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Warren Pollock Warns Of Emergency Drug Shortage As EMTs Told To Go To "Alternate Protocols"
Warren Pollock reports on a rather troubling development which we can only attribute to various cost cutting measures by near-bankrupt states, as anything beyond that would be far too macabre even for us. It appears that "several drugs are in severe shortfall, drugs used to treat emergency patients that might be transported by ambulance to emergency rooms, the drugs include heart attack drugs, epinephrine, lidocain, as well as drugs used to treat shock and other conditions. These emergency care drugs are now in shortfall with alternate protocols going out to emergency services in various parts of the nation. This means that if you need emergency services, the drugs you rely upon to save your life may not be there." As WEP asks, "where have these drugs gone? It is unrealistic to suggest that a whole variety of emergency treatment drugs would go missing from the inventory all at the same time, and areas around the country all at the same time." Pollock highlights the states of TN, PA and CA may have already seen the incorporation of the "alternate protocol." Once again, we hope this is merely an interim shortage and not a widespread effort to impair the traditional operation of emergency technicians across the country.
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Propofol, the primary drug used for induction of anesthesia for surgery, is in a severe shortage at hospitals in Texas. If it gets any worse, elective surgeries will be cancelled.
I learned of this little fact first-hand two weeks ago, and scored it high among the empirical economic data I track. Private hospitals and ASCs are having trouble getting it at any price, and it has nothing to do with cost cutting by the states. Atlas is shrugging.
"Atlas is shrugging" meaning what, exactly? The CEO of the company that makes propofol has taken off to Galt's Gulch, and those left behind can't figure out how to turn the machines that make the pills to "on"?
Really?
Who is shrugging? Your guess is as good as mine. However, that is the exact reply I received from a top level person at SCA when I asked the cause of the shortage. However, it could just be that a single 23 year old mid-level logistics clerk at the main supplier went long the maker of a competitive drug on his e-Trade account, after he jerked off in the mushroom soup, I mean FDA sample vials of his employer.
My tinfoil hat assessment is that the chi.coms, or someone, is stocking up on all things needed for war. China is long steel, fuel, medicine, and young men.
State budget shortages drive down demand for healthcare consumables, which does not create shortages, but rather surpluses.
FWIW, the web sites I listed below both have manufacturers citing increased demand as an explanation for the shortages (of epi, at least.)
Not a good sign that there's unexpected demand for trauma meds. Time to upgrade to thicker foil.
Not thicker, just 24K gold foil baby!!!!!!!!!!!!!!!
Very astute HH.
Clearly a sign (one amongst many other multi-contextual ones) that something is "up" and we're not down with it.
War came to my mind as did the possibility of what will happen when the GOM finally delivers it's blow.
If any of the worst case scenarios for the GOM disaster pan out, they will need all that and more.
People, get off the mainstream everything! There are alternatives for each and every "modern miracle" we use.
ORI
http://aadivaahan.wordpress.com
Oh regional Indian
you know what mr indian, if i resided in India when my husband died, i should of thrown myself onto his burning embers and be done with it.
Hmmmmmm..... now where did that come from Rapunzel? What an unusually disconnected remark.
ORI
http://aadivaahan.wordpress.com
no, not really.
wanted your attention.
Who are you?
Hey, I missed this earlier.
Very curious. And I'm pretty much an open book (see blog link).
Who are you?
ORI
http://aadivaahan.wordpress.com
Maybe you are the type who are free to spread their legs after such an incident. How ignorant of realities in the present World.
[deleted]
I confess that I'm ignorant about how drug prices are fixed. But I have to assume that this is related to Medicare and other programs.
Why would there be a shortage? Is it a lack of cash for the hospitals? Why aren't the drug manufacturers producing more supply if it's an actual lack of the drugs?
I know that St. Vincent's went bust in NYC for similar reasons, and that - from my spare contacts with hospital workers elsewhere - many hospitals are in similar straits.
Propofol has two main manufactors. The one in Israel just lost a HUGE lawsuit in Las Vegas. The drug is very difficult to manufacture and has a low profit margin, so they quit making it. Hence the shortage.
I don't know anything about the EMT drugs, other than most of them are pretty cheap. I don't know why they are in shortage.
