Health Care Reform Updated Daily (well almost daily)

Calling all anesthesia providers...It's crunch time people! As I write, behind closed doors lies the future of anesthesia practice as we know it...ok a bit dramatic but you get the point. It appears that the pendulum has indeed swung in favor of the public option tied to Medicare rates. The nightmare is real ladies and gents. In case you don't already know Medicare rates as they apply to anesthesia are just plain criminal. Reimbursement stands to fall 60% or more. While I enjoy the passage of gassage and feel I really use my expertise in a positive way for my patients, I just can't do it for nothing. Neither should you.

The ASA has sent an action alert detailing a proposed amendment to exempt anesthesia from the public option/Medicare rates fiasco here. It's do or die time peoples so get on the horn. Check out the ASA alert and call today.

Stethoscope? Check. Laryngoscope? Check. Ultrasound?...Check?

Yes the above may be closer than you think.  Moore's law states that gadgets get smaller over time (or something to that effect).  How is this relevant to anesthesia you ask?  Well, millions of ways but one I am excited about is the shrinkage of the ultrasound probe.

GE has managed to shrink the technology down the the size of a Motorola Star Tac.  Ok a Star Tac with a HUGE battery...but still its smaller than anything available.

GE has announce the "Vscan":

GE’s drive to miniaturize technologies in order to make them more mobile couldn’t be better illustrated than with the breakthrough Vscan technology that GE’s Chairman and CEO Jeff Immelt unveiled during his talk tonight at the Web 2.0 Summit in San Francisco. Roughly the size of a smart phone, it houses powerful ultrasound technology that can potentially redefine the way doctors examine patients. By giving doctors a view into the body from the palm of a hand, GE believes that Vscan could one day become as indispensable as the traditional physician’s stethoscope in patient exams.

Not sure about you but I would love to add this to my anesthesia workstation.  No word on price.

The public option and anesthesia.

The public option has been one of the most contentious issues regarding the health care debate. The results of the The Anesthesia Blog poll indicate a willing acceptance of it into our health care system just as long as the rates aren't tied to the pitifully low Medicare rates.

Medicare rates in what may be the predominate payer over the next few years means the end of days for anesthesia. See ASA president Roger Moore's farewell letter in which he summarizes the salient points here.

The next logical question is then, why are the Medicare rates for anesthesia so friggin bad, and why haven't we been able to do anything about it? Get involved fellow anesthesia peoples! ASA-PAC.

Journal Watch: Epinephrine Impairs Lipid Rescue for Local Anesthetic Toxicity

Local anesthetic toxicity is a situation one hopes to never be involved with, especially bupivicaine-induced toxicity. Fortunately the use of intralipid as an antidote has spread far and wide and is now (hoepfully) in every location where you provide anesthesia services.

In a study published in the September issue of Anesthesiology a rodent model using an escalating dose of epinephrine past 10 mcg/kg was shown to increase mortality. Something to keep in mind. Again not sure how this will translate to an emergency situation but something to be aware of nonetheless.

Lipid rescue is something that needs more publicity in my opinion. Cases like this one in Florida can and should be avoided at all costs.