Hospital Rip-Off

[deweyzeph]

Because medical aids is basically communism, unlike real insurance, there no real price discovery.

The best you can do is question the charge as a possible mistake or fraud.

Real insurance discriminates based on risk, which means that half the population would not have cover even if they could afford it.

 

[SauRoNZA]

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How do you think the surgeon starts a heart after a transplant or if you've been on a bypass machine.

If I recall correctly they massage it back to life.

Like bump starting a car.

 

[3Gee]

If I recall correctly they massage it back to life.

Like bump starting a car.

The massaging is to keep oxygenated blood flowing through the body.

 

[SauRoNZA]

How does the heart circulate blood if it has stopped ????



The heart does not always start on its on. Most times it is shocked. Sometimes additional shocks are required to achieve sinus rhythm.

Just like bump starting a car.

It’s essentially a reversed process to get things back to normal order and once it goes it keeps going by itself.

 

[Grant]

The donor heart is still beating when its transplanted ???

The surgeon packs ice for fun around the heart during a bypass procedure ?

The bypass machine is used simply to make the procedure seem more complicated ?


The monitor is faulty when it displays a flat line ?? The heart is actually still beating !!!!

Dude, you're wrong, just let it go.

The heart starts beating once it gets oxygenated blood by itself....

Sometimes they need to zap it to get it beating regularly but never to start it in the first place.

3gee is correct on all the above

donor heart is still when transplanted

crushed ice is packed into the chest cavity to reduce metabolic rate of heart and localised vascular system, this is done in conjunction with the introduction of cardiopledia solution via the pulmonary bypass pump (heart-lung machine).
1 - ice goes into chest cavity
2 - aorta is cross-clamped
3 - patient goes on bypass
4 - cardioplegia is pumped into the heart

5 - surgery completed
6 - normal body temperature restored
7 - aortic cross-clamp released - patient comes off bypass
7 - internal defibrillator used to restore cardiac rhythm

 

[SauRoNZA]

The massaging is to keep oxygenated blood flowing through the body.

Which is operating the heart like a pump not so?

And then it should start operating by itself again in most cases.

But I’m definitely not a heart surgeon, was just my understanding of how it’s supposed to work.

 

[3Gee]

Which is operating the heart like a pump not so?

And then it should start operating by itself again in most cases.

But I’m definitely not a heart surgeon, was just my understanding of how it’s supposed to work.

Refer to point 15

Heart Transplant

A heart transplant is surgery done to remove the diseased heart from a person and replace it with a healthy one from an organ donor.

www.hopkinsmedicine.org

 

[SauRoNZA]

Refer to point 15

Heart Transplant

A heart transplant is surgery done to remove the diseased heart from a person and replace it with a healthy one from an organ donor.

www.hopkinsmedicine.org

But that’s a bit different to the external paddles people were referring to earlier?

 

[3Gee]

But that’s a bit different to the external paddles people were referring to earlier?

Wether internal or external. Both deliver a electrical shock to the heart , either to restore sinus rhythm or to get the heart beating again.

Chest compressions do what physically massaging the heart does.

 

[SauRoNZA]

Wether internal or external. Both deliver a electrical shock to the heart , either to restore sinus rhythm or to get the heart beating again.

Chest compressions do what physically massaging the heart does.

Aren’t chess compressions rather for the lungs? Which indirectly pumps the heart.

 

[AdrianH]

Wether internal or external. Both deliver a shock to the heart , either to restore sinus rhythm or to get the heart beating again.

To correct rhythm yes, to restart heart no.

The fact is that if a patient has flat-lined (Asystole), using a defibrillator will not jump start the heart to beat again. You can google https://www.google.com/search?q=asystole+defibrillator and even the first entry tells you.

Asystole is treated by cardiopulmonary resuscitation (CPR) combined with an intravenous vasopressor such as epinephrine (a.k.a. adrenaline).[4] Sometimes an underlying reversible cause can be detected and treated (the so-called "Hs and Ts", an example of which is hypokalaemia). Several interventions previously recommended—such as defibrillation (known to be ineffective on asystole, but previously performed in case the rhythm was actually very fine ventricular fibrillation) and intravenous atropine—are no longer part of the routine protocols recommended by most major international bodies.[5] Asystole may be treated with 1 mg epinephrine by IV every 3–5 minutes as needed.

and second entry

https://www.ncbi.nlm.nih.gov/books/NBK430866/

Asystole should be treated following the current American Heart Association BLS and ACLS guidelines. High-quality CPR is the mainstay of treatment and the most important predictor of a favorable outcome. Asystole is a non-shockable rhythm. Therefore, if asystole is noted on the cardiac monitor, no attempt at defibrillation should be made.

I really don't know why you refuse to accept you are wrong in that a stopped heart back can't be shocked back to life.

 

[Grant]

A friend of mine had a mild heart attack on December and managed to call an ambulance, which promptly arrived. The paramedics stabilised him and although conscious and compos mentis he was rushed to a hospital in Benoni. This is where the rip-off took place. He was admitted into casualty at 14H09 and discharged at 15H00 to be transferred to a hospital covered by his medical aid.

