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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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The FDA has approved Pfizer's eplerenone (Inspra) for the treatment of congestive heart failure (CHF) in patients who have sustained a myocardial infarction.
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The objective of this monograph is to provide an overview of the scope of allergic disorders, and review the current understanding of the mechanism of the allergic response. Due to the extensive nature of the topic, we will limit our discussion to systemic reactions eliciting an IgE-mediated response. Further, the intimate relationship between organs involved will be reviewed, particularly the relationship between allergic rhinitis and asthma. Part I includes the current evaluation, including historical features, exposures, physical exam findings, and ancillary diagnostic options will be reviewed.
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The FDA has approved Pfizer's eplerenone (Inspra) for the treatment of congestive heart failure (CHF) in patients who have sustained a myocardial infarction.
