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When a patient presents at your ED with exposure to a potentially hazardous, but unknown substance, under what conditions do you shut down or limit operations? And what can you do to minimize your departments downtime?
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On Nov. 21, 2004, an 18-month-old baby was injured critically in a car accident with three fatalities. The baby was rushed by paramedics to the ED at Southeast Arizona Medical Center in Douglas, a small, rural town along the U.S.-Mexico border. The baby was in shock and had lost almost two-thirds of her blood from multiple injuries. She was minutes from death, and the nearest trauma center was in Tucson, more than 100 miles away.
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Random unannounced surveys conducted in 2005 by the Joint Commission on Accreditation of Healthcare Organizations will focus on the following fixed areas in hospitals.
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Neurologic emergencies of pregnancy range from life-threatening conditions such as eclamptic seizures to self-limiting disorders like meralgia paresthetica. This discussion will include those neurologic disorders directly resulting from pregnancy or the puerperium, those that are pre-existing conditions but now affect the pregnant patient or are affected by the gravid state of the patient, and those disorders that are not directly related to the pregnancy but may first become apparent during the gravid state.
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Infants with an apparent life-threatening event (ALTE) present for medical attention because an acute and unexpected incident has alarmed the caregivers. These frightening episodes of apnea and color change in infants have generated considerable concern in both professional and lay groups. This article reviews the presentation, recognition, diagnosis and ED management for children who present with an ALTE.
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Part I of this series focused on hypertensive syndromes and clinical evaluation. This second and final part will cover antihypertensive medications and management of hypertension in specific disease processes.
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The turnover of ED physician contracts at Methodist Hospital in St. Louis Park, MN, has brought into focus some of the major issues evolving in the competition between smaller, physician-owned ED groups and the larger corporate entities, such as EmCare, of Dallas; Team Health of Knoxville, TN; and Sterling Healthcare of Durham, NC. While some of those issues are philosophical, others are legal and may have significant implications for ED managers.
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When Ocala (FL) Regional Medical Center announced a new screening initiative that would involve counseling nonurgent patients to seek alternative care, a funny thing happened: Local competitors Monroe Regional and Timber Ridge became involved when they heard about our initiative, because they felt they would then be inundated by patients who were not having their treatment here, notes Susan Atkin, RN, ED director.
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The screening/counseling initiative employed by HCA facilities in Houston and Ocala, FL, appears to be in compliance with the Emergency Medical Treatment and Labor Act (EMTALA), says one expert. However, he notes that there are many aspects of the act that apply to these processes, and its crucial that ED managers understand what they are and how they can affect the design of such initiatives.
