Study: Following TBI guidelines may not reduce mortality | Many hospitals miscalculate their compliance with stroke care guidelines | Study: 43% of medical staff improperly remove protective gear
July 24, 2015
Critical Care SmartBrief
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Critical Care Update
Study: Following TBI guidelines may not reduce mortality
Compliance with Brain Trauma Foundation guidelines for intracranial pressure monitoring and craniotomies in patients with traumatic brain injury did not result in improved mortality rates, according to a study in JAMA Surgery. Lead author Dr. Aaron Dawes at the University of California-Los Angeles said the guidelines may be evidence-based but adherence to them should not be used as a measure of hospital quality. MedPage Today (free registration) (7/23)
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Many hospitals miscalculate their compliance with stroke care guidelines
A study in the Journal of the American Heart Association found that just 29% of 141 hospitals correctly judged their promptness in administering crucial thrombolytic treatment to stroke patients. Nearly 57% of patients admitted to top-performing facilities received thrombolysis within the recommended first hour, while staff estimated the figure was 60%. Lower-performing facilities tended to estimate at least 20% of patients were treated promptly, yet none were. Reuters (7/22)
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Medicine in the News
Medicare trustees predict hospital trust fund to last to 2030
Medicare trustees said the program's trust fund that pays for hospital care is expected to run out of money in 2030, the same time frame as their previous estimate. While Medicare still faces a shortfall, a slowdown in health care spending narrowed the funding gap and put the program in better financial position for the long term, the trustees said. Kaiser Health News (7/23), Reuters (7/22)
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CDC: Infant deaths declining faster than stillbirths
For the first time, there were more stillbirths than infant deaths in the U.S., according to a CDC report that found both were declining, but infant death rates were falling faster. The report also found disparities in fetal death rates. Teens, women over age 35, and women who are black, Hispanic, American Indian or of Alaska Native descent were among groups facing higher likelihood of fetal death. "The fact that blacks and other minorities have the highest rate is concerning, because research shows that these are not genetic differences but differences in access to care," said Dr. Edward McCabe, chief medical officer at the March of Dimes. HealthDay News (7/23)
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Trends and Technology
Air ambulance flights can be lifesaving, but costly
An air ambulance flight often is a lifesaving measure but costs can exceed $25,000 and for many patients, it may not be fully covered by insurance. Mickey Sauser of Mercy Medical Center's Air Care program in Sioux City, Iowa, said air ambulance companies often are not reimbursed fully for flights but since patients do not get a financial assessment before transport, medical triage is an important part of determining which patients need it. Sioux City Journal (Iowa) (7/23)
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HHS shares emergency, disaster services in online repository
HHS has developed an online repository of the federal services available to public health agencies and health care providers during emergencies and disasters. The HHS Response and Recovery Resources Compendium includes information about disease surveillance, decontamination services and field hospitals. The National Disaster Medical System's 62 medical assistance teams can be deployed in 12 to 18 hours. Health Data Management (7/21)
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There is no passion to be found playing small -- in settling for a life that is less than the one you are capable of living."
-- Nelson Mandela,
political activist and president of South Africa
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