Subaqua Sternal Rubs

KANSAS CITY, Missouri (AP) — At St. Luke's Hospital, each of the 14 new neurology intensive care rooms has a feature that's becoming standard in the health care industry: a patient lift system that can handle 600 pounds.

Hospital officials had the equipment installed out of safety concerns — it can take five or six nurses to lift extremely overweight patients, said Jennifer Ball, a patient care director with St. Luke's.

"I think we're seeing more (obese patients) and people are more conscientious about it," she said.

Severely overweight people tend to have more health problems and they often can't fit in standard beds or wheelchairs built for 300-pound people. The $3 billion market for hospital beds, wheelchairs and other equipment designed for plus-size patients is rapidly growing as more Americans become obese.

The government estimates about two-thirds of Americans are overweight or obese; 31 percent fall into the obese category.

Kinetic Concepts Inc. of San Antonio said its line of specialty hospital beds and mattresses, including those for obese patients, took in $282 million last year, a 6 percent increase from the year before.

More on CNN.com

However, it doesn't help it EMS can't get them out of the house. For the second time this month, a story about a 600-lb gentleman who called 911 due to difficulty breathing, and ended up dying because it took 2-hours to get him out of his bedroom. (Interesting side note, story is out of CT, but they show a MAST Ambulance, which is out of Kansas City, KS.) Firefighters ended up cutting out the bedroom window and lowering him down a ladder on his front door as a makeshift, as the standard ambulance stretcher wouldn't hold him. As sad as this is, it points to a growing problem is this country, that is just growing out of control. Medical services are trying to cope, but obviously ther is still work to be done. They are making ambulances now that have cranes on the back of them to lift obese patients in, as well as "oversize" stretchers. However, few EMS agencies have them. If the obesity epidemic continues, what's next? Are we going to start taking patients to the hospital in the back of dump trucks? How about a few less Big Mac's? And before you go off on me that it's all hereditary, last summer I was called to the home of a 600+ lb gentleman in cardiac arrest, with not less than 20 Burger King bags strewn on the floor all around him. What does that tell you?

Sick.

MARIETTA, Georgia (AP) — A drunken driver hit a telephone pole support wire that decapitated his passenger, police said.

He then drove 12 miles home and slept in his bloody clothes, police said, leaving the headless body in his truck.

A neighbor walking with his young daughter Sunday morning discovered Daniel Brohm's headless corpse in the truck in John Kemper Hutcherson's driveway and called authorities, said Cpl. Dana Pierce, county police spokesman.

Officers said they found Hutcherson asleep inside his home, visibly drunk and his clothes bloody, and later found Brohm's severed head at the crash site.

"It's hard for one to imagine that you would drive miles from a crash site to your home, turning in various directions, and yet not know what has happened to a passenger sitting next to you," Pierce said.

Hutcherson, 21, was charged with vehicular homicide, driving under the influence and failure to stop at an accident with death or injury. He was jailed on a $100,000 bond; it was unclear Monday whether he had an attorney.

CNN.com - Police: Drunken man drives home with decapitated friend

This picture was shown in today's Neuroscience lecture. The relative size of the features is supposed to show how many neurons each body part has in the somatosensory cortex.

I just posted it here because it looked funny.

Found over at Gross Anatomy, this animation explains the concept of a single payer health care system. While not perfect, a single payer system is better than what we have today. Which is 45 million uninsured, millions more under-insured. Hospitals overcharging the insured to cover expenses of the uninsured. HMO's telling doctors how to practice, and denying everything for any reason they can think of. Spending the most money of industrialized nations yet having similar or even worse health indicators.

Health care is a right and not a privilege of those whose employer feels like providing insurance. Back in 19th century Germany, Otto von Bismark initiated versions of the first national health insurance scheme in an effort to subvert the influence of the Communist party. Too bad the Cold War is over.

Karma sucks. I guess my car read yesterday's post. Even though it is a Japanese car, I guess it must have been in Grenada long enough to consider itself a naturalized citizen, and it took offensive to my dislike of certain Grenadian driving customs. It took its revenge by refusing to start, and what's worse, by having the hood latch stick, so that the hood could not be opened, so I couldn't even jump-start the vehicle. I called the car-rental place, and after an hour, they show up. They end up taking a screwdriver to wrench the hood open, finally allowing us to jump-start it. We also discovered the problem. There was no "water" in the battery. I didn't know they still made batteries that required that you put water in them. Anyways, I dropped it off at the car-rental place, and they gave me another one while mine was fixed… Well gotta run and get home to let the cable installer in (hopefully - this is the 3rd attempt to schedule an installation…)

