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Raurich and colleagues studied 80 patients with acute respiratory distress syndrome (ARDS) to determine whether the alveolar dead-space fraction (VD/VT, the proportion of each breath that does not participate in gas exchange) was a predictor of ultimate survival. The patients were ages 18 years or older, acutely ill in the investigators' ICU, and met the current international diagnostic criteria for ARDS.
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This study from a surgical ICU in a french university hospital sought to determine the effect on catheterization duration of a daily reminder notifying physicians that the patient had a central venous catheter (CVC) or urinary tract catheter (UTC) and asking whether there was continued need for that catheter.
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So many elderly patients in the ED are lonely, often troubled by depression, victims of abuse, or facing end-of-life decisions. The emergency physician often is called upon to handle these concerns.
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"Good people who exercised poor judgment" recently took cell phone pictures of a shark attack victim who later died in the ED at Martin Memorial Medical Center in Stuart, FL, according to a statement released by hospital officials. Although no staff members were fired, the hospital has disciplined several ED employees for taking the cell phone pictures and has asked anyone with copies of the photos to destroy them.
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Taking nearly seven months to transition from an ED staffing model of a contracted physician group to one that involved a partnership with a neighboring medical school might seem overly long, but the leadership at St. Joseph's Hospital in Buckhannon, WV, says they wanted to "do it right." That process included bringing on properly credentialed physicians, as well as doctors who would relate well with the surrounding community.
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The Joint Commission has approved revisions to Medical Staff (MS) 01.01.01, formerly known as MS.1.20. This standard, it says, "is designed to contribute to patient safety and quality of care through the support of a well-functioning, positive relationship between a hospital's medical staff and governing body."
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The Joint Commission is seeking comments in two areas of concern to ED managers: candidate performance measures for inpatient and ED care of sudden cardiac arrest patients, and its revised National Patient Safety Goal (NPSG) 03.07.01, which addresses medication reconciliation.
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[Editor's note: ED Management issued an e-bulletin to readers on March 24, 2010, about health care reform's impact on EDs. We also described recent studies on the impact of health care reform in Massachusetts on ED crowding. ED Management issues such bulletins to keep readers informed of the latest developments in emergency management. If you wish to receive future ED Management bulletins, contact customer services at (800) 688-2421 or
[email protected].]
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In the face of steadily increasing volumes (13,000 between 2008 and 2009), the ED at Peninsula Regional Medical Center in Salisbury, MD, has improved all of its operating statistics, achieving a 'door-to-bed' time of three minutes and a door-to-doc time of 21 minutes.
