I've been doing a little research about a few things to assist myself in understanding the problems associated with a Spring Hill Hospital not having an extensive Cath Lab. If Chandler or any of the paramedics would like to respond to this question, I would love to have your input (but please, no cutting and pasting of 40 or 50 articles this time).
It seems to me that in by placing a 64 slice VCT in this hospital, not only would the Spring Hill Hospital have better technology than currently at Williamson Medical or Maury Regional, but it would do a great deal in regard to limiting the need for an extensive Cath Lab? In fact, my research shows that the new technology available in this particular piece of equipment will go a long way towards making a Cath Lab virtually obsolete, at least in terms of assisting in diagnosis. Am I wrong in this assumption?
According to the CON, here is a sneak peek at the equipment that will be placed in our new hospital.
Here is a link to the equipment that is proposed in the CON
Here is a pretty good source for information on the process associated with going into a Cath Lab.
Basic Cath Lab information
Now, tell us again why adding this technology to our city on top of a 24 hour Emergency Room would be a bad thing for our city?
Sunday, June 11, 2006
Cath Lab v. 64 slice VCT
Posted by Gorilla in the Corner at 9:14 PM
Labels: Spring Hill Hospital
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IMPORTANT DISCLAIMER: The information on this website is a series of personal opinions and is not meant to reflect an official position by the City of Spring Hill.
35 comments:
VCT= Diagnose
Cath= Diagnose and treat
One link; choose your article(s):
http://www.ptca.org/ptca_ami.html
I do not claim to be an expert on hospitals. I have posted here before and have said my experience is prehospital care. My time in the fire service has taught me that just having the tools to diagnose a problem is not enough. No matter how high tech the tools are if you can not fix the problem you are only half way home. This is such a major issue and most of the public does not have the knowledge to know all of the factors involved.
Many people do not understand that emergency care is a system. It starts with the 911 dispatchers, then goes to the first responders (the fire dept), then the ems unit, to the hospital. If any part of the system breaks down then the system does not work. This has been my argument against the poor idea of a private ambulance service. I have read the comments about driving times to wmc and maury regional. It does not matter if you have a hospital in spring hill, if you have a medical emergency and drive to the er on your own you take your life in your own hands. Having a 24 hour er in spring hill does not mean that all emergencies will go there. The golden hour theory for trauma does not mean the time when ems gets there until you get to the nearest er. The golden hour is from the time of injury until you reach an or for definitive care. The only place in middle tn. that you can do that is the level 1 trauma center(vandy). The burn unit is at vandy, and so is the peds hospital. All that means critical trauma, peds and burn patients are going to vandy either by ground or by air with life flight. Those types of patients do not stop at wmc or maury now before going to vandy and they will not be going to a hospital in spring hill.
I am not for or against a hospital in spring hill. I want the best care for my family just as i suspect my neighbors do. I just want people to get educated and think about this. Having a hospital close could be a good option but it is not the be all end all of care that some believe it will be. And my personal cause, people need to stop our elected officials from selling our ems care to the lowest bidder!!!
Here is the deal. You can scan somebody all day long. That does NOT open up an artery. When you are having a heart attack you have to open the artery to stop the heart attack. There are two types of heart caths. One that is diagnostic, which means we inject dye into the artery and see where the narrowings are, and there is an interventional cath which is where we OPEN a closed artery. Many people feel that the 64 slice scanner will replace the DIAGNOSTIC cath. This is untrue as there are many issues with the 64 slice scanner (it is not effective with calcified arteries, you have to have the person's heart rate below or around 60 beats per minute, it is A LOT of radiation, etc) so it is not established that it is superior to a heart cath. If anything it is a SCREENING tool to see who needs a cath. In the case of a heart attack, you would go to the cath lab, end of story.
Think about it like this. You have flank pain. You go to the ER. The MD states that you need a CT scan to see what is causing your pain. You get a CT that shows a kidney stone. Does the CT take the kidney stone out, NO, it just tells you that it is there.
You have a heart attack, why perform a test that tells you that you have narrowings, you already know that from the EKG and/or Troponin. The 64 slice scanner has NO PLACE in the treatment of a heart attack. It is a diagnostic tool. You cannot put a stent in with a CT scanner.
Think :CT scanner : diagnostic for identifying narrowings that have not caused a heart attack
Cath Lab: opens a narrowing to establish blood flow
One other thing. The 64 slice scanner is a quick test for the patient. 15 minutes or so. However it takes about 45 minutes to reconstruct the images (this means construct a 3 D picture out of them) and almost an hour for someone to read the films.
If you are having a heart attack you have 90 minutes to open the artery. If the CT scan takes two hours to give you an answer, you have lost a lot of tissue.
Standard of care is the issue.
MRH and WMC both have emergent angioplasty. If they did not provide this, the issue would be void.
The disgruntled, know it all, ex-employee (with an ax to grind)of HCA, now employed by Williamson Medical Center is back. It's a shame he is the best voice Williamson Medical Center can put forward. I'm certain many of the WMC employee's are ashamed and embarassed.
