Emergency Medicine

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More Californians Visiting ER For Chronic Medical Conditions

Millions of Californians visit emergency departments for help with non-injury related  health problems -- and that number is rising.

Millions of Californians visit emergency departments for help with non-injury related health problems — and that number is rising.

Traditionally people think of a hospital emergency room as a place to go for injuries: someone gets in a car accident, has a heart attack, or falls out of a tree and breaks his leg. But the ER also plays a large role in treating medical patients.

Millions of Californians visit emergency departments for help with non-injury related health problems — and that number is rising, according to a study recently published in the April edition of Health Affairs.

“The study gives you kind of a bird’s eye view of what’s happening in the health care system overall.”

The study, led by the University of California, San Francisco, shows the rate of emergency room visits for non-injury related problems rose 13.4 percent in the state, from 10.1 million visits in 2005 to 11.9 million visits in 2011. The largest increase in non-injury related ER visits were for gastrointestinal diseases, abdominal pain and nervous system disorders.

Renee Hsia is a professor of Emergency Medicine and Health Policy Studies at UCSF, and the lead author of the study. She says hospital admissions rates are a window into California’s health care system.
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Uninsured? Here Are Alternative Options for Medical Care

By Emily Bazar, CHCF Center for Health Reporting

Millions of still Californians remain uninsured, either by choice or immigration status. (Getty Images)

Millions of still Californians remain uninsured, either by choice or immigration status. (Getty Images)

About 5 million Californians have new health coverage as a result of the Affordable Care Act (ACA), both through the Covered California health insurance exchange and the expansion of Medi-Cal, California’s Medicaid program for low-income residents.

But millions of others remain uninsured – by circumstance or by choice.

Up to half of California’s uninsured population is made up of immigrants who are not in the country legally, and therefore are excluded from health insurance exchanges, tax credits and most Medi-Cal coverage. Others can’t afford coverage (even if it’s subsidized), choose not to buy insurance, or are unaware that they qualify for free or subsidized insurance.

No matter who they are or what their circumstances, they get sick, too.

Q: I’m uninsured but need medical care. What are my options?

A: It’s hard to pin down exactly how many Californians remain uninsured, but Anthony Wright, executive director of Health Access California, believes there are roughly 3 million of you.

The good news is that more than a third of you are actually eligible for coverage, either Medi-Cal or subsidized insurance through Covered California, says Laurel Lucia, an ACA expert at UC Berkeley’s Center for Labor Research and Education.

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Boston ER Doctor Finds Marathon Memories Hard to Shake

By Leana Wen, for NPR

(Jim Rogash/Getty Images)

(Jim Rogash/Getty Images)

I have a recurring nightmare where I am performing CPR on a patient who turns out to be my husband.

Last Monday, my nightmare nearly came true.

It was 2:50 p.m., and the Massachusetts General Hospital ER was filled to capacity.

In the section where I was working, my patients were critically ill, with strokes, heart attacks and overwhelming infections. Even the hallways were packed with patients receiving emergency treatments.

A call over the loudspeakers announced that there had been two explosions. Many people were injured. That’s all we knew.

Screams mixed with ambulance sirens. The loudspeaker sounded again and again, announcing that more patients were on their way.
Doctors, nurses and transporters disconnected monitors and rushed to send every patient to other areas of the hospital.

As we cleared the emergency room, there was a second call. These were bombings. There were fatalities and dozens, maybe hundreds, of injured. How many were coming to Mass General? Nobody knew.

Three minutes later, the doors flew open. Stretchers came, one after the other. Some victims had no pulse and weren’t breathing. Others had legs blown to shreds. All were covered with blood and soot.

The ER smelled of burnt flesh, and each stretcher left behind a fresh trail of blood. Continue reading