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Emergency Medicine Treatment and Labor Act

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181. Perirectal Abscess (Treatment)

if the patient is elderly, febrile, hypotensive, or immunocompromised or has significant comorbidities. Transfer, if warranted, may be safely carried out if the patient is hemodynamically stable. Instability resulting from a concurrent condition or sepsis makes transfer to another institution inappropriate (and possibly illegal under the Emergency Medical Treatment and Active Labor Act [EMTALA]) unless transfer to allow delivery of a higher level of care is in the patient’s best interest. Next: Pharmacologic (...) , Department Of Emergency Medicine, State University of New York Downstate Medical Center Nizar Kifaieh, MD, FACEP is a member of the following medical societies: , , , , , and Disclosure: Nothing to disclose. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Medscape Salary Employment Patrick B Thomas, MD Fellow, Department of Pediatric Surgery, Texas Children's Hospital Disclosure

2014 eMedicine Emergency Medicine

182. Schizophrenia (Treatment)

, the type of restraint used (eg, locked room vs 4-point leather), the maximum duration of restraint, and reasons for involuntary commitment. [ ] Follow all Consolidated Omnibus Budget Reconciliation Act (COBRA) regulations when transferring patients to another facility for psychiatric care. Be familiar with hospital and ED specific regulations, Health Insurance Portability and Accountability Act (HIPAA) rules, regional statutes, and Emergency Medical Treatment and Labor Act (EMTALA) requirements (...) complications of schizophrenia and its treatment. Blood levels of certain psychiatric drugs, such as lithium and antiseizure medications used as mood-stabilizers (eg, valproic acid, carbamazepine), can be used to confirm compliance or rule out toxicity. Serum alcohol levels and drugs-of-abuse screening (blood and/or urine) can be useful when substance abuse is suspected. Interpreting the results of a fingerstick blood glucose determination is a rapid and inexpensive method of ruling out a diabetic emergency

2014 eMedicine Emergency Medicine

183. Rhabdomyolysis (Treatment)

facility if necessary. Follow the guidelines of the Consolidated Omnibus Budget Reconciliation Act (COBRA) and the Emergency Medical Treatment and Labor Act (EMTALA). In natural disasters, patients often have to be evacuated out of affected areas and transported to locations that can provide dialysis services. [ ] Once they are well hydrated, patients with normal renal function, normal electrolyte levels, alkaline urine, and an isolated cause of muscle injury may be discharged and monitored (...) and treatment of rhabdomyolysis. Eur J Radiol . 2008 Feb. 65(2):311-5. . [Guideline] Finnish Medical Society Duodecim. Rhabdomyolysis. EBM Guidelines. Evidence-Based Medicine [Internet] . Helsinki, Finland: Wiley Interscience. John Wiley & Sons; 2007 Apr 12. . Better OS, Stein JH. Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis. N Engl J Med . 1990 Mar 22. 322(12):825-9. . Iraj N, Saeed S, Mostafa H, Houshang S, Ali S, Farin RF, et al. Prophylactic fluid therapy

2014 eMedicine Emergency Medicine

184. Abdominal Trauma, Penetrating (Treatment)

stabilizing surgical intervention. Obviously, if no surgeon is available, transfer may be the only course of action. Practitioners must be cognizant of Emergency Medical Treatment and Active Labor Act (EMTALA)/Consolidated Omnibus Budget Reconciliation Act (COBRA) violations and document accordingly (see ). This legislation was enacted with the intention of removing economic considerations from important medical decisions in the ED. Previous Next: Initial Emergency Department Care A team leader should (...) General Hospital and Harvard Medical School Robert L Sheridan, MD is a member of the following medical societies: , , , and Disclosure: Nothing to disclose. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Medscape Salary Employment Paul A Testa, MD, JD, MPH Attending Physician, Department of Emergency Medicine, New York University School of Medicine Paul A Testa, MD, JD, MPH

2014 eMedicine Emergency Medicine

185. Gastroenteritis (Treatment)

if the diagnosis is uncertain. Manage complications. Transfer Transfer of the unstable patient is inappropriate under Emergency Medical Treatment and Active Labor Act (EMTALA) regulations unless benefits clearly outweigh risks. Unless the patient requires admission and has a complicated medical condition that would be better managed in another facility, transfer is neither necessary nor recommended. Next: Consultations A consultation with an infectious diseases specialist may be necessary for patients (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzc1Mjc3LXRyZWF0bWVudA== processing > Emergent Treatment of Gastroenteritis Treatment & Management Updated: Feb 10, 2017 Author: Arthur Diskin, MD; Chief Editor: Steven C Dronen, MD, FAAEM Share Email Print Feedback Close Sections Sections Emergent Treatment of Gastroenteritis Treatment Emergency Department Care Prehospital care is directed toward early and aggressive fluid therapy in patients who are unstable. The following discussion involves management in the emergency department (ED). Goals of therapy Goals