Gorilla, he must like your informative and fact based forum. There are sites with class and sites without class.
Keep up the good work.
64 slice CT; Heart View: had one done myself a couple of years ago. GREAT technology...for diagnostics. It is absolutely inappropriate for use on folks with a history of a cardiac conditions though, just ask your cardiologist. If you are having a heart attack you need a heart cath and an intervention fairly immediately. Anonymous should get a Name.
I'll remain anonymous. Let's look at your track record on attacking those who have voiced their support of the hospital.
Supports the Hospital:
David Huebner-attacked by you
Michael Glass-attacked by you
Board of Alderman-attacked by you
Spring Hill citizens-attacked by you
Alderman Duda-attacked by you
Peter Jenkins-attacked by you
Mayor Leverette-attacked by you
HCA-attacked by you
Dick Cole-attacked by you
In other words anyone who disagrees with you is subject to being attacked with false accusations and misleading/false information.
Opposes the hospital:
MRH-praises by you
WMC-praises by you (your employer)
Maury County Comm.-praises by you
Williamson County Comm.-praises by you
In other words, if in agreement with your know it all attitude, you praise. Slander, bashing, attacking, etc. whats those whom disagree.
You motives are clear.
Michael,
Please inform the last post that I (the disgruntled, blah, blah, blah) did not post the mother gorilla comment. I did post the response to the CT question you invited me to answer. Furthermore, please share with them my website as clearly they have not visited it. I state clearly on my site that you are a good guy, and that Duda should replace Leverette if this impeachment move continues to grow as it has in the last 24hours. By the way, I do not represent WMC. However many fellow employees were quite glad that someone finally stood up against this train of though displayed by the two interviewees last night. "What could ever be wrong with a hospital." Keep hiding behind your veil. You can take it off toward the end of July when the board votes No, and trust me (as good ole Danny would say) they will vote No.
Speaking of false information, do you think this hospital will truly be free? Do you think the ambulances will stay after HCA does not get the CON? Also to the mother with the letter to the editor this AM, if your child has a kidney problem, are you sure you want to take them to an HCA facility? Seems like they have trouble determining which kidney is which here lately. Plus this new hospital will not be able to take care of a child with a chronic kidney condition. The two we have now cannot. This child goes to Vandy regardless of whether there are two or 102 hospitals here. Come on gimme a break.
Anonymous @ 12:13:
"Do you think the ambulances will stay after HCA does not get the CON?"
Read Paragraph 1 of the signed TriStar letter of intent to provide Ambulances Service to Spring Hill. The agreement is independent of the CON Request.
By the way, TriStar also closes on the land BEFORE the CON hearing as well...
Wachya think of them apples?
Anon @ 12:13
Is there something that I am missing? Does it hurt you to have a choice in hospitals?
This is the United States and you will still have a choice in hospitals once 2009 or 2010 gets here. If it pains you that Spring Hill will have a hospital, I can send you over a map to allow you to navigate yourself to WMC, Vandy, or MRH. I will do that for you for free.
And yes, the ambulance service will be in place with or without a hospital. Maybe you should read that proposal again for good measure.
lets hope no matter what happens with the hospital that we do not get hca's version of ems. Especially if we do not get the hopital. That is not a nice thought, second rate patient care during the ride to franklin.
You all are the most trusting group of people I have ever encountered. Do you think that Tristar, a for profit company, is going to let an ambulance sit in a city that only gives them one call a day? NO. They will be running convelescent calls just as the Neopolis ambulance does. So you will be in the same situation as you are now. Also here's another thought. The Spring Hill fire department provides a lot of care before the ambulance arrives. They do so under the protocols of the MRH and WMC medical director. Guess what, this hospital willnot be built in time for this ambulance service to have an agreement with the Fire Department, so you will lose the care provided to you now by the Fire Department.
to anon 20:01
Amen Preach on!!! another voice of reason. It was no fun being one of the few speaking out against this idea.
You are among the few people who do not blindly accept everything they here. I bet these same folks panicked over the Y2K bug. Oh no I heard it so it must be true!!!
They are getting scared and rightfully so. In the upcoming weeks we will see an escalation of their scare/smear tactics. Everyone hold on with anticipation, there is no telling what they will pull from their bag of tricks!
We all look forward to the grand opening of the new Spring Hill Hospital. HCA is going to have a present in Spring Hill and we will continue to build upon that base.
anon. @ 21:54
Amen
You are soooooo right. Attack and lash out is what a dog does when it is backed into a corner.
to anon 21:32
So how do we get others to open their eyes and get educated? How do you show people the importance of a real ems service not the lowest bidder?
Maybe the Easter Bunny and Santa Claus can cut the ribbon. If you guys spent as much time actually reading a textbook on healthcare and actually spending time in practice, you would have a different view. It is good to have goals, too bad yours of getting this hospital will not happen. This is the most highly contested CON in many years. I challenge you to provide one truthful example of a patient who died because there was no Spring Hill hospital. I know this will be hard, but truthful will be the key word.
