Blogpost - JASE

Medical Emergency – Heart Attack

Heart disease, a term used to describe a variety of heart conditions, is the number 1 killer of men and women in the US.

Examples of heart disease include:

High blood pressure
Angina
Unstable angina
Valve disease
Arrhythmia
Heart failure
Congenital and inherited heart conditions
Coronary artery disease
Sudden cardiac arrest
Heart attack (myocardial infarction-MI)

Out of all the above conditions, heart attack leads as the number 1 cause of death in men and women in the US.

Every 40 seconds, someone in the United States has a heart attack resulting in about 805,000 people in the United States. Of these, 605,000 are a first heart attack.

What is a heart attack?

A heart attack occurs when one of the coronary arteries becomes blocked. The heart muscle is robbed of its vital blood supply and if left untreated, will begin to die because of lack of oxygen.

The more time that passes without treatment to restore blood flow, the greater the damage to the heart muscle.

Causes of heart attack

Coronary artery disease (CAD) is the main cause of heart attacks. Coronary arteries send blood to the heart. It is sometimes called coronary heart disease or ischemic heart disease. CAD is caused by plaque buildup in the walls of the coronary arteries. Plaque is made up of deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin. As plaque builds up in the arteries, the artery walls become thickened, hard and narrow over time, which can partially or totally block the blood flow. This process is called atherosclerosis. Atherosclerosis takes about five years to develop.

Another less common cause is coronary spasm during this coronary spasm, your arteries restrict or spasm on and off, cutting off the blood supply to your heart muscle (ischemia). It can happen while you’re at rest and even if you don’t have serious coronary artery disease. Some causes of coronary spasm are extreme cold, smoking, stress, pain. Cocaine, methamphetamine

Most heart attacks occur when the hardened, built-up plaque shell cracks and ruptures. Platelets, a part of the blood that helps blood clot, come to the ruptured area, and form a clot. If the clot is large enough it can block the artery and block oxygen rich blood from reaching the heart. Without adequate oxygen the heart muscle starts to die, resulting in a heart attack. The hearts’ ability to pump declines depending on where and how much scar tissue develops.

Luckily, most heart attacks are survivable, with about a 90 percent survivability rate. These statistics are due to early intervention and prevention awareness.

Symptoms can vary between men and women

Symptoms of an impending heart attack can manifest up to a month to days and even hours before. Symptoms include:

Fatigue
Dizziness
Abdominal pain
Sweating
Swelling in Legs, Ankles, and Feet
Heart Palpitations

Symptoms of heart attack in progress

Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes or goes away and comes back.
Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath with or without chest discomfort.
Other signs such as breaking out in a cold sweat, nausea or lightheadedness
About 1 in 5 heart attacks are silent—the damage is done, but the person is not aware of it.

What to do if heart attack suspected- ACT QUICKLY

Call 911 immediately, quick intervention is key to survival- if in doubt, call. Many people avoid calling until heart attack is well under way.
Aspirin or no aspirin? Don’t give aspirin unless directed by emergency personnel or care provider. There are several reasons not to give aspirin, one being the increased risk of bleeding, another is allergy to aspirin and even interaction with other medications.
Keep calm, reassure patient, stay with them until help arrives
If the person is unconscious, no pulse and/or not breathing, initiate CPR, continue until help arrives. Brain death occurs 10 minutes after 10 minutes with no oxygen
If a defibrillator (AED) is available hook up patient and follow prompts- remove patient from liquid, metal surfaces and to a safe area. Know how and when to use the AED through previous training. A heart attack can spiral into a sudden cardiac arrest. If the patient has a pacemaker, do not apply pads directly over the pacemaker. Also do not apply pads over medical patches.