HA
Same drug that contributed to Michael Jackson's state of permanent unconsciousness.
the peasants' money is being shoveled out the back door to the banks. there's no cash to provide them with meds, nor should there be.
the idea now is to drain the economy dry, and then get out of town before the complete collapse.
if fewer folks get fewer meds, that's a few hundred thousand left to riot when the SHTF
I thought the economy was booming. Why the hell are we having near-bankrupt states and why the hell do they need to cut costs on critical drugs? Makes no sense
You thought the economy was booming....I'm sure you are kidding unless you are a Progresso-Democratic propaganda swallower. (I'm not sure why I waste time on Huffington Post Propaganda Central other than to be routinely exposed to the bad tempered ignorance of true believers.)
Wouldn't this be a case of bankrupt hospitals ??
Create the itch to sell the scratch.
Here comes a "national security" pitch to bail out pharma.
The shortages are real and nationwide:
http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm050792.htm
http://www.ashp.org/DrugShortages/Current/
Key EMT drugs, such as epinephrine, are on the list, as is the Propofol mentioned above.
I seem to recall there being a key shortage of a plastics-derived solvent that started in 2H2008 due to lower levels of manufacturing (it is a by product of plastics production) and this solvent was widely used in pharma manufacture.
My bad folks.
My......um......er......drug problem has gotten a little out of hand lately. I'll cut back real soon. I promise. Really. Honest to God, hope to die. Well, not really but you know what I mean. I hope.
Ah, yes, and grateful that we do understand such, as we trudge the road of happy destiny. Many thanks for the outstanding read. The quality shows through, wearing your experience, strength and hope as a loose garment.
Victory for the bulls
-Bob Pisani
LOL ugh..
what a mindless bull he is.
Seems like nothing has impacted the supply (or price) of illegal drugs....
Yet one always seems to run out at the most inopportune moment.
You must not live in California. It's easier for kids to get MaryJane than cigarettes. And if it is decriminalized (as is on the November ballot), it will be cheaper too.
East Coast. Dry as a bone in many ways.
Heroin is BY FAR the EASIEST drug to get in St. Louis. Somehow 90% of it gets grown and manufactured in Afghanistan. Hey what's the longest war the U.S. has been involved in again???
Karzai: Cops come and try to snatch my crops.
Hillary: Cops come to try and crop my snatch.
that is nasteeeeeee
yes we can
Dying on the way to the hospital is one way to lower medical costs in this country.
Letting all of the burdens on society, the frail, sick, injured, old, useless eaters has been publicized for many years by the likes of the Kissingers, Gates (injections to control population) and Rockefellers (search the founding principles of the foundation, eugenics) to cull the herd. Keep the productive worker caste creating the wealth... No reason for the burden of the sick, aged, the useless eaters.
No, I am not suggesting this, neither condemming nor condoning such, nor considering the pros or cons. Simply stating that policies such as these have been openly debated whilst shrouded on polite terms for many years. Including, for example at the WHO which recently stated publicly that such opaqueness must be halted, the problems of population spoken about in the open, to be understood by all.
And golly gosh, in the midst of the "emergency", the hard times, they once again manifest themselves, demanding additional sacrifice upon the "middle class".
So critical drugs to treat the sick become scarce. Also sits well with the "necessity" for health care rationing, not to mention the recurring theme of higher taxes.
"No, I am not suggesting this, neither condemming nor condoning such, nor considering the pros or cons."
Really? I would because that's exactly the kind of fascist accounting that the criminals in charge would engage in. Peter Orszag (former budget dir) knew that the last 6 mos of life accounts for some 20-30% of that person's lifetime medical costs. Guess what? They are going to make sure that you'll go six months earlier (at least) than you would've otherwise. Welcome to post-Soviet style living in Amerika.
My idea has been that any medical bills paid for by MediCare in the last 24 months of life get offset by a dollar-for-dollar reduction in the estate tax exemption for the patient. Millionaires getting MRIs on Medicare when they are on death's doorstep should have some cost. No?
Yes or course. It's not like they paid any medicare taxes.
That would make sense- so it wont happen! On farm subsidies: no subsidies for any "farmer"[LLC] netting 1mil/yr.
Just speculating... could it be related to the alleged GoM induced respiratory illnesses?
How are we just going to "take a pill" like Obama tells us to, if there are no pills! Genius!
http://www.youtube.com/watch?v=U-dQfb8WQvo
http://www.ashp.org/Import/PRACTICEANDPOLICY/PracticeResourceCenters/DrugShortages/GettingStarted/CurrentShortages/Bulletin.aspx?id=573
Nice work. PM member jerking off in the sample vials. Bigger payoff than the hotel's mushroom soup, Tyler?
