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Emergency Medicine Treatment and Labor Act


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181. Toxicity, Cocaine (Treatment)

MI) and subarachnoid hemorrhage or concomitant use of other drugs (eg, heroin). Most patients with cocaine-associated pulmonary edema respond to standard medical treatment. For resistant hypoxemia, positive-pressure ventilation with continuous positive airway pressure (CPAP) or intubation supplemented with positive end-expiratory pressure (PEEP) is usually effective. For patients with respiratory depression intubation may be indicated, as it is for those with apnea. Administration of naloxone (...) and treatment. JAMA . 1983 Sep 16. 250(11):1417-20. . Prosser JM, Perrone J. Cocaine and Amphetamines. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM, eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide . 8th ed. NY: McGraw-Hill Education; 2016. 1256-59. Renzi FP. Cocaine poisoning. Harwood-Nuss AL, ed. The Clinical Practice of Emergency Medicine . 2nd ed. Philadelphia, Pa: Lippincott Raven Publishers; 1996. [Guideline] American Heart Association. Part 10: Special

2014 eMedicine Emergency Medicine

182. 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

183. Toxicity, Chlorine Gas (Treatment)

Medicine, Albert Einstein Medical Center Gerald F O'Malley, DO is a member of the following medical societies: , , , , , Disclosure: Received consulting fee from McNeil Pharmaceuticals for speaking and teaching. Coauthor(s) Robert Bassett, DO, FAAEM Fellow in Medical Toxicology, Department of Emergency Medicine, Einstein Medical Center; Clinical Assistant Professor of Emergency Medicine, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine Robert Bassett, DO, FAAEM is a member (...) . 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 Asim Tarabar, MD Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital Disclosure: Nothing to disclose. John T VanDeVoort, PharmD Regional Director of Pharmacy

2014 eMedicine Emergency Medicine

184. 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

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. Pregnancy, Asthma (Treatment)

medication use by pregnant women. [ , ] Go to for more complete information on this topic. Previous Next: Hospital Care Prehospital asthma treatment Prior to arriving at the ED, address the patient’s airway status as needed. Provide early institution of beta-agonist inhalational therapy. Provide supplemental oxygen. Treatment in the emergency department Pregnant patients who present with typical mild exacerbations of asthma may be treated in the same way that a regular asthmatic patient with similar (...) ; Consulting Staff, Vice-Chair in Charge of Research, Department of Emergency Medicine, Kings County Hospital Center Richard H Sinert, DO is a member of the following medical societies: , 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. Mark Zwanger, MD, MBA Mark

2014 eMedicine Emergency Medicine

187. Renal Calculi (Treatment)

== processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure, the focus (...) , the presence of a ureteropelvic junction (UPJ) obstruction or a ureteral stricture could make passing even very small stones difficult or impossible. Most experienced emergency department (ED) physicians and urologists have observed very large stones passing and some very small stones that do not move. Aggressive medical therapy has shown promise in increasing the spontaneous stone passage rate and relieving discomfort while minimizing narcotic usage. Aggressive treatment of any proximal urinary infection

2014 eMedicine Emergency Medicine

188. 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

189. Pregnancy, Delivery (Treatment)

was passed as a part of a much larger bill, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). Consequently, the acronym COBRA was used frequently in medical literature when referring to the statute. This statute is also titled the Emergency Medical Treatment and Active Labor Act (EMTALA). Since the latter name is more specific and descriptive, it has become the preferred acronym for referring to the statute. The full text of the statute can be found in any public library's reference (...) of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Mark Zwanger, MD, MBA Mark Zwanger, MD, MBA is a member of the following medical societies: Disclosure: Nothing to disclose. Chief Editor Mark A Clark, MD Medical Director, Block Island Medical Center; Assistant Clinical Professor, Department of Emergency Medicine, St Luke's-Roosevelt Hospital Center Mark A Clark, MD is a member of the following medical societies: , , , Disclosure

2014 eMedicine Emergency Medicine

190. Pregnancy, Preeclampsia (Treatment)

hypertension in pregnancy Antihypertensive treatment is recommended for severe hypertension (SBP >160 mm Hg; DBP >110 mm Hg). The goal of hypertension treatment is to maintain BP around 140/90 mm Hg. Medications used for BP control include the following: Hydralazine Labetalol Nifedipine Sodium nitroprusside (in severe hypertensive emergency refractory to other medications) Fluid management Diuretics should be avoided Aggressive volume resuscitation may lead to pulmonary edema Patients should be fluid (...) including (nonreassuring nonstress test, biophysical profile score, and/or persistent absent or reversed diastolic flow on umbilical artery Doppler velocimetry) Ruptured membranes Uncontrollable BP (unresponsive to medical therapy) Oligohydramnios, with amniotic fluid index (AFI) of less than 5 cm Severe intrauterine growth restriction in which the estimated fetal weight is less than 5% Oliguria (< 500 mL/24 hr) Serum creatinine level of at least 1.5 mg/dL Pulmonary edema Shortness of breath or chest

2014 eMedicine Emergency Medicine

191. 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

192. 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

193. 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

194. 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

195. 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

196. 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

197. 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

198. 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

199. Portable Normothermic Cardiac Perfusion System in Donation After Cardiocirculatory Death

as a result of congenital heart defects (problems with the structure of the heart that are present at birth), coronary heart disease (a narrowing of the heart’s coronary arteries), or any number of diseases that cause the heart muscle to become thick or rigid or to harden. Interventions to manage end-stage heart failure include medications and mechanical circulatory support; however, heart transplantation is the most effective treatment for some people with end-stage heart failure. It is considered (...) by a multidisciplinary team from the Quality business unit at Ontario Health. The clinical epidemiologist was Alexis Schaink, the health economist was Olga Gajic- Veljanoski, the patient and public partnership analyst was David Wells, and the medical librarian was Corinne Holubowich. The medical editor was Timothy Maguire. Others involved in the development and production of this report were Doug Willcocks, Claude Soulodre, Kara Cowan, Saleemeh Abdolzahraei, Kathryn Schwarz, Sarah McDowell, Vivian Ng, Andrée

2020 Health Quality Ontario

200. The use of comic books, graphic novels, and fotonovelas as a health promotion tool

. Labour/Le Travail. 2014;73:151–77. Green MJ, Mahato M. Graphic medicine: The best of 2018. Journal of the American Medical Association. 2018;320(24):2510–1. Williams IC. Graphic medicine: Comics as medical narrative. Medical Humanities. 2012;38(1):21–7. King AJ. Using comics to communicate about health: An introduction to the symposium on visual narratives and graphic medicine. Health Communication. 2017;32(5):523–4. Gessell P. Guru of graphic medicine. Canadian Medical Association Journal. 2016;188 (...) as graphic medicine: how sequential, visual storytelling is used to share health-related experiences and information (18). Comics — presented in a variety of mediums — are the visual narrative most relevant to the study of graphic medicine (18). This review explores how graphic medicine is used in medical education and patient care, examining evidence that supports the use of graphic medicine as a health education tool. While the specific focus is on HIV and other sexually transmitted infections (STIs

2020 Ontario HIV Treatment Network

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