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Straight ahead on "Our World" ... emergency medicine at the breaking point ... a new treatment for a deadly childhood illness ... and legends of civil engineering.
WEINGARDT: "He said he got his idea for its unique structural framework from studying his wife's wire bird cage, which she carried around the house from place to place. Kinda strange where engineers get their inspiration, isn't it?"
Those stories, bringing oysters back to waters off New York, and more. I'm Art Chimes. Welcome to VOA's science and technology magazine, "Our World."
The U.S. emergency medical system is stretched to the breaking point, according to a report released Wednesday by the Institute of Medicine, the independent agency that advises the U.S. government on health policy.
The Institute's three-volume report ? more than two years in the making ? found serious flaws throughout the system that is the frontline treatment for victims of heart attack, stroke, and accidents.
At a press conference on Wednesday, the chairman of the committee that prepared the report, retired hospital administrator Gail Warden, noted that there ARE centers of excellence around the country.
WARDEN: "But yet at the same time, in most communities there is a crisis under the surface. We have overcrowded emergency departments in hospitals with long waits. We have ambulance diversions because the emergency room is overcrowded and is not able to handle the volume [of new cases] that is coming to it. We have a lack of specialists available to care for emergencies in many communities. We have a shortfall in pediatric care. And we also have inadequate preparation for large-scale emergencies in many communities."
Much of the problem is financial. By law, hospitals have to treat anyone who comes into their emergency departments, even if they don't really have an urgent medical problem. Also, many emergency room patients who do have a genuine emergency don't have insurance and can't pay their medical bills. Most Americans get health insurance through their jobs, but employers are not required to provide it, so many people ? especially those with low-paying jobs and the unemployed ? don't have health insurance.
The problems aren't confined to hospitals. The level of emergency care you get when the ambulance responds to a traffic accident or a call for help in the case of a heart attack can vary tremendously. Committee member Shirley Gamble, who heads the United Way charity in Austin, Texas, says emergency medical service, or EMS, systems vary widely
GAMBLE: "For example, there is as much as a tenfold difference by community in survival rates for sudden cardiac arrest. In one community, your chances of survival could be five percent; in another community, your chances of survival could be 50 percent. One of the contributing factors to that is the lack of evidence to guide the medical practice. We don't have a scientific basis to guide these pre-hospital medical providers on the best way, for example, to treat sudden cardiac arrest. And that scientific evidence base needs to be developed and disseminated throughout the country."
The Institute of Medicine panel recommends better coordination between various parts of the emergency medical system, among other things, and more money from Washington to support improvements.
At least one group of emergency room physicians welcomed the report. But Rick Blum, president of the American College of Emergency Physicians, wondered whether lawmakers will respond to the recommendations, many of which will be expensive to implement.
BLUM: "Whether the Congress has the political will to do that, I don't know. I would hope it doesn't require a collapse [of an emergency system] for that to happen, but the cynical view would be a system would collapse, and then Congress will suddenly say, well how did that happen? And we've been talking about it for 10 years."
That collapse could be triggered by a mass-casualty event -- a natural disaster, a pandemic disease outbreak, or a terrorist attack.
Throughout the world, diarrhea is one of the most common ailments. In adults it is normally an unpleasant inconvenience. But it can be deadly, and diarrhea kills more than two million people a year, mostly children under age five.
As we hear from VOA's David McAlary, scientists have demonstrated that a medicine now used to treat some forms of diarrhea could be more widely used.