He received his statement from the medical aid which had declined payment due to the fact that the account submitted by the hospital had insufficient information for them to consider payment. He contacted the hospital accounts department to advise them that the medical aid required further information to consider payment of the account to which he was told that he must speak to casualty and ask them for the information! He argued that it was not his responsibility to get the information and submit it to the medical aid. Long story short, he got the accounts department to resubmit the account with the necessary info. He was copied on the email sent and to his horror, he found that the drugs used during the emergency amounted to R 202.14 and there was a miscellaneous charge for R 6,107.50 which was later described as a resuscitation fee.

According to my friend, he was fully aware of his surroundings and what was happening around him and categorically states that no paddles or other resuscitation equipment was used on him at.

He is now awaiting feedback from the medical aid to see if they will pay for the “resuscitation” fee.
What recourse if any does he have in order to take this “robbery” further?

mi - myocardial infarction is a pmb condition, classified as a medical emergency.
a medical emergency involving a pmb condition allows a patient to be treated at any hospital until stable, dsp or not. medical aid is legally obliged to pay in full.
patient can only be transferred to another hospital once stable and confirmation of available bed at receiving hospital has been received be the transferring hospital. if no bed is available at dsp, patient has to be kept at original hospital - medical aid has to continue payment until such time as a bed has been secured at the dsp facility.

account submitted to medical aid must have icd-10 codes + tariff codes. these can only be supplied by the hospital / treating doctor

resuscitation fee
most hospitals (private) have an emergency dept with resuscitation room.
the emergency dept is run by a private practice using the hospital's infrastructure
(doctors are not allowed to be direct employees of the hospital group)
the resuscitation fee could comprise fees from the private practice that runs the er, + hospital facility fees + radiology (most resuscitation rooms have radiology equipment), + pharmacy fees.
resuscitation (cardiac or respiratory) is carried out only in emergencies - again, a pmb condition. medical aid is obliged to pay in full.
you friend must request an itemized invoice on the resuscitation fee

**paying in full means payment at full medical aid tariff
more often than not actual tariffs are higher than medical aid tariffs - hence co-payments.

if he has problems with medical aid regards the payments, pm me

 

[3Gee]

To correct rhythm yes, to restart heart no.

The fact is that if a patient has flat-lined (Asystole), using a defibrillator will not jump start the heart to beat again. You can google https://www.google.com/search?q=asystole+defibrillator and even the first entry tells you.



and second entry

https://www.ncbi.nlm.nih.gov/books/NBK430866/



I really don't know why you refuse to accept you are wrong in that a stopped heart back can't be shocked back to life.

It would seem that the protocol has changed as stated in your first post above.

Article was updated Jan 2020

 

[3Gee]

Aren’t chess compressions rather for the lungs? Which indirectly pumps the heart.

That's where mouth to mouth comes in. You blowing air into the lungs.

 

[SauRoNZA]

That's where mouth to mouth comes in. You blowing air into the lungs.

They’ve specifically stopped blowing in first aid because it actually doesn’t work and compressions do the job better.

You only blow once if you suspect an obstruction in the airway that needs to be cleared.

 

[3Gee]

They’ve specifically stopped blowing in first aid because it actually doesn’t work and compressions do the job better.

You only blow once if you suspect an obstruction in the airway that needs to be cleared.

How does air enter the lungs then? You do CPR when no breathing and pulse is detected.

Blowing into the mouth is the worst thing possible if there's an obstruction. You going to force it further down.

 

[SauRoNZA]

How does air enter the lungs then? You do CPR when no breathing and pulse is detected.

Blowing into the mouth is the worst thing possible if there's an obstruction. You going to force it further down.

The compression action pulls air into the lungs which indirectly pumps the heart.

I don’t remember the exact details about the obstructions and blowing If I’m honest, but I very clearly remember blowing is no longer recommended.

 

[3Gee]

The compression action pulls air into the lungs which indirectly pumps the heart.

I don’t remember the exact details about the obstructions and blowing If I’m honest, but I very clearly remember blowing is no longer recommended.

You've definitely got it wrong. Have you heard of " bagging " ?

Bagging is to force air into lungs

 

[Bobbin]

The compression action pulls air into the lungs which indirectly pumps the heart.

I don’t remember the exact details about the obstructions and blowing If I’m honest, but I very clearly remember blowing is no longer recommended.

I've heard of that too. I specifically remember reading it somewhere. Cannot confirm/remember where though.

EDIT: Oh it seems it's to promote CPR for skittish people

No mouth-to-mouth required in new CPR rules

In a major change, the American Heart Association said that hands-only CPR — rapid, deep presses on the victim’s chest until help arrives — works just as well as standard CPR for most adults.

www.nbcnews.com

 

[SauRoNZA]

I've heard of that too. I specifically remember reading it somewhere. Cannot confirm/remember where though.

EDIT: Oh it seems it's to promote CPR for skittish people

No mouth-to-mouth required in new CPR rules

In a major change, the American Heart Association said that hands-only CPR — rapid, deep presses on the victim’s chest until help arrives — works just as well as standard CPR for most adults.

www.nbcnews.com

Yeah it changed in between me doing First Aid Lv 2 then redoing First Aid Lv 1.

Kind of optional but not required thing.