Oil rig explodes in Okla.; no reports of injuries

September 20, 2011

Authorities in Blaine County say an oil rig that exploded near Watonga and forced the evacuation of several homes caused no injuries.

Blaine County Sheriff’s dispatcher C.J. Woulard said Tuesday morning that the fire was still burning _ but no injuries were reported.

County Sheriff Ricky Ainsworth told reporters that homes within a two mile radius were evacuated following the Monday night explosion about 80 miles northwest of Oklahoma City. Ainsworth did not immediately return a phone call for further comment early Tuesday.

Assistant Watonga Fire Chief Verlen Bills told The Oklahoman (http://bit.ly/pZ3f6A) that the cause of the explosion was not known.

Witness Maria Slay told The Oklahoman that she heard four or five explosions and said workers are at the drilling rig around the clock.

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Information from: The Oklahoman, http://www.newsok.com

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Real-time tracking of diseases improves diagnosis

By LAURAN NEERGAARD AP Medical Writer

September 20, 2011

The doctor doesn’t think your sore throat is bad enough yet to order a strep test _ unaware that a dozen people across town were diagnosed with strep throat just last week.

Doctors rarely know what bugs are brewing in the neighborhood until their own waiting rooms start to fill. Harvard University researchers reported Monday that getting them real-time information on nearby infections could improve patient care _ for strep throat alone, potentially helping tens of thousands avoid either a delayed diagnosis or getting antibiotics they didn’t need.

“The risk you have is based on where you live and what the people around you have,” explains Dr. Kenneth Mandl of Children’s Hospital Boston, affiliated with Harvard. His analysis of 82,000 patient visits found that knowing how much strep throat is circulating can help improve the accuracy of the next patient’s diagnosis.

Today, hundreds of hospitals, clinics and health departments automatically report certain symptoms and diagnoses to the government. That practice has a wonky name _ biosurveillance _ but it’s how officials track the spread of flu, detect the latest whooping cough outbreak, and watch for weird symptoms that might signal a brand-new disease or even bioterrorism.

But until there’s an outbreak, that information is a one-way street. There’s no easy way for doctors to learn what their colleagues nearby diagnosing. Instead, doctors often call the health department to ask if anyone’s heard of a case of this or that disease as they puzzle over a patient’s symptoms, says Dr. Alfred DeMaria of the Massachusetts Department of Public Health.

Giving doctors a fast, ongoing snapshot of disease “would be very helpful,” says DeMaria, who wasn’t involved in Mandl’s research but praises the approach. “The key is to make the system entirely automated and real-time.”

Work is beginning on technology to do just that, trying to link local biosurveillance to electronic health records, maybe even mobile apps.

First, the question is whether such tracking could make a real difference. So Mandl and his colleague Dr. Andrew Fine, an emergency medicine physician, examined strep throat, an infection frequently misdiagnosed in adults.

Because strep throat is more common in young children, those with red, sore throats are given either a while-you-wait rapid test or, because that test sometimes misses the bug, a throat culture that can take a day or two for results.

For anyone 15 or older, guidelines say doctors shouldn’t order a test or prescribe antibiotics unless sore-throat sufferers rise to a certain level of suspicion because of other symptoms: fever, enlarged lymph nodes, tonsils with swelling or pus, and a lack of coughing. People with none or just one of those symptoms probably have a virus and are supposed to be sent home. A patient with a lot of those symptoms often are given antibiotics automatically, and those in between get tested.

Mandl and Fine turned to records from CVS MinuteClinics in six states where all sore-throat patients are tested and symptoms are recorded. What the government-funded study found: Knowing how prevalent strep is in a particular area is a strong enough predictor to count as an extra symptom in the test-or-treat decision.

In other words, if little strep throat is circulating, the chances that someone with several strep symptoms really has it drops enough that it’s worth testing them before prescribing antibiotics. Considering there are 10.5 million annual health-care visits for suspected strep throat, that change could prevent unnecessary antibiotics for more than 166,000 patients, the researchers reported.

