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Friday, November 4, 2016

On Call by Casey Ross

Good morning! It's STAT's first birthday. Let's celebrate with today's news on hospitals and health care. For more coverage, follow us @statnews on Twitter and like us on Facebook.

New research: Improvements in battlefield medicine mean better outcomes for blast victims 

Combat blast injuries are horrific, often involving severed limbs, pelvic fractures and huge amounts of blood.

And for the first time, surgeons are proving that blasts are not only survivable, but that victims can recover enough to live productive lives.

A new study outlines how trauma surgeons are accomplishing that feat in Iraq and Afghanistan, where survival rates from battlefield injuries are over 90 percent for the first time in history.

Here are a few takeaways from Dr. Jeremy Cannon, a study author who did tours in both theaters.

“The number one thing is having a well-established and efficient trauma system that delivers the patient to definitive care in a timely fashion,” said Cannon, a professor at the University of Pennsylvania’s Perelman School of Medicine.

That sounds simple, but it is also easily overlooked. With such severe injuries, every second matters.

In addition, Cannon said, stopping blood flow is crucial and has become easier with dressings that help blood to clot. His article mentions using pelvic binders to keep patients from jostling around and an aortic balloon to stop blood from flowing to areas where it is running out of the body.

Modern prosthetics, and reconstructive surgeries are also giving patients a much better quality of life. “It’s not just surviving,” Cannon said. “It’s surviving to be part of a community where you are a vital member.”  

Helping hospitalized patients vote on Tuesday

In the days leading up to a pivotal election, hundreds of thousands of Americans will be hospitalized, unable to get to the polls. 

Today, STAT columnist Dr. Jennifer Okwerekwu writes about an organization she co-founded that gets ballots into the hands of inpatients. Under a little-known law, the Social Justice Coalition at Cambridge Health Alliance is helping hospitalized patients vote from their beds using a designated proxy, who could very well be a hospital staffer. 

Because sickness and hospitalization tend to affect low-income and minority populations more than others, it is an issue of fairness in more ways than one, she says.

Read more.

Sponsor content by Leukemia & Lymphoma Society

A groundbreaking new clinical trial for patients with acute myeloid leukemia

There have been few advances in the treatment of AML patients for more than 40 years. LLS launched a new collaborative clinical trial designed to change the treatment paradigm by developing more individualized, effective treatment approaches. Read more.

Front lines: Sibling duo fights opioid crisis

Sam Plumb sprinted across the parking lot of a Salt Lake City apartment complex, following a panicked woman who said her boyfriend was unconscious.

Inside, he found an upscale apartment. Plumb told me a little dog was calmly sitting in the corner. Dinner — plates of pasta and salad — was laid out on the counter. In the kitchen, a man in his 30s lay motionless and sopping wet, ice cubes scattered around his body. His girlfriend had tried to revive him from an opioid overdose by dousing him with ice water.

Plumb said he examined the man and found a faint pulse. He administered a dose of naloxone.

No response.

He tried a second time, then a third — still nothing.

Plumb said he — and the victim — ended up in that situation because the woman called Utah Naloxone instead of 911. Utah Naloxone distributes the overdose reversal drug and helps raise awareness of the broader crisis. Plumb's sister, Jennifer, who started the organization with him, had answered the call but was nowhere near the woman’s location. Luckily, Sam had been at a shopping center nearby.

Despite the initial lack of responsiveness, Plumb gave the man a 6th, 7th, and 8th dose of naloxone. He noticed his respiration started to improve. Finally, on the 13th dose, Sam Plumb said, he came out of it.

“The first thing he said, in tears, was, ‘Please tell me my mom doesn’t know',” Plumb recalled. “He didn’t care about legal ramifications or the fact that he just about died. He just didn’t want to disappoint his mother. It really brought home to me that these are just people.” 

Zag of the Day: From a cracked tooth, an invention is born

Innovation often comes from a place of pain.

For Corey Stein, it came from a cracked front tooth on a Friday night. He told STAT contributor Anna Nowogrogzki that he had trouble describing the problem to his dentist. So the California dental student designed an app to fix the communication gap.

DentaCom helps patients snap photos of the inside of their mouths and deliver clear descriptions to a dentist using their smartphones. It also prevents expensive, irritating trips to emergency rooms when a crisis happens outside your dentist's normal office hours.

Thankam Thyvalikakath, now of the Indiana University School of Dentistry, helped to test and validate the tool. She found that 20 subjects, ages 18 to 61, were able to use it in four minutes or less. But it’s still a prototype, she said, and they need feedback.

“We still need to test how dentists perceive the completeness of the information,” Thyvalikakath said. “Are they able to make an informed decision?”

Referrals

  • More federal money flowing toward primary care (Modern Healthcare)
  • A case from the NFL strengthens link between ALS and head trauma (STAT)
  • HIV added to US list of carcinogens (Reuters)
  • Listing ‘notorious’ health care leaders (Fierce Healthcare)

Have a news tip or comment you want to send me?

Send me an email

Stay well, and come back Monday. Follow me on twitter.

Casey

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