Tragic Story about ER treatment of AF

William Faloon, of Life Extension Magazine, offered in September a report titled A Deadly Waiting Game about a woman with rapid atrial fibrillation who went to the ER but treatment was delayed treatment due to over-crowding. She suffered a massage stroke as a result from the untreated rapid heart rate. [www.lef.org]

He also reports on his own hospital experiences during a 31-hour stay that is very revealing.
[www.lifeextensionretail.com]

I guess that I am most fortunate to have been seen and attended to within 10 to 15 minutes of my going to ER on the 6 trips that I have made.in the past.
The Triage System takes anyone complaining of heart problems very quickly.
Having had a successful PVA in 2011 I hope those days are over for good.

Ok, now I'm officially depressed.

Keep your head up, Nancy- I sent you a PM.

EB

Thanks for posting. Very sad. Triage in UK hospitals normally does assess anyone with even mild heart symptoms within 10 minutes, though admittedly at the weekend amiodorone-based cardioversion appears to the treatment offered rather than ECV. ECV requires more doctors since propofol is used and this requires monitoring.

This is a terrible story. I wonder if there are other factors at work. Such as whether the woman and her relatives were not assertive enough in getting attention (could be because it is a custom in Asian cultures not to stir things up and just grin and bear it), or whether ER dept is overburdened.

<deleted> I referred to UCSF ER dept incorrectly. From Jackie's post, this happened elsewhere at a highly regarded west coast academic hospital.



Edited 1 time(s). Last edit at 11/22/2012 11:14AM by researcher.

The original article referenced that prompted the LEF commentary is by her son, physician John Maa, MD, Assistant Professor of Surgery at the University of California, San Francisco included this observation:

" Perhaps the various delays in this woman's care played no role in her death. After all, she was 69 years old and had chronic heart disease. But earlier initiation and closer monitoring of her anticoagulant treatment might have prevented the development of the thrombus that subsequently broke loose. Since it's difficult for professionals working in a crowded ED to precisely monitor intravenous infusions for long periods, undesirable compromises are often made in the quality of care delivered. Had cardioversion been performed shortly after the patient entered the ED, she might be alive and healthy today. We'll never know for sure. Only one thing is certain: an intelligent woman who loved her husband and son is dead. She was my mother.

Ironically, I am an academic surgeon and founder of a surgical training program dedicated to improving the availability and quality of emergency surgical care. But because I practice in a different city, I was unable to persuade the staff of my mother's hospital to expedite her care. Many Americans cling to the notion that the shortcomings that afflict our health care system affect only the poor. They are mistaken.

The cardiologist who postponed my mother's care never returned. One of the only doctors who acknowledged our loss was the ICU intern, who offered me his condolences in the hallway the following day. But when he learned that my father and I wanted to finalize my mother's funeral plans before withdrawing life support, he told us, in a frustrated tone, that her condition made further treatment futile and her ICU bed was needed for other patients. He added that it was very selfish of us not to immediately withdraw life support. His words stung, but they were true. I have since wondered how many additional patients spent unnecessary hours in the ED because my mother was occupying an ICU bed. "

More:
[www.nejm.org]