On the flip side, someone with just a sore throat and fever usually wouldn’t get tested but if the strep germ is prevalent in their community, testing could spot 62,000 previously missed patients nationally, the researchers calculated. Their study appears Monday in the journal Annals of Internal Medicine.

Strep isn’t the only example. In smaller studies, Mandl and Fine have found that knowing how much whooping cough and bacterial meningitis are spreading locally can improve diagnosis of those diseases, too.

The challenge is how to disseminate such information fast enough for doctors to use. MinuteClinic, for example, says it doesn’t record test results in real time yet but may be able to share that kind of data in the future.

Broadening the concept, federal health officials are working to create an easy-to-use Web tool that would let doctors search for local surveillance information. They also are testing how to automatically send alerts about disease outbreaks to the electronic health records of patients with similar symptoms.

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EDITOR’S NOTE _ Lauran Neergaard covers health and medical issues for The Associated Press.

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

10th person dies from injuries in Reno air crash

By DON THOMPSON and SCOTT SONNER Associated Press

September 19, 2011

A Reno hospital spokeswoman says a 10th person has died as a result of Friday’s air show crash.

Saint Mary’s Regional Medical Center says a male patient died overnight.

Spokeswoman Jamii Uboldi says she can’t immediately release the patient’s name, age and hometown.

She says one patient remains in critical condition and five are in serious condition at the hospital in Reno.

Authorities say 70 people were treated at area hospitals.

The latest death brings the total to 10 people killed _ the pilot and nine spectators.

The P-51 Mustang crashed Friday afternoon at the National Championship Air Races at the Reno Stead Airport.

THIS IS A BREAKING NEWS UPDATE. Check back soon for further information. AP’s earlier story is below.

Amid the horrific aftermath of the nation’s deadliest air racing disaster, a crash that killed nine and sent about 70 people to Reno-area hospitals, a sort of calm pervaded.

Witnesses were spattered with blood and pieces of flesh, yet video of the scene shows paramedics, police and spectators attending to the wounded with a control that seems contradictory to the devastation.

Officials and those in the tightly-knit air racing community credit not only a detailed plan for just such a crash, but the type of people at the event: pilots, veterans and others accustomed to dealing with a high-pressure situation.

Doctors, nurses and military veterans from the crowd volunteered their services to emergency crews, said Reno Fire Battalion Chief Tim Spencer, a 29-year veteran who has worked at the air races for 27 years. Those without medical skills helped firefighters transport the injured.

“It wasn’t uncommon to see one firefighter and three people in civilian clothes carrying a litter to the proper area” for evacuation, Tim Spencer said. “Everybody pulled together perfectly and worked side by side.”

Such cooperation helped save Ed Larson, one of the victims cut down by a wall of shrapnel kicked up when the Galloping Ghost, a souped-up WWII-era P-51 Mustang fighter plane, crashed into the VIP section Friday, disintegrating over a two- to three-acre area.

Metal fragments and wreckage hit Larson, 59, in the head and back and legs, shredding his calf and severing his Achilles tendon. He was knocked unconscious but came to as he was being loaded on a transport helicopter.

“All I saw was a real coordinated effort,” Larson said from a wheelchair at Renown Regional Medical Center, which handled 36 of the most severely injured patients, including two who died.

The carnage left even seasoned emergency room surgeons and rescue workers shaken.

“This is the worst I’ve seen,” said Dr. Mike Morkin, the emergency services director at Renown. He did his trauma training at Cook County Hospital in Chicago and helped in the aftermath of Chicago’s Paxton Hotel fire that killed 19 people in 1993. Yet he said he had never seen so many patients with such severe injuries at one time.

Paramedics, police and firefighters, hospitals and event organizers had drilled for such a disaster, some just hours earlier.

