s are being over-run. Most likely that’s good news.

Prius Mileage EPA Change

I buy a Prius, and what happens? Reality: Hybrid Cars’ Fantasy Mileage Ratings Drive Into the Sunset –

Good news: I’m not a horribly inefficient driver; bad news, 48/45/46 aren’t even close to what’s on my window sticker. The EPA decided to test more like people drive (speeding, etc), but with the 2008 model year.

Oh, and tank #2: 44 MPG by the calculator, 46.8 by the car computer. Hmmm.

In case you needed another reason to avoid Lybia

Six Resentenced to Death in Libyan AIDS Case –

Six foreign health workers were condemned to death by a Libyan court Tuesday on charges they deliberately infected more than 400 children with the HIV virus, in a lengthy case that has set back Libya’s attempts to repair relations with the United States and Europe. The sentence drew immediate strong condemnation from Washington, European capitals and medical groups, which said the real culprit appeared to be poor hygiene and medical services in the hospital where the children were infected.

In case you haven’t been following this:

Independent medical studies have shown that the infections, which prosecutors allege occurred in the late 1990s at a hospital in the Mediterranean city of Benghazi, predated the 1998 arrival of the six workers at the hospital by at least several years.


KRLD: Mavs Doctor hopes to raise $1 million to put AED’s in schools

DALLAS (AP) A group headed by the Dallas Mavericks team physician said Wednesday it plans to raise $1 million for at least one automated external defibrillator in every Texas public high school after a recent mandate requiring the device.

The donations would help solve how some cash-strapped school districts will afford the life-saving heart stimulator, also known as AED, which costs about $1,200.

The University Interscholastic League voted last week to require that all 1,300 public high schools have at least one AED on campus but did not address how schools would pay for them.

The Texas Sports Medicine Foundation has already raised about half its goal and will give priority to rural school districts with smaller budgets, said Dr. T.O. Souryal, the group’s founder.

“We’re the safety net,” said Souryal.

Putting AEDs on high school campuses vaulted to the forefront of the UIL’s agenda after a recent rash of students who collapsed with suspected heart trouble, including three teenage football players who died in a 10-day span in Houston.

At least 600 high schools in Texas already have the devices in place, and most large school districts own several for their many campuses.


Dr. Pou goes to the Grand Jury

per CNN: ORLEANS, Louisiana (CNN) — A New Orleans grand jury will decide if a doctor and two nurses intentionally killed patients with injections before the hospital was evacuated in the wake of Hurricane Katrina, Orleans Parish coroner Frank Minyard said Tuesday.

The Orleans Parish District Attorney’s Office would not officially confirm the report, saying only that the matter is still being investigated.

“We won’t confirm it, but I’m not going to deny it either,” Assistant District Attorney George Bourgeois said.

Minyard offered no details and refused to comment on whether he had completed his review of the four patients who died at New Orleans’ Memorial Medical Center in September.

After looking at these booking photos, I’m not having any problems choosing sides.


I’m with these three.

Chris Sims’ Splenic Fracture

I got home from another day at the ED to this headline on CNN: NFL quarterback loses game, then spleen

First thought?  Wow, he signed a really bad contract.  The article cleared some things up:

TAMPA, Fla. (AP) — Tampa Bay quarterback Chris Simms had his spleen removed after taking several hard hits in 26-24 loss to the Carolina - News and Scores from Sports IllustratedPanthers and was resting comfortably in a hospital Sunday night.

There was no immediate word on how long the fourth-year pro might be sidelined. The recuperation time for a normal person is four to six weeks, though it’s unclear how long it might take to heal enough to play football.

“Chris is doing well and we anticipate a full recovery,” team physician Dr. Joe Diaco said in a brief statement, adding the 26-year-old son of former New York Giants quarterback Phil Simms was in stable condition…

He took a good hit according to the article, and that might have been what did it (speculation). 

For those who wonder what a ruptured spleen might look like, here’s a CT illustration (mouse over for the text explanation (requires java)):


(this is NOT Chris Sims’ splenic CT; this is one with a better story I’ll tell someday).


To get an appreciation of what is involved in a laparoscopic splenectomy (I’m guessing that’s what he had, the article didn’t say, but it makes sense) here’s a demonstration.

A quick recovery to Chris Sims, and prayers for his family.

Doing my Civic Duty

Guess who got called for Jury Duty?  Yes, I am thrilled to have been so honored.

I’m going, and I’m not going to ask for a release just because it could cost me money (it will).  I served on a jury when an undergrad, and it was quite an experience.  I’ve cleared most of the week on the off chance I get chosen, so I’m not cynical about my civic duty, but I’m not hoping to be chosen, either.

Frankly I figure no two sides of attorneys want me on a jury at the same time.  We’ll see.

I was thinking about jury movies, and the one that best fits me is this one.  Except, I’m not Henry Fonda, in body or spirit.

Update: It took all day. Not selected. I’m glad, as it was a case of alleged child molestation.

Ann Richards, RIP

Via Wikipedia:

Dorothy Ann Richards (September 1, 1933September 13, 2006) was an American politician from Texas. She first came to national attention as the witty keynote speaker at the 1988 Democratic National Convention (detailed below). Considered the first woman elected Governor of Texas in her own right, she served in that post from 1991 to 1995; she was defeated for re-election in 1994 by George W. Bush, current President of the United States.

I never voted for her (too young, then not my candidate) but she was always entertaining to listen to.

Esophageal cancer isn’t very common, and bad when it happenss  Condolences to her family.

9-11 Fifth Anniversary

It’s the Fifth Anniversary of the 9-11 attacks on America and Americans.  Nearly 3,000 died, and the country was changed.  My condolences to those directly affected for the loss of lives on that fateful day.

My recommendation for this day: Chapter One of the 9-11 Commission ReportIt should be required reading in every High School History class in the US.  The rest is a bit of a snoozer, but the first chapter is an excellent recitation of what actually happened.

Yes we were, as a government and a society, caught flat footed on that day, and things have changed to work on that.  Not enough, but some moves in the right direction.

There’s much left to do.

Please spare a prayer for those lost, and those who risk their lives for us.