2014 eMedicine Emergency Medicine

186. Neonatal Resuscitation (Treatment)

of regulated suction, instruments and supplies for establishing intravenous (IV) access, trays equipped for emergency procedures, and drugs that may be useful in resuscitation. Respiration equipment includes the following: Stethoscope Cardiorespiratory leads for neonates and cardiorespiratory monitor Pulse oximeter leads (neonatal size) and pulse oximeter monitor Oxygen supply with blender, set to 10 L/minute Assorted masks (term and preterm mask sizes) Positive Pressure Ventilation (PPV) device and tubing (...) compressions. Additional personnel should be immediately available to assist in tasks that may be required as part of resuscitation, including intubation, medication administration, and emergency procedures, if needed. If the delivery is identified as high-risk, at least 2 or more skilled individuals should be assigned to the infant at delivery. Remember that staff trained in neonatal resuscitation must apprentice with experienced personnel for some time before they can be independently responsible

2014 eMedicine Pediatrics

187. Maternal Chorioamnionitis (Treatment)

sepsis in neonates are prompt recognition of bacterial infection, antimicrobial therapy, and supportive care. (In this review, supportive care is only briefly discussed below. See the Medscape Drugs and Disease article for a more in-depth care of these critically-ill neonates.) Treatment of the neonate Communication between obstetric and pediatric caregivers is essential to recognize neonatal infection. Recognition or suspicion of maternal chorioamnionitis is essential to reducing neonatal morbidity (...) Maternal Chorioamnionitis (Treatment) Chorioamnionitis Treatment & Management: Approach Considerations, Medical Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTczMjM3LXRyZWF0bWVudA

2014 eMedicine Pediatrics

188. Perianal Abscess (Treatment)

if the patient is elderly, febrile, hypotensive, or immunocompromised or has significant comorbidities. Transfer, if warranted, may be safely carried out if the patient is hemodynamically stable. Instability resulting from a concurrent condition or sepsis makes transfer to another institution inappropriate (and possibly illegal under the Emergency Medical Treatment and Active Labor Act [EMTALA]) unless transfer to allow delivery of a higher level of care is in the patient’s best interest. Next: Pharmacologic (...) , Department Of Emergency Medicine, State University of New York Downstate Medical Center Nizar Kifaieh, MD, FACEP is a member of the following medical societies: , , , , , and Disclosure: Nothing to disclose. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Medscape Salary Employment Patrick B Thomas, MD Fellow, Department of Pediatric Surgery, Texas Children's Hospital Disclosure

2014 eMedicine Surgery

189. Blunt Chest Trauma (Treatment)

. This approach is most frequently used when severe associated injuries are present that require urgent correction. Temporizing medical therapy includes the administration of short-acting beta-blockers (eg, labetalol, esmolol) to control the heart rate and to decrease the mean arterial pressure to approximately 60 mm Hg. Because repair of thoracic aortic injuries using cardiopulmonary bypass is associated with fewer major neurologic complications, some authors advocate stabilization of the victim plus beta (...) , in those with rib fractures. Elderly patients with three or more rib fractures have been shown to have a fivefold increase in mortality and a fourfold increase in the incidence of pneumonia. Effective pain control is the cornerstone of medical therapy for patients with rib fractures. For most patients, this consists of oral or parenteral analgesic agents. Intercostal nerve blocks may be feasible for those with severe pain who do not have numerous rib fractures. A local anesthetic with a relatively long

2014 eMedicine Surgery

190. Abdominal Trauma, Penetrating (Treatment)

stabilizing surgical intervention. Obviously, if no surgeon is available, transfer may be the only course of action. Practitioners must be cognizant of Emergency Medical Treatment and Active Labor Act (EMTALA)/Consolidated Omnibus Budget Reconciliation Act (COBRA) violations and document accordingly (see ). This legislation was enacted with the intention of removing economic considerations from important medical decisions in the ED. Previous Next: Initial Emergency Department Care A team leader should (...) General Hospital and Harvard Medical School Robert L Sheridan, MD is a member of the following medical societies: , , , and Disclosure: Nothing to disclose. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Medscape Salary Employment Paul A Testa, MD, JD, MPH Attending Physician, Department of Emergency Medicine, New York University School of Medicine Paul A Testa, MD, JD, MPH

