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With the release of the National Health Security Strategy (www.hhs.gov/disasters) and interim implementation guide for protecting public health in a large-scale emergency, the Department of Health and Human Services (HHS) has taken the first step toward the realization of a vision long held by emergency response individuals and organizations: a cohesive plan to be followed by everyone in the nation who is involved in disaster response.
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A review of the literature has revealed that injuries in the elderly resulting from motor vehicle crashes has been underdetected, and resulted in patients being inappropriately treated or assigned to nontrauma centers. The article was published in the January 2010 issue of the Journal of Emergency Nursing.
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Many facilities and EDs use the tool called the modified early warning score (MEWS), which includes questions about the patient's health state, to determine if patients are getting sicker and if they require transfer to the intensive care unit (ICU).
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A change in documentation procedures in the ED played a significant role in making it possible for Porter Adventist Hospital in Denver to receive certification as an advanced primary stroke center by The Joint Commission.
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Recognizing that ED wait times and throughput are affected by the entire hospital, the leaders at King's Daughters Medical Center in Ashland, KY, engaged all the departments that interface with the ED and slashed the rate at which ED patients leave before treatment from 5% to 0.5%.
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Passive leg raising (PLR), a rapidly reversible maneuver that simulates rapid volume expansion by putting several hundred milliliters of fluid back into the circulation, has been shown to predict fluid responsiveness in mechanically ventilated patients.
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Imagine being sued by a patient for an alleged act of malpractice, but evidence is introduced in the courtroom that leads the jury to believe another practitioner not yourself is the one who is truly at fault.
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Some EDs are now offering online updates on current wait times, with the stated expectation that patients will use this information to make better decisions on where to go for care.
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Whether the Emergency Medical Treatment and Active Labor Act (EMTALA) ends upon admission or extends indefinitely until the admitted patient is eventually discharged or transferred has been debated by the courts, government agencies, and EMTALA pundits for years without definitive resolution.