Archive for the ‘emergency room’ Category

St. Patrick’s Day Celebration Can Be Too Costly

March 16, 2008

By John E. Carey
Peace and Freedom
Saint Patrick’s Day

When graded by your local police, Saint Patrick’s Day is a more troublesome day for alcohol abuse than even New Year’s Eve.  In fact, except for Super Bowl Sunday, St. Patrick’s Day is the number one “holiday” for arrests, citations and emergency room admissions. 
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All because we Americans sometimes think it is OK to drink and over-drink until we are drunk.  On these three holidays and others, including Independence Day on July 4th we act as if we had a license to drink – a mandate from God to allow drunkenness and bad behavior.

Saint Patrick

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA),alcohol abuse and its related problems cost society many billions of dollars each year.

Estimates of the economic costs of alcohol abuse attempt to assess in monetary terms the damage that results from the misuse of alcohol. These costs include expenditures on alcohol-related problems and opportunities that are lost because of alcohol.

This Alcohol Alert addresses issues pertaining to estimates of the costs of alcohol abuse, focusing on the types of costs considered and on the various problems associated with their estimation.

While many difficulties in cost estimation are common to cost-of-illness studies in other health fields, two problems are particularly relevant to the case of alcohol abuse. First, researchers attempt to identify costs that are caused by, and not merely associated with, alcohol abuse, yet it is often hard to establish causation. Second, many costs resulting from alcohol abuse cannot be measured directly. This is especially true of costs that involve placing a dollar value on lost productivity. Researchers use mathematical and statistical methods to estimate such costs, yet recognize that this is imprecise. Moreover, costs of pain and suffering of both people who abuse alcohol and people affected by them cannot be estimated in any reliable way, and are therefore not considered in most cost studies.

These difficulties underscore the fact that although the economic cost of alcohol abuse can be estimated, it cannot be measured precisely. Nevertheless, estimates of the cost give us an idea of the dimensions of the problem, and the breakdown of costs suggests to us which categories are most costly. In the most recent cost study, Rice and co-workers estimated that the cost to society of alcohol abuse was $70.3 billion in 1985; a previous study by Harwood and colleagues estimated that the cost for 1980 was $89 billion.

By adjusting cost estimates for the effects of inflation and the growth of the population over time, Rice projected that the total cost of alcohol abuse in 1988 was $85.9 billion, and Harwood projected that the cost in 1983 was $116 billion.

Some clinicians, working closely with economy analysts, today estimate the total cost of alcohol abuse in America as in excess of $300 billion annually.

Although these figures are staggering, they have little deterrent impact on a drinker headed out for a night on the town.

So let’s just bottom line this beast alcohol right now.Attend any Alcoholics Anonymous (AA) meeting and you are likely to hear a story of how alcohol lead someone to total professional and personal ruin.  Many successful men and women succumb to the disease of alcoholism.  They can tell stories about losing their spouse, kids, job, fortune, house (or houses) and car (or cars). 

I personally know people who, after being highly successful and relatively wealthy, ended up living in shopping carts.  I even have a friend that was thrown out of a bridge overpass and his “home” in a cardboard box.  It seems his excessive drinking was too much for his wino “roommates – who asked him to leave.

And every reader (just about) who has made it this far will say: “I am not an alcoholic.  I just drink.”

Everyone says this at first.  AA calls it “denial.”  Honest self assessment and a desire to be sober are essential to AA – and are in fact the only entry ticket you need to go to any AA meeting.

Related:
Why Americans love the Irish (St. Patrick’s Day in Monday)

Our Medical System Often Fails Lost Souls

January 5, 2008

 By Colbert I. King
The Washington Post
January 5, 2008; Page A17

Excerpts from the transcript of a videotaped deposition of a former Howard University Hospital emergency room physician, conducted Aug. 3, 2007:

Physician: “When I came upon him, I asked what was wrong with the patient to a nearby nurse, and where is the chart, and looked at the chart rack. The nurse had not seen a chart and there was no chart on the chart rack.”

Question: What did she say to you at that point?

He is just an alcoholic, and I don’t know where the chart is or something close to that, but I remember her telling me that he was an alcoholic.

Tell me about the conversation you had with this nurse about the [Emergency Medical Services] stretcher?

I just asked why was the patient there on that stretcher in the hallway and not-[sic] entered into a dialogue about him having vomit on his clothing.What did you say about the vomit on his clothing?

It is hard for me to recall specifically what I said. I just remember the general conversation, that this patient should not be on that stretcher, and cleaned up, if indeed he is an alcoholic, you know.

Do you remember anything that the nurse said back to you about either the stretcher or the vomit?

Specifics, no, but she basically did not want to help to transfer the patient because she was busy doing other things. You know, they were short staffed.

Do you remember anything she said that gave you that impression?
She said she wasn’t able to transfer him right now, that he was just an alcoholic.

Tomorrow is the second anniversary of an event that some folks in the District would just as soon let pass without notice. It’s not gonna happen.On the evening of Jan. 6, 2006, a man was brutally attacked and robbed in a Northwest neighborhood. He died two days later from a massive head injury. Between his savage beating and the moment of his death, that critically injured man was subjected to government incompetence and medical malpractice of the first order. District police and fire and emergency medical services workers as well as Howard University Hospital staff members cavalierly dismissed him as a drunken “John Doe.”

His name was David E. Rosenbaum. He was a reporter for the New York Times. But his job was not the reason he became the subject of several columns I wrote over the past two years.

The columns attacked the veil of secrecy that was initially draped over John Doe’s death, the lies woven to protect the negligent and the indifferent, the rotten work ethic that runs rampant in our city, and inept government oversight by District leaders.

Today, the Fire and Emergency Medical Services Department is led by a new chief, Dennis Rubin. Pushed by Rosenbaum’s survivors, the city claims to have made changes in the department. Firefighters and EMS workers are to be cross-trained. Teamwork and professionalism are the department’s new watchwords.

The deposition cited above, which was not received from David Rosenbaum’s adult children or their lawyer, was taken in connection with a lawsuit the Rosenbaum family filed against Howard University Hospital. The hospital recently settled with Rosenbaum’s adult children.

That takes the slain journalist out of the news.

But it doesn’t eliminate the conditions that threaten the quality of life of all who live in this city: criminals roaming the streets in search of human prey; an apathetic and complacent government workforce; nonproducers ensconced in high places; and elected leaders who fall for snow jobs.

Would that Fire and Emergency Medical Services was the only D.C. agency in need of a makeover. The list is long, with some departments, such as Youth and Rehabilitation Services, operating as fiefdoms.

At the heart of the problem is a government that has outgrown — and outfoxed — the leaders elected to oversee it, namely the 13-member D.C. Council.
This isn’t a knock against the ability of council members, although some are more able than others.

Truth is, the council is confronted with a nearly $10 billion government enterprise run by 32,000 career workers who constitute a $2 billion payroll. Without a powerful investigative arm of its own, the council is like a pussycat pitted against a python.It’s a sad day when the council must turn to outsiders to investigate a scandal in the D.C. tax office.

To meet its responsibilities under the Home Rule Act and to improve the accountability of city government, the council should have at its disposal the equivalent of Congress’s independent, nonpartisan Government Accountability Office. The D.C. auditor’s office is too small and limited in scope. The D.C. inspector general is administratively within the mayor’s office, operates with a budget beyond the council’s reach and basically sets its own agenda.

The council needs its own watchdog agency staffed with accountants, lawyers, policy analysts and program specialists to support aggressive legislative oversight.

Otherwise, prepare for more hand-wringing over government foul-ups as city bureaucrats continue doing whatever they please.

kingc@washpost.com