2014 eMedicine Surgery

191. Shoulder Dislocations (Treatment)

Shoulder Dislocations (Treatment) Shoulder Dislocation Surgery Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) Medicine Clinic Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Pekka A Mooar, MD Professor, Department of Orthopedic Surgery, Temple University School of Medicine Pekka A Mooar, MD is a member of the following medical societies: Disclosure: Nothing to disclose

2014 eMedicine Surgery

192. Corneal Abrasion (Treatment)

Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Chief Editor Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director for Emergency Medicine, Sanz Laniado Medical Center, Netanya, Israel Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: , , , , , , , , , Disclosure: Nothing (...) upper and lower eyelids should be flipped in order to look for foreign bodies that may be lodged in the upper eyelid, causing injury with eye blinking. Corneal foreign body. The cornea can become hazy if there is edema due to the abrasion. Conjunctival injection usually located near the limbus may also be present. Previous Next: ED Treatment Considerations Tetanus prophylaxis, eye patching, and antimicrobial therapy for patients with corneal abrasions who present to the emergency department (ED

2014 eMedicine Emergency Medicine

193. Supporting adult carers

. This guideline covers general principles that apply to all adult carers. Recommendations about supporting carers of people with specific health needs can be found in NICE guidance on those conditions. This guideline should be read together with the Care and support statutory guidance under the Care Act 2014 and the Children and Families Act 2014. Who is it for? Who is it for? Local authorities, clinical commissioning groups and other organisations that assess, plan, and commission local services or provide (...) support and information for adult carers and people receiving care Providers of health and social care services, including: Social care providers Primary care (including pharmacists and GPs) Hospital and community care (including acute and mental health trusts and residential care) Emergency services Community and voluntary organisations Health and social care practitioners (including personal assistants) working with adult carers Adults who provide unpaid care for 1 or more people aged 16 or over

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

194. Physical therapy Full Text available with Trip Pro

. Physical therapists may utilize surgical instruments, wound irrigations, dressings and topical agents to remove the damaged or contaminated tissue and promote tissue healing. Other commonly used interventions include exercise, edema control, splinting, and compression garments. The work done by physical therapists in the integumentary specialty do work similar to what would be done by medical doctors or nurses in the emergency room or triage. Neurological [ ] Neurological physical therapy is a field (...) organisation. Most Physical therapists who practice in a sporting environment are also active in collaborative sports medicine programs too (See also: ). Community Physiotherapy [ ] At present community based Physiotherapy rehabilitation are the main areas where specially trained candidates of physiotherapists intervening disabled conditions and rehabilitating them. They act as agents of change in Community setups by educating and transferring the basic skills and knowledge and giving treatments

2012 Wikipedia

195. History of electroconvulsive therapy in the United Kingdom

generally positive in the early days of its use. The Ministry of Labour ran a recruitment campaign for psychiatric nurses featuring a picture of someone undergoing ECT. Barnwood House, which catered for "ladies and gentlemen suffering from nervous and mental disorders", said in advertisements that it offered "all the most modern methods of treatment including electric shock and prefrontal leucotomy". There were however dissenting voices. Cyril Birnie, the medical superintendent of , Middlesex, raised (...) : 1232-33. Fleming GWTH, Golla FL and Grey Walter W (1939) Electric convulsion therapy of schizophrenia. Lancet 234 , 30 December: 1352-1355. Editorial (1939) More shocks. Lancet 234 , 30 December: 1373. Mccrae N (2006)'A violent thunderstorm': cardiazol treatment in British mental hospitals. History of Psychiatry 17 : 67-90. ^ Brain WR and Strauss EB (1945) Recent advances in neurology and neuropsychiatry , 5th edition. London: J & A Churchill Ltd. Allen C (1949) Modern discoveries in medical

2012 Wikipedia

196. Occupational therapy Full Text available with Trip Pro

occupational therapy", as it lacked the "exactness of meaning which is possessed by scientific terms". Other titles such as "work-cure","ergo therapy"(ergo being the greek root for "work"), and "creative occupations" were discussed as substitutes, but ultimately, none possessed the broad meaning that the practice of occupational therapy demanded in order to capture the many forms of treatment that existed from the beginning. Occupational therapy during WWI: bedridden wounded are knitting. The emergence (...) have re-emerged as dominant themes in the profession. Over the past century, the underlying philosophy of occupational therapy has evolved from being a diversion from illness, to treatment, to enablement through meaningful occupation. Three commonly mentioned philosophical precepts of occupational therapy are that occupation is necessary for health, that its theories are based on and that its central components are people, their occupations (activities), and the environments in which those

