Veterans Die While Waiting . . .

Honestly, I wish this was fiction. As a nurse– I wanted to call attention to this.

Imagine . . . you have served your country faithfully and just need to see a doctor. The VA system requires patients be seen in a timely manner of 14-30 days. Evidently in Phoenix, there was a system in place to hide the fact that 1,500 veterans were waiting months to see a physician and according to this CNN piece— 40 died while waiting.

There were two lists. One that was shown to auditors to prove that they were meeting this appointment criteria. What was really occurring is that a veteran would make a request and would be electronically placed on a “secret list”. When their appt came up under the 14 day mark, it would be registered, when if fact they were waiting several months to be seen.

With the government assuming more control over healthcare I fear more and more of these stories are going to come to pass.  Doctors are leaving traditional practices and opening up concierge services. My own primary care physician did this. We chose not to pay him out of pocket for “access” on top of our normal insurance rates. We had to find a new physician.

The government is also becoming the largest payer to hospitals through Medicaid, Medicare and now the ACA. When you have one primary customer– that customer will dictate how your hospital runs. Right now, hospitals are cutting back staff, staff incentives and such because they are worried about reimbursement from government agencies. My own hospital has done these things.

What about you? How do you feel about the current state of our healthcare system? What changes have you seen take place that you like or don’t like?

You can check out lengthy pieces on this subject here and here.

New Medical Device: X-STAT

As a medical nerd, I’m always a little fascinated by new medical devices and what they can do. I was alerted to this device by Mike H. via Facebook (Thanks, Mike!) and found it worthy to post upon to keep all your medical treatment scenes in those novels up to date.

The Blaze

It is true that not all bleeding can be controlled by direct pressure. It is also true that bleeding is the leading cause of death when it comes to bullet wounds (unless you have suffered a direct hit to either your heart, brain, and/or spinal cord which is likely the end of your life here on earth.) Uncontrolled bleeding from limbs is one thing that harkened back the use of the tourniquet. First by the military and now by civilian EMS agencies. They found the concern over tissue damage didn’t pan out in the research.

For those other folks who get shot in the chest and/or abdomen, it’s always a race to the hospital where definitive control of bleeding can happen– which usually necessitates a trip to the OR– which takes time. You may have heard the term “Golden Hour” which is generally the preferred window to get the patient to definitive treatment before they die.

Rapid control of bleeding could actually extend this hour in my opinion.

Enter the X-STAT.  For lack of a better term, the X-STAT is a tampon shaped (sorry, guys) device that is filled with dime-sized medical grade sponges that are coated with a hemostatic (stops bleeding) agent. It is inserted into the wound and the plunger places these sponges deep into the wound where they expand (like the firework snakes) and stem bleeding without direct pressure. The expansion of the sponges prevents them from being forced out of the wound.


Thus far it seems to be listed as an investigational device and its use is limited but if it does what it says it does I think this could mean a big difference for trauma patients.

You can read more about the X-STAT here

What do you think of the X-STAT? Would you use it in a novel? You can bet I’ll find a way to.

Combat Medicine in Today’s Army

I’m so pleased to have Nelda Copas return for a look inside military medical operations.

Welcome back, Nelda!

From surgical care to physical therapy to blood supplies, the military medical system is moving its assets closer to the front lines to be more responsive to patient needs and, when possible, to return wounded troops to duty faster.

At the same time, the military is boosting know-how about treating combat casualties so everyone on the battlefield, regardless of job specialty, knows the most basic steps to take to help save a life.

Operations in Iraq and Afghanistan represent the first time these concepts, which the Army started introducing about eight years ago, are being applied in combat. A commander of the U.S. Army Medical Department Center and School at Fort Sam Houston, TX, said the trend reflects research about injuries, particularly trauma injuries. “What we have found is that the sooner you get to people after they have been wounded, the better your chances of saving them,” he said.
That’s particularly true of injuries involving extensive blood loss, because that’s what kills people on the battlefield if they don’t die instantly. So the sooner we can get the medical people to them, the better the outcome. Recognizing the importance of quick care for wounded troops, the Army started beefing up its training programs — introducing a three-day combat lifesaver course taught to all soldiers in their units and creating a whole new job description for combat medics, who receive their training at Fort Sam Houston.
In addition, the Defense Medical Readiness Training Institute here prepares doctors, nurses, physician assistants and other medical service corps professionals from all military services for the rigors of combat and the challenges of providing patient care on the front lines. Even more important as increasing expertise about combat lifesaving is, getting it as close as possible to the patient.
In response, each Army company typically includes four to five combat medics, who operate “right there where the action is happening.” In addition, forward surgical teams, 20-person units that include three surgeons and an orthopedic surgeon are being assigned at the battalion or brigade level. These teams move alongside the combat forces during the early, “maneuver” phase of operations in Afghanistan, cutting medical evacuations, when necessary, to less than 20 minutes.
These teams offer not just trauma care, but also a full spectrum of services ranging from physical therapy to preventive medicine. So not only can we treat them far forward, we can prevent them from getting sick and needing to get evacuated.
Nelda Copas graduated with a BS in Psychology/Criminology and a Master’s degree in Mental Health Counseling both from Western Kentucky University. She has worked extensively with law enforcement and is frequently a workshop presenter on the topic of Serial Killers. Nelda retired from the United States Army, where she worked as a nurse and combat medic. Twisted Desires was her debut novel, which was followed by it’s sequel Twisted Revenge. She lives with her husband near Fort Knox, Kentucky. Nelda is currently working on the third installment of the Detective Delsey MacKay series, a true crime novel, and a young adult zombie apocalypse novel.