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July 2010 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for July 2010. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Flu Vaccine for Upcoming Season Approved

FRIDAY, July 30 (HealthDay News) -- The annual flu vaccine for the 2010-2011 influenza season has been approved by the U.S. Food and Drug Administration, the agency said Friday.

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Population-Based Survey Reveals Work Injury Rates

FRIDAY, July 30 (HealthDay News) -- A module added to the 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey by 10 states found that the proportion of workers work-injured in the previous year ranged from 4.0 to 6.9 per 100 employed individuals, and that the proportion of these cases paid for by workers' compensation ranged from 47 to 77 percent, according to a report published in the July 30 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Specialties See Modest Compensation Increases in '09

FRIDAY, July 30 (HealthDay News) -- Most medical specialties saw modest compensation increases in 2009, but many provider organizations are still operating at a substantial loss, according to the findings of the American Medical Group Association's (AMGA) 2010 Medical Group Compensation and Financial Survey.

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Many Visit Emergency Room in Year Prior to Suicide

THURSDAY, July 29 (HealthDay News) -- Many mental health patients who later commit suicide visit the emergency department in the year prior to their death, with some individuals visiting frequently, according to a study published online July 26 in the Emergency Medical Journal.

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Two Studies Offer Support for Compression-Only CPR

WEDNESDAY, July 28 (HealthDay News) -- Instructions from emergency dispatchers to give cardiopulmonary resuscitation (CPR) with chest compressions only or compressions with rescue breathing are associated with similar survival rates, according to two studies published in the July 29 New England Journal of Medicine.

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Hospital Strategy to Increase PCI Use May Be Unneeded

TUESDAY, July 27 (HealthDay News) -- Hospital-based strategies for increasing patient access to primary percutaneous coronary intervention (PCI) for treatment of ST-segment elevation myocardial infarction (STEMI) may not be the best option in terms of cost and effectiveness if emergency medical services (EMS) are sufficient for getting patients to the care they need, according to research published online July 27 in Circulation: Cardiovascular Quality and Outcomes.

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Alteplase Remains Safe Up to 4.5 Hours After Acute Stroke

TUESDAY, July 27 (HealthDay News) -- Extending the treatment window for administration of alteplase from three hours to 4.5 hours in patients who experience an acute ischemic stroke is safe and does not result in delayed treatment of patients, according to a study published online July 27 in The Lancet Neurology.

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Some Epilepsy Drugs Linked to Self-Harm, Suicidal Behavior

MONDAY, July 26 (HealthDay News) -- Patients taking newer antiepileptic drugs (AEDs) that are associated with a high risk of depression may have an elevated risk of self-harm or suicidal behavior, but other groups of AEDs do not appear to carry this risk, according to research published in the July 27 issue of Neurology.

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Postconcussion Syndrome in Children Often Lasts Months

MONDAY, July 26 (HealthDay News) -- A substantial number of children who experience mild traumatic brain injury (mTBI) are still symptomatic for postconcussion syndrome (PCS) three months after injury, apparently independent of trauma, maternal psychological adjustment, or family dysfunction, according to research published online July 26 in Pediatrics.

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Medical Device-Related Injuries High in Pediatric Population

MONDAY, July 26 (HealthDay News) -- In a recent two-year period, nearly 150,000 children visited an emergency department for treatment of medical device-associated adverse events (MDAEs), suggesting a need for more intensive efforts to prevent such injuries, according to research published online July 26 in Pediatrics.

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Direct Trip to Intervention Center Improves STEMI Outcomes

FRIDAY, July 23 (HealthDay News) -- Pre-hospital triage of ST-segment elevation myocardial infarction (STEMI) with direct transport to an intervention center is associated with decreased symptom-to-balloon time and a lower mortality rate, according to research published in the July issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Seat Belts Protect Pregnant Drivers During Collisions

FRIDAY, July 23 (HealthDay News) -- Wearing a seat belt protects pregnant drivers by reducing the risk of abdominal pressure or contact with the steering wheel during frontal and rear collisions, according to a study published in the July issue of the American Journal of Obstetrics & Gynecology.

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Heart Failure Emergency Care, Physician Skill Sets Explored

FRIDAY, July 23 (HealthDay News) -- The competencies required for physicians caring for heart failure and transplant patients and the need for research to better manage heart failure in emergency departments are explored in a pair of reports published in the July 27 issue of the Journal of the American College of Cardiology.

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Malicious Use of Drugs Affects Dozens of Children Annually

FRIDAY, July 23 (HealthDay News) -- About 160 young children are victims of deliberate, malicious exposure to drugs and alcohol each year in the United States, according to research published online July 21 in the Journal of Pediatrics.

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Heart Failure Mortality Down Significantly in Veterans

FRIDAY, July 23 (HealthDay News) -- Although veterans with heart failure have presented with more comorbidities and have been rehospitalized more frequently in recent years, their 30-day mortality rates have decreased significantly, according to a study in the July 27 issue of the Journal of the American College of Cardiology.

