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Emergency Medicine Treatment and Labor Act

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1. Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

for urine drug testing pretreatment and randomly during treatment. The American Pain Society and American Acad- emy of Pain Medicine also teamed up to develop the landmark APS/AAPM 2009 Guidelines (http://americanpainsociety.org/ uploads/education/guidelines/chronic-opioid-therapy-cncp.pdf accessed 07/14/2017), which include examination of various aspects of urine drug testing and recommend pretreatment and concurrent monitoring of patients. The American Society of Ad- diction Medicine (ASAM) released (...) Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients LABORATORY MEDICINE PRACTICE GUIDELINES EDITED BY LORALIE J. LANGMAN AND PAUL J. JANNETTO Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients Co-Sponsored byLABORATORY MEDICINE PRACTICE GUIDELINES Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients Loralie J. Langman Committee Chair Department of Laboratory Medicine and Pathology Mayo Clinic

2018 American Academy of Pain Medicine

2. Civil Monetary Penalties Resulting From Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018. (Abstract)

Civil Monetary Penalties Resulting From Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018. The objective was to describe characteristics of civil monetary penalties levied by the Office of the Inspector General (OIG) related to violations of the Emergency Medical Treatment and Labor Act (EMTALA) involving psychiatric emergencies.Descriptions of EMTALA-related civil monetary penalty settlements from 2002 to 2018 were obtained (...) settlement for psychiatric-related cases was $85,488, compared with $32,004 for non-psychiatric-related cases (p < 0.001). Five (83%) of the six largest settlements during the study period were related to cases involving psychiatric emergencies. The most commonly cited deficiencies for settlements involving psychiatric patients were failure to provide appropriate medical screening examination (84%) or stabilizing treatment (68%) or arrange appropriate transfer (30%). Failure to provide stabilizing

2019 Academic Emergency Medicine

3. Response to Invited Commentary for "Civil monetary penalties resulting from violations of the Emergency Medical Treatment and Labor Act (EMTALA) involving psychiatric emergencies, 2002-2018." (Abstract)

Response to Invited Commentary for "Civil monetary penalties resulting from violations of the Emergency Medical Treatment and Labor Act (EMTALA) involving psychiatric emergencies, 2002-2018." We would like to thank Dr. Bitterman for his thoughtful and detailed commentary on our manuscript "Civil monetary penalties resulting from violations of EMTALA involving psychiatric emergencies, 2002-2018." We appreciate his recognition of the importance of our work in raising the issue of psychiatric care

2019 Academic Emergency Medicine

4. EMTALA (Emergency Medical Treatment and Active Labor Act) Obligations: A Case Report and Review of the Literature. (Abstract)

EMTALA (Emergency Medical Treatment and Active Labor Act) Obligations: A Case Report and Review of the Literature. The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 in the United States to address "patient dumping," or refusing to provide emergency care to patients and instead transferring them to other hospitals. Under EMTALA, the "reverse-dumping" provision prevents hospitals from refusing patients who require specialized capabilities or facilities (...) trauma center, the patient spent 61 days in the intensive care unit; she required 9 operative procedures, which totaled 1,520 minutes of operative time. Eighteen medical specialties and 8 ancillary medical consulting teams were involved in her care. She underwent 1,436 laboratory and 83 radiographic studies. The total reimbursement from Medi-Cal (California's Medicaid program) for her care in our tertiary care center was $463,753; the hospital charges were more than tenfold higher.Dumping and reverse

2019 The Journal of Bone and Joint Surgery. American Volume

5. Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs

synthetic opioids as reported in the media and in other sources of information in Canada and the United States. Finally, the bulletin includes a discussion of the implications of this phenomenon for those working in: ? Public health and harm reduction ? Emergency medical services and emergency response services ? Laboratories ? Poison control centres ? Law enforcement Reports of Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs The following table provides a non (...) -comprehensive sample of recent reports of synthetic opioids appearing in counterfeit pharmaceuticals and other illicit street drugs. The purpose of this table is to illustrate the diversity of the products, their presence throughout North America, and the active substances that have been detected in them. This table is not an exhaustive listing of reports. (All reports were last accessed on June 2, 2016.) † Emerging evidence suggests that W-18 is not an opioid. However, it can be mixed in drugs