How heart attack diagnosed

Blood test- troponin level measures the amount of proteins in the blood. During a heart attack, heart muscle cells die and release proteins in the bloodstream.
EKG measures the electrical activity of the heart
Heart imaging tests such as cardiac CT scan

Risk factors for heart attacks

Note: Risk factors are the same for silent heart attacks as their symptomatic counterparts

Brush your teeth, get regular dental exams-The link between periodontal pathogens and cardiovascular disease (CVD) Recent studies have linked periodontal pathogens with atherosclerotic plaque in 80% of specimens, meaning that periodontal bacteria (among others) were identified in 80% of plaque in carotid artery specimens. (Atherosclerotic plaques leading to atherosclerosis)
High blood pressure
High cholesterol
Diabetic– adults with diabetes are twice as likely to have a heart attack or stroke
Smoker
Overweight
Physical inactivity
Genetic predisposition
Stress, especially chronic stress
Even young and healthy population can experience heart attack

Prevention

Lifestyle

Manage and reduce stress- Deep breathing, therapy, talking to friends and loved ones can significantly reduce and manage stress
Maintain healthy cholesterol levels through diet, exercise and stress management
Exercise regularly- consult your care provider regarding type, how often and how much exercise
Healthy diet-eliminate sugar, consult with your provider the ideal diet for you and your preexisting diagnosis and meds.
Quit smoking- smoking constricts blood vessels, and chemicals in cigarettes can cause the blood to thicken and form clots.
Brush teeth twice a day, replace toothbrushes as needed. Oral bacteria has been found in the fatty deposits of people with atherosclerosis.
Drink your water! Dehydration can cause your heart to beat faster, cause an irregular heartbeat or even palpitations. In addition, dehydration makes your blood thicker and constricts blood vessel walls. This can cause high blood pressure and put strain on your heart.

Meds

Along with preventative lifestyle choices it may be necessary to add medication(s). Some of these include:

Over the counter meds such as aspirin- consult provider before using
Beta blockers-some examples include- atenolol (Tenormin), metoprolol (Lopressor, Toprol XL) propranolol (Inderal). Beta-blockers-block the effects of adrenaline, which comes on in response to stressful situations.
Ace inhibitors- some examples include- benazepril (Lotensin), captopril (Capoten), enalapril-(Vasotec), fosinopril (Monopril), lisinopril (Zestril and Prinivil), qinapril (Accupril), ramipril (Altace). ACE (angiotensin-converting enzyme) inhibitors prevent the body from producing the artery-constricting hormone angiotensin. Arteries relax with ACE inhibitors which in turn lowers blood pressure.
Prescription blood thinners-examples include warfarin, clopidogrel
Statins- some examples include atorvastatin (Lipitor), fluvastatin (Lescol XL), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol- Statins lower LDL cholesterol, reduce inflammation.

- Brooke Lounsbury, RN

Medical Content Writer

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First Aid Kit for Dogs – Be Prepared!

Dogs have historically been called Mans best friend. (In 1789, King Frederick of Prussia once said that a dog is a “man’s best friend” and this phrase has lasted throughout the generations.)

Dogs are the most popular pet

Over 48.3 million households own dogs with cat owners coming in second in popularity at 31.9 million.

Are you the proud owner of the most popular pet in the U.S.? Do you have a first aid kit for your dog?

Preventative care is the best care. Keep up to date with exams, vaccinations, and have extra prescribed medications. In addition, a first aid kit and common otc medications can prevent trips to the vet (or if the vet isn’t available) and prevent further injury and even death.

Ask your vet to recommend products specific to your dog as they know your dog’s health condition and are the best ones for this task. However, there are a few items that you can have stocked in a first aid kit for minor injuries and illnesses in the event veterinary care isn’t readily available.

Doctor and assistant checking up golden retriever dog in vet cli

First aid supplies

Find or purchase a rugged box where you can store items. A tackle box, small Rubbermaid tote or a lunchbox with dividers is ideal for setting up a first aid kit. Make sure it is clearly labeled for your pet as a first aid kit on the outside of the container. Inside this container stock:

Contact card with your veterinarian phone number and other contact information. In addition to contact information, have your dog’s name, age, health conditions, meds and allergies listed. The Pet Poison Hotline 855-764-7661 should also be on the contact card.

Laminate this card and place it where this card will be easily seen when the kit is opened.

This card is for anyone taking care of your dog while you are away, or on vacation or traveling and you aren’t available. Add all the contact information to your cellphone also.