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Patient-Centered Care Linked to Improved AMI Survival

THURSDAY, July 22 (HealthDay News) -- Patient-centered care (PCC) of patients hospitalized for an initial acute myocardial infarction (AMI) is associated with modestly improved survival over a one-year period, according to a study published online July 20 in Health Services Research.

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Phone Intervention Helps Heart Failure Patients Long Term

THURSDAY, July 22 (HealthDay News) -- A telephone intervention aimed at improving education and compliance in heart failure patients can lead to fewer heart failure hospitalizations and a lower death rate than no intervention up to three years after the program ends, according to a study in the July 27 issue of the Journal of the American College of Cardiology.

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Study Looks at Pediatric Pneumonia Complication Rates

TUESDAY, July 20 (HealthDay News) -- Rates of systemic complications associated with community-acquired pneumonia (CAP) fell only in children under the age of 1 following the introduction of heptavalent pneumococcal conjugate vaccine (PCV7) in 2000, but local complications related to CAP have increased among all pediatric age groups, according to research published online July 19 in Pediatrics.

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5.2 Percent of Residency Applicant Essays Plagiarized

TUESDAY, July 20 (HealthDay News) -- About 5 percent of the application essays to residency programs -- often referred to as the personal statement -- contain plagiarized material, according to research published in the July 20 issue of the Annals of Internal Medicine.

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Post-Op, Sepsis More Common Than MI, Pulmonary Embolism

TUESDAY, July 20 (HealthDay News) -- The incidence of post-surgical sepsis is higher than the incidence of post-surgical myocardial infarction or pulmonary embolism, and risk factors for sepsis include older age, need for emergency surgery, and comorbidities, according to research published in the July issue of the Archives of Surgery.

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Transfusion of Recovered Blood Is Cost-Efficient Strategy

TUESDAY, July 20 (HealthDay News) -- During emergency surgery, transfusing a trauma patient with his or her own blood offers an effective and less costly alternative to transfusion with allogeneic blood, according to a report in the July issue of the Archives of Surgery.

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FDA Warns Public Regarding Stolen Advair Diskus Inhalers

MONDAY, July 19 (HealthDay News) -- The U.S. Food and Drug Administration issued a warning to consumers, pharmacists, and wholesalers that certain lots of Advair Diskus (fluticasone propionate and salmeterol inhalation powder) inhalers were stolen from a GlaxoSmithKline distribution warehouse near Richmond, Virginia, in August 2009 and have recently been found in some pharmacies.

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Pain and Depression Dim Work Expectations After Whiplash

FRIDAY, July 16 (HealthDay News) -- Among people who suffer whiplash-associated disorder (WAD) resulting from a car accident, those in the most pain and those with depression symptoms appear to have the lowest expectations of returning to work, according to a study in the July 1 issue of Spine.

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Stroke Risk Doubled One Hour After Drinking Alcohol

THURSDAY, July 15 (HealthDay News) -- The risk of stroke is more than doubled in the hour after ingestion of alcohol, according to the results of a study published online July 15 in Stroke.

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Emergency Nurse Practitioners Rarely Miss Injuries

THURSDAY, July 15 (HealthDay News) -- Emergency nurse practitioners (ENPs) exhibit high diagnostic accuracy, and there are no significant differences between ENPs and physicians related to diagnosis and management of minor injuries and illness, according to research published in the July issue of the Journal of Emergency Nursing.

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FDA Issues Requirements for Baxter Infusion Pump Recall

THURSDAY, July 15 (HealthDay News) -- The U.S. Food and Drug Administration has issued conditions for Baxter Healthcare Corporation to follow in performing its April 2010 recall of Colleague Volumetric Infusion Pumps (CVIPs), and the agency is requiring the company to provide refunds or replacement pumps for customers or terminate their leases.

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Many Postpartum Women Visit ER Within Weeks of Delivery

THURSDAY, July 15 (HealthDay News) -- Nearly 5 percent of women who deliver babies in hospitals across the United States visit the emergency department within 42 days of delivery, most often for pregnancy-related conditions, according to research published in the July issue of the American Journal of Obstetrics & Gynecology.

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BMIPP Data Improve Acute Coronary Syndrome Diagnosis

THURSDAY, July 15 (HealthDay News) -- Use of β-methyl-p-[123I]-iodophenyl-pentadecanoic acid (BMIPP) data in addition to initially available information can help with the early diagnosis of acute coronary syndromes (ACS), according to research published in the July 20 issue of the Journal of the American College of Cardiology.

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Attempted Method Predicts Later Successful Suicide

WEDNESDAY, July 14 (HealthDay News) -- The method a person chooses to attempt suicide appears to be predictive of whether they will attempt suicide again and succeed, with attempts involving hanging, firearms or explosives, drowning, gassing, or jumping from a height at least moderately associated with later successful suicide, according to research published July 13 in BMJ.

