New EMS system dramatically improves survival from cardiac arrest

A new system that sent patients to designated cardiac receiving centers dramatically increased the survival rate of victims of sudden cardiac arrest in Arizona, according to a study published online in Annals of Emergency Medicine.”We knew lives would be saved if the hospitals implemented the latest cutting edge guidelines for post-cardiac arrest care and we were able to get cardiac arrest patients to those hospitals, similar to what is done for Level 1 trauma patients,” said lead study author Daniel Spaite, MD, Director of EMS Research at the University of Arizona Emergency Medicine Research Center in Phoenix and Tucson and a professor and distinguished chair of emergency medicine at the University of Arizona College of Medicine. “Taking these patients directly to a hospital optimally prepared to treat cardiac arrest gave patients a better chance of survival and of preventing neurologic damage, a common result of these cardiac events.”Under the study, 31 hospitals, serving about 80 percent of the state’s population, were designated as cardiac receiving centers between December 2007 and November 2010. Approximately 55 emergency medicine service agencies also participated in the study.The study shows that the survival rate increased by more than 60 percent during the four-year period of the study, from 2007 to 2010. More importantly, when the results were adjusted for the various factors that significantly impact survival (such as age and how quickly the EMS system got to the patients after their arrest), the likelihood of surviving an arrest more than doubled. In addition, the likelihood of surviving with good neurological status also more than doubled.This statewide effort was accomplished through the Save Hearts Arizona Registry and Education-SHARE Program, a partnership involving the Arizona Department of Health Services, the University of Arizona, over 30 hospitals and more than 100 fire departments and EMS agencies. The SHARE Program is part of a network of statewide cardiac resuscitation programs dedicated to improving cardiac arrest survival and working together as the HeartRescue Project.”We worked closely with the hospitals around the state to implement these Guidelines and then formally recognized the hospitals as Cardiac Receiving Centers (CRCs) ,” said Ben Bobrow, MD, Medical Director of the Bureau of Emergency Medicine Services and Trauma System for the Arizona Department of Health Services in Phoenix, Ariz. “We then developed protocols for our EMS agencies to transport post-cardiac arrest patients to those centers. Our overarching goal was to have more cardiac arrest victims leave the hospital in good shape and be able to return to their families and careers. As we suspected, ‘regionalizing’ the care for these critically-ill patients markedly increased their likelihood of survival and good neurologic outcome.”Dr. Bobrow, who is also a professor of emergency medicine at the University of Arizona College of Medicine-Phoenix and an emergency physician at Maricopa Medical Center, said the study shows that just transporting these patients to the nearest emergency department does not maximize the likelihood of a positive outcome. …

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Asbestos Blunder Results in Demolition Firm Fine

Home » No Win No Fee » Latest Personal Injury News » 2014 » 3 » Asbestos Blunder Results in Demolition Firm FineAsbestos Blunder Results in Demolition Firm FineA Portsmouth company has faced criminal charges today after it stripped more than 50 metres of asbestos board without the correct licences.James Site Services, of Cosham, was taken to Court by the Health and Safety Executive (HSE) after inspectors carried out a routine inspection at one of its small development sites in Fareham, Hampshire and uncovered serious failings.Asbestos InsulationPortsmouth Magistrates’ Court was told that James Site Services, which specialises mainly in site preparation for demolition projects, had been hired to strip out asbestos from a bungalow that was due to be refurbished.During an inspection, the HSE discovered the company had illegally removed 54 metres of cancer-causing insulation boards, even though it did not have the correct licence.Only registered tradesmen are allowed to handle asbestos removal work because of the dangers it poses, with Mesothelioma cancer, which is caused by fibres from the material coating the inside of a worker’s lungs, resulting in hundreds of deaths a year in the UK.Asbestos Survey IgnoredAlthough James Site Services had correctly commissioned a survey to identify the presence of asbestos, the HSE said the company chose to ignore its findings and carried out the asbestos removal work itself, exposing workers to serious dangers.For its part in this decision, James Site Services was fined a total of £500 and told to pay £1,000 in costs after it pleaded guilty to a single breach of the Control of Asbestos Regulations 2012.In cases where executives ignore the concerns of third parties in relation to asbestos, penalties are normally larger, but because James Site Services is only a very small company, the sanctions were made less severe.”Serious Failing”Speaking after his organisation’s successful prosecution, HSE inspector Dominic Goacher said, “This was a serious failing on the part of the company. Having received the survey they asked for, it looks as though no one at James Site Services bothered to read it. Or, if they did, they disregarded its contents and failed to act to protect workers from possible exposure to one of the deadly killers in industry.”HSE operates a highly-regulated licence regime in order to ensure work with asbestos is carried out safely by a skilled, competent workforce. By taking the work on, James Site Services not only put their workers at risk but also gained an unfair financial advantage.”Mr Goacher added that it is very important companies not only get an asbestos survey done, but that they also follow its guidance and ensure that staff members are properly protected.One of the most dangerous factors in dealing with asbestos is that it is almost invisible and is very hard to identify at first glance.Asbestos Hidden Killer CampaignIn an attempt to highlight the dangers of exposure to asbestos materials, the HSE recently launched its Hidden Killer campaign to educate small business owners on the seriousness of asbestos inhalation.Not only can improper asbestos extraction lead to litigation, it can cause those affected to suffer from a slow, painful death, as the inner-lining of the lungs is heavily damaged by the material.By Francesca WitneyOr Call freephone 0800 884 0321SHARE THIS