Nitrile exam gloves to protect both you and the dog
Tweezers- for tick, splinter, thorn, or bee stinger removal
Bandage scissors. Be sure to stock only bandage scissors since they have the blunt end, which can help avoid injury when rendering care.
Nonstick telfa pads. These pads won’t stick to wounds when applied as the first layer in a dressing.
Neosporin or other ointment- to help reduce bacteria count and provide a layer of protection to the wound.
Hibiclense or generic equivalent wound cleanser to clean wounds before applying dressing.
10 cc and 50 cc syringes to irrigate wounds and clean ears if needed. Have multiples of these.
Coban dressing- 4-inch roll is the most useful size. If your dog is smaller you may want to pick up 2 and 3 inch rolls also. Be sure when applying this to an appendage to not wrap too tight (which could create a tourniquet effect)
Gauze squares, separated into 5-10 packs, place in individual baggies for easy access.
Roll of gauze to hold dressing in place until you can apply Coban.
Rectal thermometer made for dogs and pets, along with lubricant. (Know how to use the thermometer)
Styptic powder to control bleeding (handy to have if you are trimming nails and cut too close and it causes bleeding) Corn starch works (but not as well) if styptic powder not available.
Small flashlight with extra batteries to examine wounds, etc.
Extra towels- paper and cloth
Bottled water and a small foldable bowl for drinking in case of dehydration.

Over the counter medications

With supply chain disruptions and a multitude of other factors creating instability in our world, having just a few of these meds on hand could be lifesaving.

A fantastic you tube series by a former practicing veterinarian has playlists for emergency care, meds and more: Veterinary Secrets

Contact your veterinarian for instruction and guidance on the following medications. Make sure written instructions are with each medication.

Benadryl (generic name is Diphenhydramine)– for allergic reactions, itching, hives
Pepcid – generic name is Famotidine– upset stomach, vomiting, gastric reflux
Activated charcoal– in case of ingestion of poisonous substances-DO NOT USE UNTIL YOU TALK TO VETERNARIAN OR HAVE WRITTEN INSTRUCTIONS ON WHEN AND HOW TO USE
Eye wash– to remove pollen, irritation or objects in eye
Ear wash for irritated ears – ask your vet what they recommend
Pain reliever -with instructions from veterinarian on use. One common otc pain reliever is uncoated aspirin, but this needs to be used with caution.

In addition to the above supplies and medicines- do you know the symptoms of and how to treat:

Water toxicity? (when swimming can ingest water to avoid it going to lungs)

How to tell if in pain?

Foods toxic to dogs?

Be ready for your best friend’s emergency needs. Know what to do if your dog has an emergency or ingests something they shouldn’t. They are truly our best friends!

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

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The Overlooked Vital Sign

As long as man has walked the earth, pain has been part of life.

Pain is defined as a localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and emotional distress and typically results from injury or disease. It is a complex mechanism that alerts us to injury or illness. Pain isn’t a pleasant experience; however, it can save your life.

Why is pain called the 5^th vital sign?

In 1995, Dr. James Campbell addressed the American Pain Society urging that health care providers treat pain as the “fifth vital sign” (The other vital signs are blood pressure, heart rate, temperature, and respiratory rate.) highlighting the need for improved pain care. The tide has turned for the better. Historically, care providers hadn’t adequately managed pain. It is now considered a very important part of a patients assessment and well-being.

Pain can be both physical and psychological. In fact, physical and psychological pain share the same neuro mechanisms and the same regions of the brain where these processes take place. In addition, both physical and psychological pain stems from inflammation and the inflammatory response.

Physical pain-acute and chronic

Acute pain- Acute pain comes suddenly, can be severe and resolves over a short period of time (within a month or so). Injuries, illnesses (such as sore throat), labor and childbirth, dental work, are classified as acute pain.

Chronic pain- Chronic pain is pain that lasts a sustained period, usually lasting 3 or more months. Examples are arthritis, bone healing after break, cancer, back pain, fibromyalgia, autoimmune diseases. Chronic pain can cause tense muscles, lack of energy, depression, and anger, which can lead to psychological pain. An estimated 35-45% of chronic pain sufferers experience depression.

Psychological pain- Rejection, loss of a loved one, loss of job or health and chronic pain are a few ways psychological pain can manifest. These emotions (anger, depression, rejection, loss) can trigger inflammation, which in turn can cause psychological pain. Which then manifests as physical pain.

Assessing pain-verbal and nonverbal/physical cues

Seek medical attention if experiencing abdominal pain, pain from an injury, trauma, pain for unknown causes or a fever for unknown reasons.