2012 Wikipedia

197. COVID-19 and Pregnant Patients

pregnant women have decreased lung functional residual capacity and have a relative inability to clear respiratory secretions ( ) PubMed 32227760 The New England journal of medicine N Engl J Med 20200330 SARS-CoV-2 is proposed to interact with the renin-angiotensin-aldosterone system (RAAS) through angiotensin-converting enzyme 2 (ACE2), an enzyme that physiologically counters RAAS activation but also acts as a receptor for SARS-CoV-2 ( ) PubMed 15273828 Brazilian journal of medical and biological (...) to minimize chance of spreading infection adhere to local infection control practices including personal protective equipment if no to all symptoms and signs in (above), assess clinical and social risks for COVID-19 infection including comorbidities, such as hypertension, diabetes, asthma, HIV, chronic heart disease, chronic liver disease, chronic lung disease, chronic kidney disease, blood dyscrasia, and immunosuppressive therapy obstetric complications, such as preterm labor an inability to care

2020 DynaMed Plus

198. Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience

or vulnerably housed person currently using opioids Very low certainty ???? • Identify opioid use disorder. • Ensure access within primary care or via an addiction specialist to opioid agonist therapy (OAT), potentially in collaboration with a public health or community health centre for linkage to pharmacologic interventions. Clinical considerations: Encourage all patients taking opioid medication to have a naloxone kit. Though barriers to prescribing methadone and buprenorphine remain, be aware of new (...) an effect on mental health outcomes. 47,52,55,56 The impact of these interventions on substance use outcomes were mixed. Provision of housing vouchers did not affect substance use over 3 years; 55 however, compensated work therapy showed immediate reductions in drug (reduction: –44.7%, standard error [SE] 12.8%; p = 0.001) and alcohol use problems (–45.4%, SE 9.4%; p = 0.001), as well as the number of substance use–related physical symptoms (–64.4%, SE 8.0%; p = 0.001). 52 These differences, how- ever

2020 CPG Infobase

199. Lyme disease

and documented. See the General Medical Council's Prescribing guidance: prescribing unlicensed medicines for further information. f Do not use azithromycin to treat people with cardiac abnormalities associated with Lyme disease because of its effect on QT interval. T o find out why the committee made the recommendations on antibiotic treatment and how they might affect practice, see rationale and impact. Ongoing symptoms after a course of antibiotics Ongoing symptoms after a course of antibiotics 1.3.9 (...) disease 26 Clinical assessment 27 Laboratory investigations 28 Emergency referral and specialist advice 29 Antibiotic treatment 30 Ongoing symptoms after a course of antibiotics 37 Non-antibiotic management of ongoing symptoms 38 Management for women with Lyme disease during pregnancy and their babies 38 Information for people with Lyme disease 39 Context 41 Finding more information and resources 43 Lyme disease (NG95) © NICE 2019. All rights reserved. Subject to Notice of rights (https

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

200. Financial education for HIV?vulnerable youth, orphans, and vulnerable children: A systematic review of outcome evidence Full Text available with Trip Pro

% of new HIV infections globally in 2015, despite accounting for just 11% of the adult population (UNAIDS, , p. 8). As of 2014, 13.3 million children were OVC 2 OVC, as defined by PEPFAR (U.S. President's Emergency Plan for AIDS Relief), are children aged 0–17 years who have lost a parent to HIV/AIDS, who are otherwise directly affected by the disease, or who live in areas of high HIV prevalence and may be vulnerable to the disease or its socioeconomic effect (PEPFAR, ) by AIDS globally of an estimated (...) Union, ). The confidence and “self‐efficacy” to act on knowledge is a complex mix of personal and societal norms and conditions (Bandura, ; Bandura, ). Therefore, the ability to reach economic goals may also be associated with increased self‐efficacy to avoid unprotected sex that some housing and income‐generating arrangements entail (Jennings, Ssewamala, & Nabunya, , p. 279). ICRW ( ) found that social supports and mentoring improved outcomes in their review of eight economic and plural

2020 Campbell Collaboration

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