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Substance use by adolescents on an average day is alarming

Aug. 29, 2013 — On an average day, 881,684 U.S. teenagers aged 12 to 17 smoked cigarettes, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report also says that on an average day 646,707 adolescents smoked marijuana and 457,672 drank alcohol.To provide some perspective, the number of adolescents using marijuana on an average day could almost fill the Indianapolis Speedway (seating capacity 250,000 seats) two and a half times.”This data about adolescents sheds new light on how deeply substance use pervades the lives of many young people and their families,” said SAMHSA Administrator Pamela S. Hyde. “While other studies indicate that significant progress has been made in lowering the levels of some forms of substance use among adolescents in the past decade, this report shows that far too many young people are still at risk.”The report, which highlights the substance abuse behavior and addiction treatment activities that occur among adolescents on an average day, draws on a variety of SAMHSA data sets.The report also sheds light on how many adolescents aged 12 to 17 used illegal substances for the first time.On an average day:7,639 drank alcohol for the first time; 4,594 used an illicit drug for the first time; 4,000 adolescents used marijuana for the first time; 3,701 smoked cigarettes for the first time; and 2,151 misused prescription pain relievers for the first time. Using data from SAMHSA Treatment Episode Data Set (TEDS), the report also analyzes how many adolescents aged 12 to 17 were receiving treatment for a substance abuse problem during an average day. These numbers included:Over 71,000 in outpatient treatment, More than 9,302 in non-hospital residential treatment, and Over 1,258 in hospital inpatient treatment.In terms of hospital emergency department visits involving adolescents aged 12 to 17, on an average day marijuana is involved in 165 visits, alcohol is involved in 187 visits, and misuse of prescription or nonprescription pain relievers is implicated in 74 visits.

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Outdated practice of annual cervical-cancer screenings may cause more harm than good

July 9, 2013 — For decades, women between the ages of 21 and 69 were advised to get annual screening exams for cervical cancer. In 2009, however, accumulating scientific evidence led major guideline groups to agree on a new recommendation that women be screened less frequently: every three years rather than annually.Despite the revised guidelines, about half of the obstetrician-gynecologists surveyed in a recent study said they continue to provide annual exams — an outdated practice that may be more harmful than helpful, said Drs. Russell Harris and Stacey Sheridan of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.”Screening is not the unqualified good that we have advertised it to be,” they wrote in an editorial titled, “The Times They (May Be) A-Changin’: Too Much Screening is a Health Problem.” The editorial accompanied a research study reviewing physician practices around cervical-cancer screening and vaccination for human papilloma virus (HPV), which has been linked to cervical cancer.The study, “Physicians Slow to Implement HPV Vaccination and Cervical Screening Guidelines,” was published July 9 in the American Journal of Preventive Medicine.”Screening for cervical cancer and other cancers such as breast and prostate, has clear potential for harms as well as benefits, and these must be carefully weighed before a rational decision about screening can be made,” wrote Harris and Sheridan, who are professor and assistant professor of medicine, respectively, at UNC’s School of Medicine. They also hold adjunct appointments at UNC’s Gillings School of Global Public Health.The study noted physicians said they were comfortable with longer testing intervals, but were concerned their patients might not come in for annual check-ups if Pap tests, the screening test for cervical cancer, were not offered. The problem, Harris said, is that annual Pap tests produce more abnormal results leading to additional, invasive testing that itself bring risks.”Many women have ‘abnormal’ [Pap test] findings that are not cancer, but may be a ‘cancer precursor.’ We know that the great majority of these abnormal findings would never progress to actual invasive cancer, yet these women are referred” for further, more invasive testing, Harris said.One such test, called a “colposcopy,” [cohl-PAH-scoh-pee], involves examining the cervix for possibly cancerous lesions, followed frequently by a biopsy, i.e., taking a small sample of the lesion, which can cause pain and bleeding, as well as potential psychological harm. “The screening test itself can raise concern about dreaded cancer; a positive screening test heightens this worry; finding a cancer precursor, even one of uncertain importance, just increases worry further,” they wrote.The authors recognize the important benefit of screening for cervical and other cancers, but “screening every three years [for cervical cancer] retains about 95 percent of the benefit of annual screening, but reduces harms by roughly two-thirds.” Less-frequent screening also reduces costs significantly in terms of patient and physician time and laboratory testing supplies and other resources.The newest cervical-cancer and HPV screening recommendations were released in March 2012, too recent to have been included in the July 9 study. Women should still begin Pap tests at age 21 and every three years afterward, but women between the ages of 30 and 65 may choose to extend the Pap test interval to every five years, provided they also get an HPV test, according to the U.S. Preventive Services Task Force and the American Cancer Society, among others. However, the authors added, “the debate about a do-less approach to screening — for cervical cancer and other conditions as well — is ongoing.”The editorial concluded: “Bob Dylan sang about changing times before they actually changed, yet his singing moved the public discussion in a positive direction. …

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