“This happened so fast, there was just a sense of shock. But people were very calm. You know, they didn’t know me. They came, held my hand, told me I was going to be all right,” Noah Joraanstad, a 25-year-old commercial airline pilot from Anchorage, Alaska, told The Associated Press from his hospital bed at Northern Nevada Medical Center in Sparks. “They walked into a scene where people were amputated, whatever, and just carnage everywhere, and they decided to help. To me, those were the real heroes.”

Emergency workers were quickly putting into practice the skills they’d learned in drills. They separated the wounded depending on the severity of injuries as ambulances and transport helicopters moved in. A Vietnam-era Huey helicopter from a military display was pressed into service to fly victims to the hospital.

“It was triage on the tarmac,” said David Edgecomb, 41, a volunteer security guard from Paradise, Calif., who said he saw a man in an electric wheelchair dead in the spectator area. Edgecomb cut strips of bunting from the VIP boxes into strips to be used for tourniquets, while larger pieces of the material were used to cover body parts.

The Rev. Thomas Babu was at St. Michael’s Catholic Church four blocks from the airport when he saw the fire engines and ambulances streaming past.

“I thought it was my duty to go there,” said Babu, 37.

He held hands and prayed with the family of a woman who had been killed.

“Tragedy brings people together. We become more good human beings when there is something bad happening around us,” he said.

In an interview with a cable news station on Monday, National Transportation Safety Board member Mark Rosekind said investigators were analyzing the “tremendous amounts of material” collected at the scene and submitted by spectators who photographed and videotaped the crash.

A key focus of the investigation is the tail of the high performance aircraft, which some photos seem to show lost a part before the crash.

“There are a lot of photos of specific aspects of the tail,” Rosekind said. “We have found in the wreckage some parts of tail from the accident aircraft. We have those photos.”

Gov. Brian Sandoval said some of the air race emergency crews had dealt with victims just two weeks ago when Eduardo Sencion opened fire in Carson City with an AK-47 assault rifle. He shot 11 people before turning the weapon on himself. Four victims died, including three members of the Nevada National Guard at an International House of Pancakes restaurant.

“We’ve had two incredible tragedies in the last two weeks. We have a lot of heroes here,” Sandoval said. “They have been trained and they have been training and today it showed. It paid off.”

Michael Houghton, president and CEO of the Reno Air Races, said it took 62 minutes to get all of the injured on their way to area hospitals, a pace of about one each minute.

“They kind of came in waves,” said Morkin, the Renown hospital ER director. “You’re just running from one patient to the next. You stabilize one … and you go to the next patient.”

Some lost limbs, others had severe facial wounds. There were many patients with broken bones or lacerations. Two of the patients in critical condition had massive head injuries.

Yet it could have been far worse, officials said as the National Transportation Safety Board investigated what went wrong at the National Championship Air Races afternoon.

The plane crashed at the edge of the crowd, narrowly missing the grandstand where thousands more people were watching. Spectators were sprayed with aviation fuel, but the plane did not explode, and its fuel did not catch fire.

Ken Liano, a structural engineer and aircraft consultant, was surprised the plane didn’t explode into a fireball, as was the case in a fiery accident a day later at a West Virginia air show that killed the pilot but did not harm spectators.

“I guess God was on the people’s side,” Liano said.

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Associated Press writer Ken Ritter contributed to this story.

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Witness recounts plane crash into Ind. golf course

September 16, 2011

A man who witnessed a small plane crash into an Indiana golf course says he rushed to help, but both occupants were dead when he arrived.

Eric Smith tells the Indianapolis Star ( http://bit.ly/oVE1KT) he was the first to reach the plane Thursday afternoon after it circled above the Harbour Trees Golf Club in Noblesville, 25 miles north of Indianapolis, and “corkscrewed” onto a green.

The 45-year-old Smith, who lives near the golf course, says he pulled away a wing that was lying on top of one of the occupants, but the man had no pulse. Only when emergency personnel arrived did he realize there was a second man in the plane.

Noblesville Police Lt. Bruce Barnes says the identities of the victims wouldn’t be released until family members are notified.

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Information from: The Indianapolis Star, http://www.indystar.com

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.