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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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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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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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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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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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Although vasculitic diseases generally are uncommon in the pediatric population, early recognition of processes that do occur is important to prevent sequelae. The authors provide a comprehensive review of the most common vasculitic diseases in children, with an emphasis on diagnostic clinical features, key laboratory studies, and appropriate therapy.
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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. In-depth articles, at-a-glance tables, and Q-and-As on real-life situations are presented, and key differences between the "old" EMTALA and the new changes are succinctly explained,
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What would happen today if a patient with suspect or probable SARS were admitted to your hospital? To help you prepare for the threat, Thomson American Health Consultants offers the upcoming audio conference: The Resurgence of SARS: Why your hospital may not be as prepared as you think, on Dec. 9, from 2:30-3:30 EST. Let our experts help you answer that and many other critical questions with practical tips and solutions to detect first cases and protect other patients and health care workers.
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To improve patient survival, the emergency physician (EP) must be knowledgeable about current concepts and controversies in the management of patients in shock. No longer can one simply rely on the presence of traditional clinical markers of shock to make the diagnosis. New and innovative monitoring techniques, as well as continually evolving treatment algorithms, are at the forefront of shock research. This article will educate and update the EP on current and future trends in the management of patients in shock. Equipped with this information, the EP more effectively can identify patients in shock, administer the latest evidence-based treatment, and ultimately improve patient outcome.
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This column addresses reader questions about the Emergency Medical Treatment and Labor Act (EMTALA).