2016 Canadian Centre on Substance Abuse

6. Intrapartum care for women with existing medical conditions or obstetric complications and their babies

-for-gestational-age baby 46 1.17 Large-for-gestational-age baby 46 1.18 No antenatal care 47 1.19 Previous caesarean section 50 1.20 Labour after 42 weeks of pregnancy 52 T erms used in this guideline 52 Recommendations for research 54 1 Subarachnoid haemorrhage or arteriovenous malformation of the brain 54 2 Needle siting in pregnant women who are obese 54 Intrapartum care for women with existing medical conditions or obstetric complications and their babies (NG121) © NICE 2019. All rights reserved. Subject (...) to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Last updated April 2019 Page 3 of 963 Obesity as a risk factor for perinatal morbidity and mortality 54 4 Risk assessment for women in labour with signs of sepsis 54 5 Previous caesarean section 55 Rationale and impact 56 Information for women with existing medical conditions 56 Planning for intrapartum care with women with existing medical conditions – involving a multidisciplinary team 56 Risk assessment for women

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

7. Medical Training to Achieve Competency in Lifestyle Counseling: An Essential Foundation for Prevention and Treatment of Cardiovascular Diseases and Other Chronic Medical Conditions: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

medicine. The American College of Lifestyle Medicine also provides a list of institutions that offer certificates or graduate programs for non-MDs who wish to complete programs related to lifestyle and preventive medicine. With the recent interest in the rising incidence of chronic NCDs, continuing medical education programs for practicing physicians also are emerging. A leading example involves 2-day workshops and online materials offered by the Institute of Lifestyle Medicine through Harvard Medical (...) Medical Training to Achieve Competency in Lifestyle Counseling: An Essential Foundation for Prevention and Treatment of Cardiovascular Diseases and Other Chronic Medical Conditions: A Scientific Statement From the American Heart Association Medical Training to Achieve Competency in Lifestyle Counseling: An Essential Foundation for Prevention and Treatment of Cardiovascular Diseases and Other Chronic Medical Conditions: A Scientific Statement From the American Heart Association | Circulation

2016 American Heart Association

8. Emergency Medical Treatment and Labor Act (EMTALA) 2002-15: Review of Office of Inspector General Patient Dumping Settlements Full Text available with Trip Pro

Emergency Medical Treatment and Labor Act (EMTALA) 2002-15: Review of Office of Inspector General Patient Dumping Settlements The Emergency Medical Treatment and Labor Act (EMTALA) of 1986 was enacted to prevent hospitals from "dumping" or refusing service to patients for financial reasons. The statute prohibits discrimination of emergency department (ED) patients for any reason. The Office of the Inspector General (OIG) of the Department of Health and Human Services enforces the statute (...) respectively); 184/192 (95.8%, $6,152,000) settlements were against hospitals and eight against physicians ($205,000). Most common settlements were for failing to screen 144/192 (75%) and stabilize 82/192 (42.7%) for emergency medical conditions (EMC). There were 22 (11.5%) cases of inappropriate transfer and 22 (11.5%) more where the hospital failed to transfer. Hospitals failed to accept an appropriate transfer in 25 (13.0%) cases. Patients were turned away from hospitals for insurance/financial status

2016 Western Journal of Emergency Medicine

9. Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014. (Abstract)

Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014. We determine the incidence of and trends in enforcement of the Emergency Medical Treatment and Labor Act (EMTALA) during the past decade.We obtained a comprehensive list of all EMTALA investigations conducted between 2005 and 2014 directly from the Centers for Medicare & Medicaid Services (CMS) through a Freedom of Information Act request. Characteristics of EMTALA investigations and resulting citation for violations (...) %, and citations from 5.3% to 3.2%, between 2005 and 2014. There were 3.9 EMTALA investigations and 1.7 citations per million emergency department (ED) visits during the study period.We report the first national estimates of EMTALA enforcement activities in more than a decade. Although EMTALA investigations and citations were common at the hospital level, they were rare at the ED-visit level. CMS actively pursued EMTALA investigations and issued citations throughout the study period, with half of hospitals

2016 Annals of Emergency Medicine

10. A Misdirected Patient Transfer Raises Emergency Medical Treatment and Labor Act Liability Issues. (Abstract)

A Misdirected Patient Transfer Raises Emergency Medical Treatment and Labor Act Liability Issues. Children often require transfer to pediatric hospital emergency departments (EDs) after evaluation in community hospital EDs. Such transfers are regulated by the federal Emergency Medical Treatment and Labor Act. Unusual circumstances, such as logistical errors in the physical transfer of the patient, may increase Emergency Medical Treatment and Labor Act-related liability risks for hospitals