Thanks. So this could just be a short-term shortage related to recalls.
Obviously it's easy to read too much into what could be casual coincidences. On the other hand, our global supply chain in many commodities and products have grown more narrow and therefore fragile, especially with the widespread use of just-in-time inventory. If just one manufacturer makes a key input, it could put parts of the system in jeopardy. In the '30's something like 30% of the US lived on farms. Now it has to be around 1%. How many days of food exist at any one time in the distribution channel? 7-10?? Have you read about the depletion of the aquifer below the Great Plains (which is really a virtual desert)? How about the over-reliance on one or two strains of Round-Up ready soybeans? And then the booming prevalence of R/U-resistent super-weeds?
Clearly, that would be reading too much into one OT issue. But, the shortage of critical life-saving drugs is potentially just one example of how our system is having a hard time perpetuating itself. People soon forget how quickly society can run out of key inputs and how the social mores can break down. Remember Katrina and people living without food and water in that dome? Just my dooms-dayer thoughts...
I'm a paramedic in St. Louis. This is real. Holy crap! I was wondering what the hell was going on. We switched to a new "resource hospital" a year ago, and I thought this was temporary growing pains.
The drugs we are in need of are Epinephrine (given for codes (cardiac arrests)) mostly, and D-50 that is given in an almost daily basis for diabetics with hypoglycemia... We are told to use Vasopressin instead for codes which the Europeans have been doing for years anyway but as far as the D-50 we're pretty much screwed.
Unbelievable...
I love replying to my own messages almost as much as I enjoy talking to myself in the mirror. Anyway. Another thing I find rather amusing is several hospitals in our area no longer give us clean sheets for our stretchers. We take a patient in and routinely use the sheets to lift the patient over to the ER bed. So we are now short a sheet. When we go to supply, they give us this Bounty paper towel-like thing that we are supposed to use. It rips easily, and looks like shit on the cot. They do this as a cost-cutting measure. I can only imagine the astronomical cost-savings of taking away actual bed sheets from paramedics and giving them back paper towels in return. Probably in the trillions of dollars...thanks for listening to me bitch.
Long Live ZeroHedge!
Hmmm...I wonder why England is working toward unregulating health-care???
Maybe rationing healthcare and underpaying healthworkers is not the best plan:
http://www.nytimes.com/2010/07/25/world/europe/25britain.html?_r=2&hp
If healthcare costs are too high, then tell the USGovt to stop printing so much money and devaluing our savings and earnings. Notice how essentials like food and healthcare are going up in price in the face of deflation, not down. Wonder why? M1 increases from FED money printing. The FED can only create currency. It cannot control where it goes.... The Fed would be tickled if their newly created currency went to prop up the housing market, but they cannot control that.
This is totally random. Anesthesia drugs are routinely in short supply. There are a lot of different factors and hospitals apply secondary procedures all the time. Hospitals have known this for nearly year.
The layoff numbers for hospitals probably give you the best picture of how well the states are paying their bills. The pharma bill for a hospital is not really a problem for budgetting and planning.
Um.
Lidocaine?
People, let's not get hysterical here.
Lidocaine is what most dentists use. When you get "novacaine" at the dentist's, you're actually getting lidocaine.
Oh, and it's filthy cheap. As in, the stuff they put in your mouth when you're in the chair is less than 5 bucks.
So, let's stay calm.
WRONG!
Lidocaine is a potent anti-arrythmic routinely given to cardiac patients having dangerous episodes of Ventricular Tachycardia. The algorithms now prefer Amiodarone (uber expensive) over lidocaine (as you say, very cheap), although there is no significant improvement for one over the other...
The paramedic . . . for the win.
Marcaine, and to a lesser extent, Lidocaine, with or without epinephrine, are routinely used in most surgical procedures.
Hermann Hesses "The Glass Bead Game" is currently playing on BBC radio 4 this week.
The fact that this very inflammatory book which strikes to the very quick of the current global system of governance is playing on the Home service speaks volumes for the turmoil within elite circles in the west and is indeed a very positive development.
Thanks for the head's up. I'll check it out.
What did people think was going to happen? All the people wanting the states and cities to cut, cut, and cut some more. Did they think that this only meant services that they would never use and could never need?
The only way that these cuts aren't going to effect you is if you are one of the super-rich. Otherwise you are going to get hurt too.