First, you have to open your eyes and be objective. Second, remove your personel agenda and look at the whole picture.
How many patients have died at either Williamson Medical or Maury Regional. What's your point? At least they can die in Spring Hill and not at WMC or MRH.
You cannot educate these people. They are convinced that google.com is the gateway to knowledge. It does not matter that we have been in practice for years. We are opposed to this bad decision, and they have extrapolated that out to mean that we are opposed to Spring Hill. This has become a part of who they are now. If we state that they do not need this ambulance service or that they do not need THIS hospital, then rather than looking at the facts they provide us with stories of how they feel that they deserve a hospital and then they try to label you disgruntled or something else. Anything to keep them from doing a little research beyond google.com. Michael Glass innocently displayed their knowledge base at the county commission when he suggested that a noninvasive diagnostic tool, the 64 slice CT scanner would replace an emergent cath. Somehow magically the stent would just appear. I have come to a conclusion, we know the real issues here because we have degrees in healthcare at the associates, bachelor, or master's level. I have completed many years of school to earn a master's and my certification. We cannot expect to be able to educate these people in a three or four month period, especially when their fears have been utilized to garner support for this hospital. It will take something dramatic to convince them. This will come when the hearing is complete. You and I both know that this issue is bigger than Spring Hill. HCA is using Spring Hill as a pawn. This battle is HCA versus the other Middle TN providers. One one side you have the HCA empire and on the other side you have a Catholic St. Thomas, a Baptist hospital, a world renowned Vandy, a non profit Williamson, and a non profit MRH. I can tell you that I have never heard of Vandy losing in front of the board. While HCA carries a lot of power, Vandy carries more. You cannot educate these folks. They are tainted with the idea that if they get this hospital their city will be legit. We cannot devalue ourselves by expecting people to have our understanding with no formal medical education. This has been hard for me to accept, but it is the truth. They have made this a personal affront, as if we are saying they are not good enough or not smart enough. However if we tried to do their jobs and debate an area of their expertise, they would be just as frustrated.
anon. @ 22:15
You are going to be very surprised to find out the number of medical professionals who support our Spring Hill Hospital. I guess they are not as informed and educated as those who oppose it, huh?
anon. @ 22:27
By the way, those healthcare professionals whom support the Spring Hill Hospital also have an associates, bachelor, or master's degree.
No, the personal affront was made by governmental bodies (meddling in our affairs), and individuals (whom claim to know it all). The HSDA will make a decision based on facts and that is all we ALL should ask for.
anon 22:31
I have no dought there are many educated people in support of the hospital. I would challenge you to find many emts or medics that work in emergency care that support the idea of a private ems service in spring hill. I certainly am not one.
anon. @ 22:27
Curious, did Vandy oppose the CON for Stonecrest in Smyrna? If not, then way are they opposing the CON for the Spring Hill Hospital?
anon 22:42
It is true that someone else will make the decision about the hospital. What worries me is that the boma will make the decision about the ambulance service. I do not believe that i have ever seen any of them on a fire engine or ambulance. I do not claim to know it all but i do have 15 years of fire and ems work so i think that on this subject i know more than most.
Thankfully the decision will be made based on FACTS. Vandy did not oppose those hospitals because they are actually FULL SERVICE and not just claiming that. I am sure other professionals in support of the hospital are educated. However they would also warn you of the dangers of claiming this hospital is full service. As well their contracts with HCA maybe on the line if they do not express support. Furthermore, they are probably placed in a very tough situation when HCA strongly suggests that they write a letter.
Yes, you are the expert. But Danny and the good ole boys apparently know more than you. The one on that BOMA that thinks for himself, that I have encountered, is Duda. He practices the novel idea of researching the issue.
to anon 22:16
What is my personel agenda and what is the whole picture?
The last I heard Duda supports and is working hard for the Spring Hill Hospital. Apparantly, his research paid off. Lets analyze, Duda does research and supports the hopital but Danny and the good ole boys don't do their research but also support the hospital. Go figure.
I also talked to Duda at the county commission meeting about the ambulances. He stated that the ambulance service they arelooking at works in Tulane. He stated they can easily handle Spring Hill if they can handle Tulane. The problem is that they are the only game in Tulane. We have MRH and WMC that will pay better than the private service, so our skilled EMS workers already work for them and will not jump ship. You will get the EMS folks who are either inexperienced or burned out working for this service. Duda actually understood this because his decisions are not based on how to make up for the loss of revenue due to the alleviation of city taxes. Anon can you do more than one thing at once? I am just asking because you assume linear relationships that are no present. This usually represents a very odd thought process.
So we are to have a service that does not operate in this state that will be staffed by people that could not get hired by the emergency services that are here now. Is anyone else uncomfortible with that?
They actually do operate in the state in some places but all they do is convelescent care. NO emergency care.You will have to wait on their response, they have to check with the mayor to see what they should think.
anon 23:58
Who is it?
What was the topic again.. oh yea something that had nothing to do with what you are talking about. Strong work.
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