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EMTALA: The Essential Guide to Compliance from Thomson American Health Consultants, publisher of Emergency Medicine Reports, explains how the changes to EMTALA will affect emergency departments and off-campus clinics.
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The ED physician and trauma surgeon must have evidence-based
information on indications for emergency department thoracotomy that
can be determined rapidly, easily accessible equipment, and the ability
to recognize situations in which EDT clearly is not in the patients
best interest.
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In this randomized control trial, Schneiderman and Associates evaluated the effect of an intervention, namely, an ethics consultation, on several variables associated with the care of patients eventually dying in the ICU.
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Measuring the quality of a complex service like critical care that combines the highest technology with the most intimate caring is a challenge. Recently, consumers, clinicians, and payers have requested more formal assessments and comparisons of the quality and costs of medical care.
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New rules put forth by the bush administration that took effect on Nov. 10 significantly relax strictures in the 1986 Emergency Medical Treatment and Labor Act (EMTALA) that required hospitals and some hospital-owned clinics to examine and treat people who need emergency medical care even when those patients cant pay.
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Using a universal consent form for multiple procedures anticipated for a patient can nearly double the consent rate for most of the invasive procedures performed in an intensive care unit, according to researchers in Chicago. But observers say the tactic may violate the spirit of the informed consent process.
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The universal consent form described eight commonly performed procedures: placement of an arterial catheter, a central venous catheter, a pulmonary artery catheter, a peripherally inserted central catheter, lumbar puncture, thoracentesis (surgical puncture through the chest wall with drainage of fluid from the thoracic cavity), paracentesis (surgical puncture through the abdominal wall with drainage or aspiration of fluid from the abdominal cavity), and intubation/mechanical ventilation.
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A patient daily goals checkoff form used twice daily during rounds has helped the surgical intensive care unit (SICU) team at Hartford (CT) Hospital achieve a 25% drop in its mortality rate, while cutting lengths of stay and ventilator days.
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