Well, after yesterday's Diving Update, I figured I would follow it up today with a Driving Update. Yup, even after a month of driving on the wrong side of the road (despite what you occasional visitors from across the pond think), I am (amazingly) still alive Despite seemingly the highest per capita amount of learners, the people of Grenada still don't know how to drive. The learners are out on normal roads going all of about 10 mph, and when they come to a roundabout, they will not enter it until there is no object visibly moving for 30 miles. (The island is only 22 miles long.) However, once the scarlet letter "L" has been removed from their vehicles, all previous trepidation is gone, and Grenadian drivers speed towards roundabouts at high rates of speed, looking as though stopping for traffic already in the roundabout is merely optional. This happened to me yesterday, and I stopped in the roundabout fearing that the driver approaching the roundabout would not stop. He managed to stop, but not without an angry expression on his face. Excuse me for attempting to follow the rules of the road. Upon turning onto the highway, I met another driver that had not yet progressed past the neophyte state, travelling only 20mph on the Maurice Bishop highway. Granted, this "highway" is only about a mile long, and driving faster will not make that much difference, but I at least I wanted to travel the speed limit. (40mph). Later that night, drove home and encountered two more drivers who exhibited behaviours which were extreme pet peeves of mine. The first driver suddenly stopped in the middle of the road without warning to drop off a passenger. This is perfectly acceptable here, stop whereever you feel like, and traffic will have to move around you. It didn't help that he stopped right around the area where the draninage grate is and he forced me to drive through a 1foot deep pothole (no kidding), which I could have otherwise avoided. Then I was almost blinded by another driver who had left his high beams on. This is also accepted here. I mean, I understand that dark-skinned people randomly walking on the side of the road can be hard to see, but blinding me to the point where I can no longer see, causing me to collide with you head on really doesn't help matters now either, does it?

Went diving on the Bianca C today, this time on nitrox. It was refreshing to see double digit no-decompression limits, as opposed to last time, where according to my computer download of my dive computer, I was within 10-20 seconds of NDL. (Not to worry, my dive computer is a little conservative, so if I had been using my old computer, I would have gotten more time. Anyways, I survived) For those of you interested, the Bianca C is a several hundred foot cruise ship in 90-130+ feet of water that sank a few decades ago. (Nothing like specifics there) Anyways, it was better the second time I did it, but I don't think I'll need to do it again. (That is unless I do my wreck diver speciality and learn penetration diving. But they don't penetrate Bianca, as she is rather old, and rather unstable.) Anyways, the second dive was Shark Reef, off Glover Island. As the name suggests, it is a breeding ground for young nurse sharks. This time we saw three (last visit garnered too many to count), as well as a couple of moray eels (including one that had a diameter of at least 10-12 inches), some large lobsters and crabs. Unfortunately, Grenada Fish and Game rules prohibit taking lobsters/crabs with scuba gear. Something about an unfair advantage.

As previously mentioned, the rest of the day will be studying. Repeat x1 tomorrow.

Coming out of England, (the land of the overburdened Public Health Service), they are trialing the new status of "Emergency Care Provider." Basically there are paramedics that receive additional training and can decide what type of care is appropriate for the patient - i.e. a full-blown emergency department, a walk-in clinic, their GP or even refuse to transport those who call with non-emergent conditions. While I personally would love this, the training/oversight would have to be rather stringent. While I personally feel comfortable making decisions about the urgetness of a patient's condition (and I did such as the Triage "RN" at an Emergency Department), there are some providers in the field that lack this decision-making capability. (Dare I say it… Firefighters….) Anyways, what do you all think? Is this a prudent way to control inappropriate ED visits, ED overcrowding, and reduce ED wait-times for those with true emergencies; or is it placing too much decision-making capability in those not qualified, and a disaster waiting to happen?

Medical Researchers Urge Policy Makers to Test Trials of Paramedics Pruning of Emergency Admissions

University of Warwick Medical School researchers are concerned that the health service could fail to learn important lessons from a crucial series of ambulance and emergency trials that increase the skills of paramedics and help reduce unnecessary emergency hospital admissions.

Dr Matthew Cooke, Head of the Emergency Care & Rehabilitation research group at the University of Warwick’s Medical School in England, will outline his concern at the “Emergency Care Conference”, at the University of Warwick on 2nd September 2004.

Dr Cooke is set to praise the general idea behind the trial schemes that seek to give paramedics and nurses additional training, allowing them to make more detailed and varied medical assessments of the patients they come across than ever before.

This additional training creates a new class of “Emergency Care Practitioners”, which allows them to identify patients that do not need to be transferred to an A&E department. In the past almost all patients who requested an ambulance by 999 were simply transferred to hospital by ambulance no matter what, with paramedics only taking decisions and making medical interventions in the cases of life threatening or other extremely serious injury. In future, they will undertake assessment and treatment that allows them to choose other alternatives, such as taking them to a GP surgery or deciding if they are fit to stay at home.