Not true...yet...I've run cardiac arrests in one of the wealthiest suburbs of St. Louis as well as in the ultra ghettos of East St. Louis...My treatment is exactly the same. However the higher paying jobs usually attract the better paramedics, on average. As in I worked in the ghetto when I was "new", and now work in a more upper-middle class area now that I have more experience. However, I work with some uber-retards now and there were some of the best medics I've ever seen in the ghetto...
Midtown,
The more knowledgable (work in the field or done some actual research) posters on this thread have made it appear that this has less tin foil hat meaning than we were reading into this. But assuming it was strictly a broke municipality argument:
This has less to do with people wanting to "cut, cut, and cut some more." as it does with there being no damn money left. Quit spending now, or quit spending later, the end result is the same, you're just a little older.
I'll gladly pay you Tuesday for an epinephrine shot today.
Being as we are all Goodfellas here on ZH always lookin' to make a buck or two^two^two^two, may I make a suggestion?
First we need to locate an "unsupervised" storage of several of these humanitarian pharmacueticals, and then liberate a modest supply for resale.
Pssst...Hey buddy...You won't be able to have your appendix out without this little number, which for a reasonable cost can be yours.
American Innovation Lives!
You'd have to find a paramedic or ER nurse or heroin addict to start the IV for you before you could push it, but otherwise it's a good idea.
LOL
Heh, don't be dissing my shooting buddy. He ain't never missed the vein yet. :>)
There is always the Central Line Option.
I think soon Xanax will be the next shortage as stressed out budget keepers try to crunch numbers smaller and smaller while ingesting larger and larger doses over time.
Ummmmm, may I be more blatant? It is my plan in the event of any disaster or SHTF situation to head straight to a pharmacy and persuade the tech to give me a large supply of asthma related drugs. My son has it bad and would perish for sure if he had to do without it. I might request some other items while I am at it because they will be equal to gold IMO.
Yeah, forget Rick..... I'M JESSIE JAMES, BITCH!
I read this on Rense. com earlier.
Rense is good, but Incogman.com is better.
Geez, Are we short Hopium too?
When epinephrine injections go into back order, the situation is serious. Propofol is basically a higher-priced, shorter-acting Valium (diazepam). There's no subsitute for epi.
http://www.ashp.org/Import/PRACTICEANDPOLICY/PracticeResourceCenters/DrugShortages/GettingStarted/CurrentShortages/Bulletin.aspx?id=640
Welcome to Socialism!
Folks this is sounding more and more like a bad dream from Great er England. They too have these facts about rationing. Welcome to single payer, more or less= USA.
An economics professor at a local college made a statement that he had never failed a single student before, but had failed an entire class. That class had insisted that Obama's socialism worked and that no one would be poor and no one would be rich, a great equalizer.
The professor then said, "OK, we will have an experiment in this class on Obama's plan".
All grades would be averaged and everyone would receive the same grade so no one would fail and no one would receive an A...
After the first test, the grades were averaged and everyone got a B. The students who studied hard were upset and the students who studied little were happy. As the second test rolled around, the students who studied little had studied even less and the ones who studied hard decided they wanted a free ride too so they studied little.
The second test average was a D! No one was happy.
When the 3rd test rolled around, the average was an F.
As the tests proceeded, the scores never increased as bickering, blame and name-calling all resulted in hard feelings and no one would study for the benefit of anyone else.
All failed, to their great surprise, and the professor told them that socialism would also ultimately fail because when the reward is great, the effort to succeed is great but when government takes all the reward away, no one will try or want to succeed.
Could not be any simpler than that. (Please pass this on)
Remember, there is a test coming up. The mid-term election in 2010!
That was in an email I received, it has a picture of the guy but not his name. I hope its true.
who are you going to vote for? rumsfeldchenybushclintonpetersonarmeybeckblankfeinobamabernankedimonimfwsjbi$? carly farina?
they are all the same shat, but for a pressured few.
‡
I'll be voting for people that are NRA, TEA and Ron Paul endorsed (I might check with ARIZONA Governor Jan Brewer as well), and if they don't act the way I expect I will vote them out and replace with another. IF they want to keep their job they will do what they said they would to get my vote. I'm not going to stick my head in the sand and say that nothing can be done and reward the crooks with additional terms....... are you?
I was asked who I was voting for and I gave an honest reply. I would like the chicken shit that flunked me to tell me who they are voting for. I don't care if you disapprove, I just want to hear your plan.
