Health Matters Blog


Published September 4, 2014

Jon C. Thatcher, MD by Jon Thatcher, MD It is an unpopular reality that our bodies begin a slow decline after our mid 30s as we slide into those “golden years.” Differences in hair color, muscle mass, and eyesight are obvious changes, but what goes unnoticed is the gradual loss of bone mass. Often it is not until a fracture occurs due to a simple fall from a low height, such as standing, that fragile bones become apparent. These “fragility fractures” are most common about the shoulder, wrist, hip, and spine, often require surgery and can have life changing consequences. Osteoporosis has become a well-recognized bone condition. As life expectancy ha...

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When Rapid Care Isn’t Rapid

Published August 22, 2014

Brian Richardson By: Brian Richardson Rapid Care in the BMH Emergency Department is a concept; a process rather than just a place. It is not just a couple of treatment rooms but rather it is a commitment to you and our community. It combines the correct patient with the correct provider in the correct room. It has allowed the Emergency Team to better utilize resources and deliver care in a safe and compassionate fashion. The process in our Emergency Department is also a work in progress, a different train of thought in an environment that demands flexibility. Much of the time this process works but on occasion the rapid care process is anything but rapid. ...

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Dental Care in the Emergency Department (Part 2)

Published August 19, 2014

George Pierce Terwilliger, MD By George Terwilliger, MD In first of this two part series about dental care, I explained the causes and treatment of dental pain. The upshot is that most dental problems are preventable through good diet, regular brushing and flossing, and getting regular professional dental care. Dental problems that bring people to the ED usually are not very amenable to the skill set of emergency departments. Most dental pain needs the services of a dentist or an oral surgeon. Current law states that emergency departments and urgent care centers in Vermont must evaluate every patient who shows up, regardless of ability to pay. However, there is no s...

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Dental Care in the Emergency Department (Part I)

Published August 7, 2014

George Pierce Terwilliger, MD By George Terwilliger, MD Dental problems are among the more common reasons people visit the Emergency Department (ED). In Brattleboro, between 2 and 3% of ED visits are for dental pain. While some of these cases are due to trauma, by far, most are related to dental decay and could have been almost completely prevented with good diet and good dental hygiene. [caption id="attachment_8254" align="alignright" width="199"] George Pierce Terwilliger, MD[/caption] An acute dental pain emergency usually results from a long history of poor diet (prolonged daily exposure to sweets) and poor dental hygiene (inadequate brushing, not flossing an...

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Quality Patient Care in Your Emergency Department

Published July 31, 2014

Laurie Kuralt, BSN, RN, CCRN By Laurie Kuralt, BSN, RN, CCRN Many improvements have been made in the new BMH Emergency Department (ED) as of late. Not only do we have a new, modern facility, but we are working on making improvements about the process of how we care for patients from the time they enter the doors, until they leave. Many of these changes are geared toward improving the patient experience in the ED as well as quality care. We are striving for excellence. As with most change implementation, this takes time and continuously relooking at strategies to get the changes correct. Sustaining the change is the ultimate goal. Some of the improvements we have ma...

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Pertussis in the Community

Published July 25, 2014

By Dr. Kathleen McGraw, CMO Summer is here in full force, and with that comes more outdoor activities, scraped knees, and the occasional summer cold. However this past month we also had a more unwelcome guest in our community – Pertussis. The Vermont Department of Public Health has reported 11 cases of Pertussis in Windham County during the month of June, most of which were children ages 3-17. While none of these cases have been seen in at Brattleboro Memorial Hospital, we do see the need to do all that we can to prevent its further spread. Pertussis, also known as Whooping Cough, can be a very serious illness which is easily spread t...

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Door to Doc

Published July 24, 2014

George Pierce Terwilliger, MD By George Terwilliger, MD Anybody, Anything, Anytime: Emergency Departments have a tall order: provide excellent care to anybody, all age groups, regardless of ability to pay. An ED (Emergency Department) must be able to handle any type of medical illness or trauma, no matter how severe. And this must be done anytime: days, nights and holidays. We are very good at this, as you would expect. Now, we are trying very hard to deliver that care more efficiently with some innovative and effective improvements. [caption id="attachment_8254" align="alignright" width="199"] George Pierce Terwilliger, MD[/caption] When you go to the ED, what y...

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Registration is a Critical Part of Patient Care

Published July 10, 2014

By Deborah Lemnah You’ve probably read and heard a lot over the past year about how Brattleboro Memorial Hospital’s Emergency Department (ED) expansion and renovation project improves patient care. While the Patient Registration staff does not provide medical services, we do play an important role in helping patients have a good ED experience. Before the renovation, ED staff registered their own patients. When you consider 14,000 people visit our emergency department every year, this becomes a difficult task to perform thoroughly while simultaneously providing emergency medical care. To register a patient our registration staff has ...

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Redesigning the Flow of the Emergency Department

Published July 3, 2014

Brian Richardson By: Brian Richardson Emergency medicine has been plagued for decades by two significant issues: first, the issue of Emergency Department overcrowding and second, extended periods of time waiting to be seen by the physician, nurse practitioner or physician’s assistant. [caption id="attachment_8127" align="alignright" width="233"] Brian Richardson[/caption] Since the late 1990s and early 2000s to the present day, emergency departments have seen a significant increase in utilization. Some of this increase can be explained by limited access to primary care physicians and some by changes in the healthcare system. Regardless of the cause...

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Anxiety in the Primary Care Setting

Published June 26, 2014

John Todd, APRN By John Todd, APRN, FNP Anxiety is an emotional and physical health problem. It is marked by feelings of fear, unease, and worry that can sometimes be so severe as to make us feel physically unwell. The source of these feelings is not always known. Sometimes it involves past trauma or injury; sometimes it involves fear about something uncertain in the future. A patient might say to me, “I need something for my anxiety.” They might have had prescriptions in the past for quick-acting medicines such as Xanax, Ativan, Valium, or Klonopin. Those are benzodiazepines, medicines that should only be prescribed with great caution and awarenes...

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