Brain aneurysms are more likely to rupture if they are growing even if they are small, a new study in Radiology reports. Aneurysms of 7 mm or more are the size where the benefits of treatment generally outweigh the risks of rupture, based on earlier studies. This had been interpreted that size alone is determinative of rupture risk. But ones that grow in size over time are at even greater risk for rupture, regardless of size. This means that all aneurysms of any size need to be followed. If they are growing, then treatment needs to be considered. Monitoring can be done by annual CT examination which is readily available and not cost prohibitive.
Emergency care with EpiPen for severe allergic and asthmatic reactions is life saving, but many patients who carry them for emergency use forget how to use them after 3 months. Medscape reports on a study reporting at the American College of Allergy, Asthma & Immunology that most patients thought they knew how to use the EpiPen, but none of them knew of the need to rub the site after injection to cause absorption of the medication. Some even had a problem figuring out which side of the pen to use - and that was when not even experiencing an emergency. Continued education is necessary for people to use the device properly. Every day 9 people die from asthma attacks.
Emergency care leading to hospital readmission rates within 30 days of a prior discharge will be penalized by Medicare and Medicaid in the form of reduced payments. The costs associated such readmission penalties will likely run into the millions of dollars. Two thirds of U.S. hospitals (2,211hospitals) will be penalized starting in 2013. Two hundred seventy eight (278) facilities have already been told that they will receive the maximum penalty of a 1% reduction in payments, which means millions less in payment to penalized hospitals. For example in Tennessee, Vanderbilt University Medical Center expects to be penalized between $500,000 and $1,000,000 a year, and Saint Thomas Health Hospital expects to lose about $1.2 million dollars a year in payments. Because every dollar lost hurts hospital operations, there will be increased pressure on Emergency Room physicians to not readmit recently discharged patients who need care.