Depending on the age and mental capacity of the patient, pain can be expressed in either verbal, nonverbal/physical. Young children, infants, and patients with cognitive deficits (Alzheimer, autistic) won’t be able to adequately report pain. It is important to assess the person’s ability to accurately express their pain. Dementia patients may state they aren’t hurting; however, their body language may reveal otherwise. The same goes for young children. Nonverbal cues should be relied on in these groups. Observe and evaluate.

Verbal expressions- Yelling, crying, tears, hyperventilating, stating they are in pain, moaning, calling out for help are examples of verbal expressions of pain.

Ask:( Verbal patients with no age related (young children and infants) or cognitive impairment)

Type of pain? Stabbing, burning, aching, dull, throbbing sharp, cramping?
Location (is there more than one place)
Duration/activity- How long has it hurt? Does the pain come and go? Is there pain with specific activity- are there activities that make the pain worse? Are there any activities or postures that provide pain relief?

Use the pain scale assessment to determine severity of pain

Nonverbal/physical- Some nonverbal expressions of pain include facial expression of pain, altered gait/limping, rubbing a body area, tense tone/rigidity, decreased movement, guarding a part of the body that is hurting, pacing, rocking, fidgeting, increased heart rate and blood pressure, sweating. This type of assessment will be necessary when working with nonverbal patients and very young children.

Infants pain communication

Infants- Since infants can’t tell you when they are in pain, it is very important to know the signs of distress/pain.

They may cry or whimper and be unable to settle.
They may be tense, with clenched fists and may keep their arms and legs close to their chest.
They may be fidgety, agitated or have a disturbed wake / sleep schedule.
They may be pale, flushed or sweaty.
They may shut their eyes tightly, furrowing their eyebrows or have larger than normal pupils.

The NIH has developed a neonatal/ infant pain scale, which can be accessed here. This is a handy tool to help determine your child’s level of distress/pain.

Interventions

(Always check with your care provider if the pain is excessive, unknown in origin and before taking any over the counter medications)

Pain scale

Utilize the pain scale assessment tool. Have them point to which face they feel best describes how they are feeling or use the 1-10 severity of pain level tool.

Medication

Since pain causes inflammation, anti-inflammatory drugs such as ibuprofen and naproxen can help. Pain can cause muscles to tense (guarding) which can make the pain worse. Talk to your care provider about therapies or drugs that may help with this.

Nonpharmacological interventions to relieve pain

Both acute and chronic pain sufferers can benefit from several therapies to relieve pain.

Some of these therapies/interventions are:

Accupuncture– involves the insertion of extremely fine needles into the skin at specific “acupoints.” This may relieve pain by releasing endorphins, the body’s natural pain-killing chemicals, and by affecting the part of the brain that governs serotonin, a brain chemical involved with mood.
Companionship can relieve anxiety and take the focus off the pain.
Positioning to relieve pain.
Hot/cold therapy Depending on the type of pain (injury or cramp, for instance) heat or cold can be a powerful tool to alleviate pain.
Massage therapy- Especially effective if tense from pain.
Meditation/prayer can calm the mind and body.
Relaxation/guided imagery positive, guided imagery is beneficial by allowing the body to relax-check out this video on guided imagery
Deep breathing exercises- check out this video on deep breathing to reduce pain.
Transcutaneous Electrical Nerve Stimulation (TENS) is a procedure in which electrodes, placed on a person’s back, give off an electric signal that stimulates nerve cells through the skin. The numb-like feeling that results. It can help some people overcome pain. TENS blocks pain messages to the brain and modifies pain perception.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Order Today

Join Our Newsletter

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April 4th is National Vitamin C Day!

Each year this powerhouse vitamin is celebrated for all the ways it benefits our health

What is vitamin C?

Vitamin C, also known as L-ascorbic acid, is a water-soluble vitamin, meaning that it dissolves in water and does not get stored in the body. Since we are unable to produce these vitamins, they must be consumed daily.

Sources- Food and supplements

(Source from NIH fact sheet on vitamin C)

Vitamin C is found in many food sources. Probably the most well known is the citrus family. While citrus fruit contain vitamin C, there are many other sources.