Dr Cooke is pleased with the potential benefits this will bring in decreasing the number of unnecessary admissions to hospitals, which means real emergency cases will be dealt with even faster than before. However, he is very concerned that this wave of innovative trial schemes with enhanced paramedic roles is being carried out without any investment in serious research or monitoring of how these trial schemes are working.

Dr Cooke will state at the forthcoming conference: “Many of these crucial schemes have been running for over six months yet all we seem to be hearing from them is mere anecdote – we are squandering a unique opportunity to learn real lessons on paramedic and nurse training, ambulance use, and A&E admissions that could be used to benefit patients and staff across the whole health service. It’s ironic that we have some great new ideas being tested on the evaluation of potential emergency patients, but no serious evaluation of those great new ideas.”

The current trials have created 216 Emergency Care practitioners in schemes in Greater Manchester, Hampshire, London, Bedfordshire, Hertfordshire, Coventry, Warwickshire, Hereford, Worcester, Kent, Surrey, Sussex, Norfolk, Suffolk, Cambridgeshire, Teesside, East and North Yorkshire, County Durham, Darlington, South Yorkshire, Devon and Cornwall.

So the January class must really be the dumber class. We have had so many decels (people dropping classes, and taking a semester longer to complete the program) that our class size is now smaller than the 4th term class size. (We started out bigger.) So as of Monday, we will be in the Bourne Hall, which has fewer seats than the Bell Hall, our current home. Bourne is a nice hall, has the same amenities, except that you are closer to the lecturer without the benefit of stadium seating, and there are more comfortable chairs with actual backrest padding. (Making it easier to fall asleep, see previous point on being up-close-and-personal with the lecturer.) It'll actually be complete chaos on Monday, as no one has their "usual" seat anymore, and everyone will be running around trying to 1) sit near their friends and 2) sit as far away from the lecturer as possible, while still having a good view of the screens. It should be interesting.

Well it is the weekend now, and I already have it booked out. The Immunology text book has not come in yet — evidently it was delivered to Grenada, Spain! So the professor handed out photocopies of Chapters 2 and 3… and then when the book still wasn't in, made 150 copies of Chapter 4. There are 290 people in our class, so I wasn't one of the lucky ones to get one. Well, I borrowed a copy of the book from someone who took the class last term, and I have already finished a chapter today… Only two more to go this weekend. Of course, I decided to rent a few videos from the DVD store to help me in my studying mission. Or maybe it was the fact that I wanted to watch something, as my cable has not been hooked up yet. I have made a couple of different appointments, but they either don't show up or show up at completely the wrong time. Like today, where I told them I wouldn't be home after 10:30am, but I get a voicemail on my phone at 8:30am, angrily asking where I am. Like I told the scheduling person, class. Then when I call back at 10:30 am, I hear kids screaming in the background. Must be nice to be home of not-even two hours of work. The work ethic of some people.
Anyways, gonna relax with a pizza (which I just ordered) and beer(s) tonight, then tomorrow morning it's diving Nitrox (hopefully) on the Bianca C, and then Shark Reef. If I make it back, then some self-study and study groups. Repeat for Sunday.

Well, gg pick up that pizza.

The New York Times reports:

Rising costs for health coverage and a continuing fall-off in the number of workers in employer-sponsored health plans are among the reasons that a greater number of people did not have health insurance last year, experts say.

The increase in uninsured people last year, as reported by the United States Census Bureau yesterday, was 1.4 million, to a record 45 million.

More than 10 million of those without insurance were young people, 25 to 34 years old, government officials said, an increase of 576,000 from 2002. "Young adults got hammered," said John F. Holahan, a health economist at the Urban Institute, a nonprofit research center in Washington.

Great, and my COBRA coverage is set to expire next year. I guess it's a good thing that I am required to have insurance for school, otherwise I probably wouldn't. I mean it just so darn expensive.

Also in the news, this time from Yahoo:

Nineteen California pharmacies filed a state lawsuit Thursday accusing the world's largest pharmaceutical companies of conspiring to inflate U.S. drug prices. The pharmacies accuse the 15 drug makers of illegally conspiring to charge inflated prices in the United States while barring pharmacies from buying the makers' drugs at lower prices outside the country.

"We are being charged higher prices than foreigners are being charged," said Joseph Alioto, representing the pharmacies. "If we are selling the same drug we want to pay the same prices as everyone else."

The lawsuit, filed in Alameda County court in Oakland, alleges the pharmaceutical companies have hurt the pharmacies' bottom lines by violating California's antitrust and unfair business practices laws.

Finally someone taking on these immoral, profit mongering drug companies….