2016 Pediatric Emergency Care

11. Chronic pain disorder medical treatment guideline.

information about individual drugs, including indications, contraindications, dosing and time to therapeutic effect, major side effects, drug interactions, and laboratory monitoring. Alpha-acting agents Anticonvulsants Antidepressants Cannabinoid products Hypnotics and sedatives Nonsteroidal anti-inflammatory drugs (NSAIDs) Opioids Post-operative pain management Skeletal muscle relaxants Smoking cessation medications and treatment Topical drug delivery Other agents Anticonvulsants Evidence Statements (...) Frequency (RF) Ablation—Dorsal Nerve Root Ganglion Due to the combination of possible adverse side effects, time limited effectiveness, and mixed study results, this treatment is not recommended . Radio Frequency Ablation—Genicular Nerves: Neurotomy There is currently inadequate evidence to support radiofrequency neurotomy for knee osteoarthritis failing conservative therapy. Radio Frequency Denervation—Medical Branch Neurotomy/Facet Rhizotomy Cooled radiofrequency is generally not recommended due

2017 National Guideline Clearinghouse (partial archive)

12. Complex regional pain syndrome/reflex sympathetic dystrophy medical treatment guideline.

maximum medical improvement (MMI) care, refer to Section J.4, Maintenance Management, Injection Therapy, in the original guideline document. Sympathetic Injections See the original guideline document for description, indications, special considerations, complications, contraindications, relative contraindications, drugs affecting coagulations, and treatment parameters, as well as time to produce effect, frequency, and optimum and maximum duration of treatments. Peripheral Nerve Blocks (...) neuropathic pain, including evidence and time frames for alpha-acting agents, anticonvulsants, antidepressants, cannabinoid products, hypnotics and sedatives, NSAIDs, post-operative pain management, skeletal muscle relaxants, smoking cessation medications and treatment, topical drug delivery, and other agents. Opiods Evidence Statements Regarding Effectiveness and Side Effects of Opioids Strong Evidence In the setting of chronic nonspecific low back pain, the short and intermediate term reduction in pain

2017 National Guideline Clearinghouse (partial archive)

13. Emergency medical treatment and labor act: what every physician should know about the federal antidumping law. (Abstract)

Emergency medical treatment and labor act: what every physician should know about the federal antidumping law. Since 1986, the Emergency Medical Treatment and Labor Act (EMTALA) has imposed an obligation on hospitals and physicians to evaluate and stabilize patients who present to a hospital ED seeking care. Available sanctions for noncompliance include fines, damages awarded in civil litigation, and exclusion from Medicare. EMTALA uses several terms that are familiar to physicians (eg (...) , "emergency medical condition," "stabilize," and "transfer"), but the statutory definitions do not map neatly onto the way in which these terms are used and understood in clinical settings. Thus, there is potential for a mismatch between a physician's on-the-spot professional judgment and what the statute demands. We review what every physician should know about EMTALA and answer six common questions about the law.

2015 Chest

14. Emergency Medicine Treatment and Labor Act

Emergency Medicine Treatment and Labor Act Emergency Medicine Treatment and Labor Act Aka: Emergency Medicine Treatment and Labor Act , EMTALA From Related Chapters II. Background Emergency Medicine Treatment and Labor Act (EMTALA) was Enacted in U.S. in 1986 as part of COBRA Ensures access to emergency services regardless of ability to pay Applies to most hospitals in the United States (those that accept CMS payment) III. Criteria Includes an emergency medical screening to determine if a medical (...) Emergency Medicine Treatment and Labor Act Emergency Medicine Treatment and Labor Act Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4

2018 FP Notebook

15. The Patient Centred Medical Home: barriers and enablers to implementation

relationship with clinicians treating patients, and patients and their family members. • Dedicated care coordination roles • Located within doctor’s office. 12 THE PATIENT CENTRED MEDICAL HOME: BARRIERS AND ENABLERS TO IMPLEMENTATION | SAX INSTITUTE Component of change and why it’s important Barriers/challenges Enablers Care coordination beyond the practice: Supports effective management of patients and transition between emergency department/hospital and primary care. • Continued reliance on paper-based (...) implementation. Performance measurement and feedback Collecting, submitting and receiving feedback on data helps with process improvements necessary for becoming a PCMH despite difficulties in collecting and reporting reliable measures. Roles supporting PCMH functions: • Medical practice assistants • Community health workers • Pharmacists • Integrated community specialists A range of roles exist or are emerging that practices could use effectively in delivering PCMH care: • Medical practice assistants