Food	Milligrams (mg) per serving	Percent (%) DV*
Red pepper, sweet, raw, ½ cup	95	106
Orange juice, ¾ cup	93	103
Orange, 1 medium	70	78
Grapefruit juice, ¾ cup	70	78
Kiwifruit, 1 medium	64	71
Green pepper, sweet, raw, ½ cup	60	67
Broccoli, cooked, ½ cup	51	57
Strawberries, fresh, sliced, ½ cup	49	54
Brussels sprouts, cooked, ½ cup	48	53
Grapefruit, ½ medium	39	43
Broccoli, raw, ½ cup	39	43
Tomato juice, ¾ cup	33	37
Cantaloupe, ½ cup	29	32
Cabbage, cooked, ½ cup	28	31
Cauliflower, raw, ½ cup	26	29
Potato, baked, 1 medium	17	19
Tomato, raw, 1 medium	17	19
Spinach, cooked, ½ cup	9	10

Other sources include rose hips (made into tea), sauerkraut, and supplements such as sodium ascorbate; calcium ascorbate; other mineral ascorbates; ascorbic acid with bioflavonoids.

A study revealed Liposomal vitamin C is more bioavailable for the body. Liposomes are tiny, nano-sized bubbles normally made out of sunflower lecithin that mimic the body’s own cell membranes. It is absorbed directly into the cells compared to the bloodstream with supplemental vitamin C.

Health benefits

Increases iron absorption in foods

A recent study concluded that taking supplemental vitamin C with an iron supplement did not increase iron absorption.

Taking supplemental vitamin C along with iron rich non heme (not animal source) foods, such as dried beans, nuts, grain products increased iron absorption.

However, when food sources of both vitamin C and iron are consumed iron absorption increased.

Vitamin C also:

Helps activate B vitamins
Is an antioxidant, neutralizing free radicals
Modulates natural killer (NK) cells
and stimulates immune system,
Provides protection against oxidative stress
Reduce heavy metal toxicity
Production of collagen
Aids in wound healing
Natural antihistamine
Lessens duration of colds
Improve insulin resistance and stabilize glucose levels

Dosage

Supplementation should be considered only if you are not able to consume enough vitamin C rich foods. Since there are so many versions of vitamin C on the market the following table, obtained from the NIH should be used as a guide only. Most supplements contain ascorbic acid which as been found to be the purest form.

Age Male Female Pregnancy Lactation

0–6 months 40 mg* 40 mg*

7–12 months 50 mg* 50 mg*

1–3 years 15 mg 15 mg

4–8 years 25 mg 25 mg

9–13 years 45 mg 45 mg

14–18 years 75 mg 65 mg 80 mg 115 mg

19+ years 90 mg 75 mg 85 mg 120 mg

Smokers Individuals who smoke require 35 mg/day more vitamin C than nonsmokers.

If taken as a supplement, vitamin C should be taken in the morning or during the day, not at night, especially in people with GERD as this can make symptoms worse.

Vitamin C deficiency

Symptoms of vitamin C deficiency include:

Fatigue, inflammation and/or bleeding of the gums, brittle nails and hair, bruising easily, iron deficient anemia, and joint pain.

Vitamin C deficiency is unusual in developed countries; however some diseases can deplete vitamin C stores and lead to deficiency. Individuals with irritable bowel disease, celiac or other forms of intestinal inflammation are at risk for vitamin C deficiency.

Side effects of vitamin C supplementation

It is almost impossible to get too much vitamin C from diet alone. There are several side effects from taking vitamin C in supplement form. In most cases, excess vitamin C is excreted in urine within 24 hours. Some side effects are:

Nausea, vomiting and diarrhea
Heartburn
Stomach cramps or bloating
Headache
Skin flushing
Insomnia
Fatigue

Who should not supplement with vitamin C?

Consult with your primary care provider about vitamin C supplementation if:

Kidney disease or a history of kidney stones
Hereditary iron overload disorder (hematochromatosis)
Smoker (may need more than stated dose)

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Order Today

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Don’t Get Complacent- Avoid Prepping Burnout

5 Tips to get back on track to self-sufficiency.

Its that time of year again. Tax time, Spring break, plans for summer vacation, getting your garden started,playing and working outdoors are all forefront in our minds.