I might even believe you if everyone and their mother hadn't been sent that story in an e-mail. Anyone reading here can take about any line from the “story” part and Google it – there will be some 6 million hits...
I call B.S., was no such teacher, and you assuredly were never in the make believe class...
Nice try, but we don’t like such games here at ZH, and you are marking yourself as one of the trolls.
Put another way: In capitalism, long term profits trend towards zero. In socialism, productivity trends towards zero.
Guess which system provides the highest standard of living to all participants?
Thanks, ZH. This was news to me, and I've now subscribed to this guys's youtube channel!
CAN I HAS MOAR SOSHALIZED MEDESSIN PLS?
In North Carolina there was a flap a couple of years ago about EMTs declaring someone hit by a car dead at the site. EMTs are NOT licensed physicians. They do not have the decision making authority an MD has. I would be very surprised to learn an EMT has a DEA number. Better check who has the actual authority to decided what an EMT can and cannot do for medical procedures. We live in a global deflationary environment. There is no reason for the cost of any medical procedure to be rising. NO REASON. I toured a drug company location several years ago. Five drug packaging lines were sitting idle. They all had large bowls of neon green water sitting beside them to test for quality: package sealing, tampering, misalignment. So anyone stating re-importing drugs from outside the US is dangerous is full of BS.
How about: production and supply will be decreasing in the face of steady (or increasing) demand? The more the economy contracts, the worse off people will be, and generally they will need more medical attention. Less medicine, for more people.
EMTs (1 semester class) should not be declaring people dead, I would agree. Paramedics (3 years of training to get your license) can and do. A paramedic has a medical director who is an M.D. who gives guidance over the phone. However we have protocols that we work off of 99% of the time, and a good paramedic only needs a physician's guidance about 1% of the time. Knowing that, we don't call codes in the field with trauma unless it is obviously inconsistent with life, as in, the torso is still in the car but the head is on the hood, or brain matter showing, something that can't be fixed. Other than that, we run them, often too no avail.
An EMT or paramedic does not have a DEA number, but the service that the paramedic works for does have a DEA number. In my ambulance I carry morphine, fentanyl, and valium under lock and key. I have to count and sign off on the "narc log" before and after every shift.
Keep up the good work.
Sincere thanks for the work you do.
There's a simple explanation, that explains this and many other things that are going on right now:
Washington knows that the Yellowstone supervolcano is about to blow, and is taking steps to build underground bunkers to ensure the survival of the VIPs (employees of Goldman Sachs and a small handful of others).
http://www.youtube.com/watch?v=FOn3wkehluk&feature=related
Let the damn yellowstone go. The last time it covered Arkansas in feet of ash.
We are ready to roll at a moments notice towards the Smokies in the east. Hopefully ahead of all the other refugees. We probably will be gone a year or more.
It's not so much the loss of several states (Wyoming, Utah, etc), as the shutdown of global agriculture and air travel for about a decade after a large-scale eruption.
Not to mention nonstop winter for several years due to the ash clouds blocking out the sun.
I'm hoping to hitch a ride with Sen. Kerry if I can make it to Newport in time.
http://www.bostonherald.com/news/columnists/view/20100725liveshot_swift-...
Government will ALWAYS make the cuts where it causes the most pain for it's citizens and the least pain for itself.
LOL, that sounds like a true/false question I should give all new acquaintances.
True _X__ False ____
I don't think this is any 'wide spread' effort.
I believe this may be just companies saving money by reducing inventory both by the end user and the distribution companies.
Many ambulance companies are private (not state).
Let's see if reality does in fact play out here...
Would you, as a pharmaceutical manufacturer, prefer to sell your product in an indebted, declining market for depreciating USD or would you sell first to growing economies with stable or rising currencies?
Like Biff, I'm also a paramedic - and responsible for a good deal of purchasing at the organization I work for. In the fall of last year, we were circulated a letter from IMS/Amphastar who was a generic manufacturer of medications, making epinephrine, lidocaine, D50, etc. They advised that due to increasing regulation that they were ceasing a large portion of operations in the generic medication market. IMS was responsible for a large portion of "code drugs" available.
Its not so much a demand issue as a supply shock.
There are lots of unusual shortages, for example a wrinkle in the road building part of the stimulus crap is the lack of asphalt paint: http://www.nrtoday.com/article/20100729/NEWS/100729740/1063/NEWS&ParentProfile=1055
Do a google search, there are numerous other articles as well.
We all ought to just get used to there being shortages of various types and issues with the suply chain