2018 Sax Institute Evidence Check

16. Safe Medication Use in the ICU Full Text available with Trip Pro

, establishing causality of death in an ICU patient as a direct result from a specific medication remains a challenge due to the presence of multiple confounding variables such as comorbid disease states, severity of illness, and treatment variability ( ). One report estimated 106,000 hospitalized patients in the United States experienced a fatal adverse drug reaction (ADR) during 1994 ( ). Comparing the fatal ADR rate to the overall recorded death rate (2,286,000) during that same year, these drug-induced (...) ), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare & Medicaid Services (CMS), and the National Library of Medicine improve consumer-oriented drug information resources and medication self-management support ( ). Overall, several government, as well as, nonprofit organizations have identified medication safety as a priority for healthcare in the United States ( ). The Institute of Healthcare Improvement and Institute for Safe Medication Practices (ISMP) provide tools and resources

2017 Society of Critical Care Medicine

17. British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum

. | | Previous perinatal episodes of illness in the women and family history of severe perinatal episodes. | | The woman’ s treatment history including her responses and tolerability to medication, talking therapy and other interventions and her experience of them. | | Past episodes of self-harm, suicide attempts and risks to others. | | Duration of remissions on and off medication. | | Social functioning. | | Time to relapse after previous discontinuation. | | Time to recovery on reintroduction (...) of Pharmaceutical Science, King’s College London, London, UK 25 Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK 26 University of Manchester, Manchester, UK 27 UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK 28 Institute of Genetic Medicine, Newcastle University, Newcastle, UK Corresponding author: R H McAllister-Williams, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL

2017 British Association for Psychopharmacology

18. The enduring role of the Emergency Medical Treatment and Active Labor Act. Full Text available with Trip Pro

The enduring role of the Emergency Medical Treatment and Active Labor Act. The Emergency Medical Treatment and Active Labor Act (EMTALA) is a seminal law that imposes screening, stabilization, and transfer duties on all Medicare-participating hospitals that have emergency departments. More than twenty-five years after its enactment, EMTALA continues to generate controversy over the scope and depth of its obligations on issues ranging from the nature of the screening obligation and rules (...) regarding on-call specialists to whether EMTALA's stabilization protections exclude emergency inpatients. Despite ongoing questions that flow from its detailed provisions, EMTALA is an enduring testament to society's evolving views that hospitals must provide emergency care not only to their established patients but to the broader communities they serve.

2013 Health affairs

19. Routine psychosocial care in infertility and medically assisted reproduction ? A guide for fertility staff

for a healthy experience of treatment Risk factors Valid assessment tools Psychosocial care that DOES NOT REQUIRE - Presence of mental health professionals - Specialized training 8 For instance, medical doctors usually provide information about treatment to patients and can use validated interventions. Administrative personnel usually deal with bureaucratic issues and can use the tools described in Appendix 2 for service user evaluation. Interventions that can only be delivered by mental health (...) -566. Dancet EA, Nelen WL, Sermeus W, De Leeuw L, Kremer JA, D'Hooghe TM. The patients' perspective on fertility care: a systematic review. Hum Reprod Update 2010;16: 467-487. Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977;196: 129-136. Fann JR, Ell K, Sharpe M. Integrating psychosocial care into cancer services. J Clin Oncol 2012;30: 1178-1186. Gameiro S, Boivin J, Domar A. Optimal in vitro fertilization in 2020 should reduce treatment burden and enhance care

2015 European Society of Human Reproduction and Embryology

20. Does The Emergency Medical Treatment and Labor Act Affect Emergency Department Use? (Abstract)

Does The Emergency Medical Treatment and Labor Act Affect Emergency Department Use? Emergency departments (EDs) face increasing patient volumes and economic pressures. These problems have been attributed to the Emergency Medical Treatment and Labor Act (EMTALA).To determine whether modifying EMTALA might reduce ED use.We surveyed ED patients to assess their knowledge of hospitals' obligations to treat all patients regardless of insurance and to determine whether knowledge is associated with ED

2012 Journal of Emergency Medicine

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