Oh yes, and pending war, famine, next pandemic, social unrest, solar flares, record breaking weather patterns (tornados in the South, epic rainfall and snow in the West), food and gas prices spiraling out of control, bank failures, supply chain disruptions. In fact, probably the most disturbing news so far came from the World Economic Forums’ Global Cybersecurity Outlook 2023 report where 86% Business and 93% of cyber leaders believe global geopolitical instability is moderately or very likely to lead to a catastrophic cyber event in the next two years. A mass cyber event would have far-reaching and untold hardship in ways we can’t even comprehend.

Let us not forget our medical system

Our medical system is now at tipping point leading to total collapse. Hospitals closing, staff shortage, medical device shortage,( Cardiac diagnostic, and monitoring products, Specimen collection – testing supplies and equipment, Radiological devices, General ICU/ hospital products) the inability to perform procedures due to shortages of medications and instruments.

Overwhelmed? Now is NOT the time to shut down

As the war drums continually beat, as high food, energy and gas prices steadily climb to new highs, and as we face the reality that our medical system is in crisis, this isn’t the time to be complacent.

Breaks and vacations are important but don’t live there

Take a break from the noise of all the crises but don’t let this become your “new normal”. In fact, short vacations, hobbies, time with family and friends are vital to overall health and wellbeing. Schedule time away from screens and technology. Information overload causes us to feel we are powerless. This leads to complacency and the inability to think clearly. The survival of our families is dependent on our ability to navigate this unchartered territory.

We are entering a time never seen before in the history of the world.

Our global economy and trade have positioned us in a very precarious position; one where we may feel powerless. This couldn’t be further from the truth. We have amazing, untapped talents and abilities we never knew we had until we decide to get back in the game.

Businessman changing the word impossible into possible

5 tips to get back on the track to preparedness and self-sufficiency

Attitude is everything

Everything we believe we can or can’t do starts with attitude. Attitude can move mountains. By focusing on solutions instead of allowing the media and others to pull you down, step away from the negativity and work out ways to overcome obstacles. If the obstacle is too big, shelve it and revisit at a later date.

Start your day off on the right foot, and continue.

The first hour upon awakening sets the tone for the rest of your day. Stay off your phone that first hour. Instead, meditate, pray, reflect on what you are grateful for and if able get some natural first morning sunlight.

Prioritize your day, week, month and year. Set realistic goals.

Set aside uninterrupted time to prioritize goals. Start by writing down the goals, then prioritizing them. Which are the most pressing and important? Number them, starting with #1 as the most important and pressing. Do you have a goal of paying off debt? Weight loss? Finishing a project or starting a hobby? Do you want to eat better within an already strained budget?

The SMART acronym

A very popular tool for goal setting.

Specific- Narrow down what goal you wish to achieve, take time evaluating the goal.

Measurable- Is the goal measurable? For instance, if you want to lose weight, how much?

Achievable- Is the goal realistic and achievable. Some of this is based on your attitude and ability to achieve the goal. Do you feel you can achieve the goal and do you have the resources and tools needed?

Relevant- Is your goal relevant in your life? For instance, would losing 10 pounds add value to your quality of life?

Time-bound- Make sure your goal has a completion date. This can be modified as needed as you work towards achieving your goal.

Be flexible but stay the course

Life happens, roll with the punches, but always go back and reflect on your reasons for why you are preparing. If you need to step away for a time, go ahead, but don’t make this a permanent way of life. It you have experienced major life changes it is time to refocus and reevaluate your goals and get back on track as soon as you are able.

If it was easy, everyone would do it

The discipline, focus, drive and determination needed to prepare for our uncertain future isn’t an easy road but it will be rewarding and bring peace of mind. You can’t possibly do everything. Find others that are like minded that can help fill in the gaps for you and reciprocate. Check with local emergency responder groups, gardening and livestock communities along with family friends and neighbors for support. We aren’t an island. We need each other now more than ever before.

Be an example. Be a leader

People are watching us even if we don’t realize it. We will inspire others more through our actions than any other way. As more people come together to solve local and regional problems facing all of us, we will all not just survive but thrive while navigating the waters of the unknown,

By the way, have you ordered your Jase Case for each member of your family yet?

