Death Attacks

Yesterday the stories(1)(2)(3) were on race and aftercare cardiac survival rates and how Blacks do worse than Whites according to the most recent research published in the Journal of American Medical Association (JAMA). HealthDay included a link to the American Heart Association on cardiac arrest which includes the information that: "No statistics are available for the exact number of cardiac arrests that occur each year. It's estimated that more than 95 percent of cardiac arrest victims die before reaching the hospital. In cities where defibrillation is provided within 5 to 7 minutes, the survival rate from sudden cardiac arrest is as high as 30–45 percent."

Twelve (12) percent of five (5) percent doesn't seem significantly important except if you beat the odds and make it to the hospital you're a part of the five (5) percent. However it ain't over and surviving to receive care isn't the end whether you're Black or White. You're still likely to perish as a result of what ever created your cardiac condition. The difference isn't in your color but in what hospital you select - which for many is a matter of your skin color.

"Racial Differences in Survival After In-Hospital Cardiac Arrest" When the article refers to the National Registry of CardioPulmonary Resuscitation (NRCR) for their research using hospitals affiliated with the registry we immediately sought to get a local lists. Unfortunately such a list isn't available from their website but what is listed is their original research on Cardiac arrest in the Emergency Department: A report from the National Registry of Cardiopulmonary Resuscitation which refers to a link to a second (PDF) two (2) page report also links to a third report which concludes: "What does this mean to your facility? Patients who suffer a cardiac arrest in the ED are a unique population having better survival to discharge compared to patients arresting in other hospital locations. As ED location was an independent positive predictor of survival, further analysis of process variable such as personnel, training, and frequency of practice may identify opportunities for improvement."

The linked research concludes: "ED CAs have unique characteristics, and better survival and neurologic outcomes compared to other hospital locations. Primary ED CAs have a better chance of survival to discharge than recurrent events. Traumatic ED CAs have worse outcomes than non-traumatic CA."

We included the video reports here for your own edification. Most edifying are the additional comments by Dr. Chan on the issue of race abd treatment excluded from the main report but a part of the official "B" roll. The comments follow one after the other.

Medical Oops

The health care debate continues to demand our attention as town halls become shouting matches and a new report released by the Hearts Newspapers have highlighted our concerns on the number of deaths as a result of medical mistakes. The report named the states where the reporting is open and the information available to the public and the standard "and the District of Columbia" tag was added. When he tried to investigate the information we found it ONLY available from the "Dead By Mistake" website. While the info is collected by DC it isn't collected or distributed by either DC, MD or VA - what it can cost us is our lives.

How do we survive IF we survive the emergency
room and our stay in the hospital? CBS news recommends: looking your doctor in the eye before surgery, writing on your body what should be done where it should be done and writing on your body what shouldn't be done, asking about what medications are being given to you and why. Who knew that Bill Cosby in the 60s and Malcolm in the Middle in the 90s would have the best solution to survive medical oops.

Great suggestions right? Not if you're unconscious or unable to verbally assist in your own recovery. Wouldn't it be better to have the procedure - whatever the procedure as an outpatient rather than in patient hospital care. The price would certainly be less than a day in a hospital bed which would reduce the costs of health care and give us better care. While hospitals would not report their complications the idea of reporting another facilities fatality might be possible.

What we need is a study on outpatient to inpatient survival rates. Lost in the health care debate is the patient and while patients death rates creep up at a one (1) percent increase per year. While it is only 1% it is still an increase and we can be the one. So we will contact the hospitals and evaluate and report which hospitals are opposed and why. What we find could save your life so continue to watch this space.