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Pneumonia, Raised CRP Level Tied to Severe H1N1 Outcomes

TUESDAY, July 13 (HealthDay News) -- Pandemic H1N1 influenza infection often leads to hospitalization in previously healthy individuals, as well as people with underlying conditions, and an abnormal chest X-ray or an elevated C-reactive protein (CRP) level -- particularly in obese individuals or those with pulmonary conditions other than asthma or chronic obstructive pulmonary disease (COPD) -- is associated with a potentially serious outcome, according to research published in the July issue of Thorax.

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Hospital Care of Heart Attack Patients Has Improved

TUESDAY, July 13 (HealthDay News) -- Hospitals nationwide have improved their care of heart attack patients and are increasingly administering therapies -- such as percutaneous coronary intervention (PCI) -- in a timely manner, safely, and according to clinical guidelines, according to a new analysis of data from the American College of Cardiology's National Cardiovascular Data Registry published in the July 20 issue of the Journal of the American College of Cardiology.

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Diffusion-Weighted Imaging Superior for Stroke Diagnosis

MONDAY, July 12 (HealthDay News) -- Diffusion-weighted imaging (DWI) is accurate and appears to be more useful than noncontrast computed tomography (CT) for diagnosing acute ischemic stroke within 12 hours after symptoms appear; however, there is not enough evidence to support or refute the efficacy of perfusion-weighted imaging (PWI) in diagnosing acute ischemic stroke, according to an analysis published in the July 13 issue of Neurology.

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H1N1 Tied to Death, Serious Illness in Transplant Patients

FRIDAY, July 9 (HealthDay News) -- Influenza A H1N1 can cause substantial morbidity and mortality in solid organ transplant recipients; however, initiation of antiviral therapy within 48 hours of symptom development may decrease intensive care unit (ICU) admissions, according to a study published online July 9 in the The Lancet: Infectious Diseases.

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Wearable Defibrillator Shows Benefits in Mortality

FRIDAY, July 9 (HealthDay News) -- Nationwide, wearable cardioverter-defibrillator (WCD) compliance is satisfactory, and use of the device is associated with low sudden death mortality, though asystole is an important cause of mortality, according to research published in the July 13 issue of the Journal of the American College of Cardiology.

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Many Doctors in Specialties Other Than Their Early Choices

WEDNESDAY, July 7 (HealthDay News) -- Ten years after graduation, approximately one-fourth of doctors work in a specialty other than the one they chose in their third year post-graduation, according to research published online July 6 in BMJ.

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Car Seats Can Be Dangerous When Used Outside of Car

TUESDAY, July 6 (HealthDay News) -- Infants can be seriously injured when they are in an infant car seat being used outside of the car, and parents may not be aware of the danger, according to research published online July 5 in Pediatrics.

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Underage Drinking Emergency Room Visits Rise Over Holiday

FRIDAY, July 2 (HealthDay News) -- Emergency department visits for underage drinking almost doubled during the Fourth of July weekend in 2008, according to a new study from the Substance Abuse and Mental Health Services Administration (SAMHSA).

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Out-of-Hospital CHD Mortality Higher in Young Men

FRIDAY, July 2 (HealthDay News) -- Young men have a higher rate of out-of-hospital coronary heart disease (CHD) mortality than young women, which could partly explain the fact that young women are more likely than young men to die when hospitalized for myocardial infarction (MI), according to research published in the July 1 issue of the American Journal of Cardiology.

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West Nile Neuroinvasive Disease Rate Lowest Since '01

FRIDAY, July 2 (HealthDay News) -- There were 386 cases of West Nile virus (WNV) neuroinvasive disease reported in the United States in 2009, for an incidence of 0.13 cases per 100,000 population, the lowest incidence since 2001, according to a report published in the July 2 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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CDC: Vaccinia Virus Infection Linked to Sexual Contact

FRIDAY, July 2 (HealthDay News) -- Following sexual contact with her military serviceman boyfriend, who had been recently vaccinated for smallpox, a woman in Washington state contracted vaccinia virus infection in her vagina, according to a case report published in the July 2 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Early Stroke Complications Rob Patients of Healthy Years

THURSDAY, July 1 (HealthDay News) -- Early complications following ischemic stroke cost patients about two years' worth of optimal health, in addition to the loss of optimal health due to the stroke itself, and a higher number of complications is linked to a larger loss of healthy life-years, according to research published online July 1 in Stroke.

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Report Addresses Physician Financial Conflicts in Care

THURSDAY, July 1 (HealthDay News) -- In a new report, the Association of American Medical Colleges (AAMC) urges U.S. teaching hospitals to establish policies that ensure financial relationships between physicians and industry do not result in conflicts of interest that influence patient care.

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