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Order Today

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Over 600 Rural Hospitals at Risk of Closing

Throughout the nation many rural hospitals are on the brink of closure, citing physician shortages and lack of adequate funding to keep their doors open. A report from the Center for Healthcare Quality and Payment Reform (CHQPR) revealed that more than 600 rural hospitals – nearly 30% of all rural hospitals in the country – are at risk of closing in the near future.

These hospitals are not just emergency rooms, many are the anchor for primary care, rehabilitative therapies, labs and x ray departments and maternity care. If the hospital closes many , if not all, other rural healthcare services in the area will also disappear.

Lack of adequate revenue

Rural hospitals and clinics are forced to operate many times at a loss- not because they are inefficient but because they have the same overhead as their urban counterparts.

ER staffing 24/7- Urban hospitals have more patients coming through their doors than their rural counterparts. Even though both require adequate round the clock staffing, the volume of patients in urban areas offsets the overhead.

There are over 1,000 small rural hospitals, representing more than 25% of all the short-term general hospitals in the country, but they receive only 2% of total national hospital spending.

Insurance reimbursement disparity

A recent report by Center for Healthcare Quality and Payment Reform (www.CHQPR.org):

“A common myth about rural hospitals is that most of their patients are on Medicare and Medicaid. In fact, about half of the services at the average rural hospital are delivered to patients with private insurance (including both employer-sponsored insurance and Medicare Advantage plans). Low margins or losses on patients with private insurance, combined with losses on Medicaid and uninsured patients, can force small rural hospitals to close.”

Physician shortage

According to NHRA (National Rural Health Association)

“Ease of access to a physician is greater in urban areas. The patient-to- primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas. This uneven distribution of physicians has an impact on the health of the population.”

Some reasons cited for the rural physician shortage are long hours, lower reimbursement of insurance compared to urban areas, aging population of physicians that are nearing retirement, managing patients with higher proportion of chronic illnesses (diabetes, coronary heart disease) and lifestyle of rural living.

Rural hospitals and clinics serve farmers, ranchers, and others that provide food and services for the entire nation. Many of the nation’s natural resources- coal mines, oil and natural gas production are in these areas. Rural hospitals and clinics also provide care for visiting tourists to national parks and outdoor recreation if an emergency arises. If this population can’t continue to live and work in rural areas because of lack of medical services, the entire nation will suffer.

Solutions

Match reimbursement with cost of doing medicine

Current insurance reimbursements are below cost of delivering care. Saving Rural Hospitals states that increasing spending to meet cost of services (total would be 4 billion annually) could help offset the financial losses. This sounds like a lot of money, however this amounts to only 1/10 of 1% of total national healthcare spending, which is more than $1.3 trillion spent on all urban and rural hospitals in the country.

Telemedicine

Rural communities could benefit from telemedicine, which solves the problem of rural patients having to drive long distances (sometimes over 70 miles) to see a doctor or consult with a specialist. Telemedicine can treat chronic conditions and provide a preventative approach to healthcare not usually found in rural areas.

Establish more rural residency programs and mentoring opportunities. As more rural physicians enter retirement age they are ideally positioned to mentor and support new physicians in rural medicine.
Utilize midlevel providers to offset the long hours the physician faces along with providing care more economically. Midlevel providers- nurse practitioners and physician assistants- are a more economical way to support the physician and can provide relief from long hours faced by rural physicians.

Until such a time that above solutions can be implemented, anyone living in rural areas should consider the very real possibility that their local hospital could be shut down in the near future. Are you prepared for such an event?

- Brooke Lounsbury, RN

Medical Content Writer

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Customize your Jase Case

Symptoms & Scenarios

KidCase

Dental

UTI

Jase Go

Mission Case

Gout

Cruise

Jase Daily

Customize Your Jase Case

Symptoms & Scenarios

UTI

Gout

Cruise

Periods

Jase Daily

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Lifesaving Medications

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- Brooke Lounsbury, RN

Lifesaving Medications

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- Brooke Lounsbury, RN

Lifesaving Medications

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- Brooke Lounsbury, RN

Lifesaving Medications

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- Brooke Lounsbury, RN

Lifesaving Medications

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- Brooke Lounsbury, RN

Lifesaving Medications

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