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Emergency Medicine Treatment and Labor Act

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81. Interfacility neurosurgical transfers: an analysis of nontraumatic inpatient and emergency department transfers with implications for improvements in care. Full Text available with Trip Pro

facilities may lack necessary resources or expertise, and the Emergency Medical Treatment and Active Labor Act (EMTALA) obligates tertiary care centers to accept these patients under those circumstances. Telemedicine and integration of electronic medical records may help guide referring hospitals to pursue additional workup, which may eliminate the need for unnecessary transfer and provide additional cost savings. (...) Interfacility neurosurgical transfers: an analysis of nontraumatic inpatient and emergency department transfers with implications for improvements in care. OBJECTIVEInterfacility neurosurgical transfers to tertiary care centers are driven by a number of variables, including lack of on-site coverage, limited available technology, insurance factors, and patient preference. The authors sought to assess the timing and necessity of surgery and compared transfers to their institution from emergency

2018 Journal of Neurosurgery

82. The economic evaluation of early intervention with Anti-Tumor Necrosis Factor-alpha treatments in pediatric Crohn's disease

Table 2.5.7.1.1-1. Costs and Doses of Anti-TNF-a Treatments. 72 Table 2.5.7.1.1-2. Costs and Doses of Immunomodulators. 74 Table 2.5.7.1.1-3. Costs and Doses of Corticosteroids. 76 Table 2.5.7.1.1-4. Costs and Doses of Antibiotics. 79 Table 2.5.7.1.1-5. Costs and Doses of Oral 5-ASA Drugs. 81 Table 2.5.7.1.1-6. Cost and Dose of Enteral Nutrition Brands. 83 Table 2.5.7.1.2-1. Medical Procedure Costs for CD Patients. 86 Table 2.5.7.1.2-2. Costs for Adverse Events of Special Interest and Surgical (...) and their families. 2 The traditional treatment of pediatric CD has involved a step-wise approach, or “step-up” strategy, involving several classes of drugs such as corticosteroids, immunomodulators and tumour necrosis factor alpha antagonist (anti-TNF-a) biologics. In Canada and the US, based on clinical practice guidelines, remission is typically induced in newly diagnosed CD pediatric patients using oral corticosteroids or exclusive enteral nutrition (Cincinnati Children's Hospital Medical Center, 2007

2019 SickKids Reports

83. What constitutes an effective and efficient package of services for the prevention, diagnosis, treatment and care of tuberculosis among refugees and migrants in the WHO European Region? Themed issues on migration and health

in the Region in 2016, with an estimate 71 000 cases of rifampicin-resistant/ MDR-TB. MDR-TB is difficult to treat because of its resistance to multiple first-line anti-TB medications, including the most potent ones (isoniazid and rifampicin), and presents significant challenges to the elimination of TB (3,4). Its occurrence is thought to have diverse reasons including quality of medicines, infection prevention control and the substantial driver of poor treatment completion rates, in particular (...) programme, Division of Health Emergencies and Communicable Diseases, WHO Regional Office for Europe Soorej J Puthoopparambil Consultant, Migration and Health programme, Division of Policy and Governance for Health and Well-being, WHO Regional Office for Europe Jon S Friedland Head of Infectious Diseases and Immunity, Imperial College London, London, United Kingdomvi vi External peer reviewers Knut Lönnroth Professor of Social Medicine, Department of Public Health Sciences, Karolinska Institutet

2018 WHO Health Evidence Network

84. Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder

) until they are stabilized. Individuals then receive ongoing treatment from community services and/or a primary care provider who may receive support, resources and training about addiction management from the addiction clinic staff. 6 ? Rapid access to addiction medicine services have resulted in reduced emergency department visits, reduced wait times and lessened stigma, 6 as well as greater retention in treatment. 51 However, there is insufficient data to determine if this is a best practice (...) , diacetylmorphine- assisted treatment (with or without flexible methadone doses) resulted in greater treatment retention and reductions in illicit drug use compared to methadone treatment or baseline substance use. 16,17,55,56,57,58,59,60 There is a risk of serious events, however, so this treatment should only be considered for individuals for whom other treatment options have not been successful, and with careful medical supervision. 55,59 ? Naltrexone (antagonist) should be considered for those wanting

2018 Canadian Centre on Substance Abuse

85. Nonsurgical Treatments for Urinary Incontinence in Women: A Systematic Review Update

20. Quality of life outcomes for pharmacological interventions versus placebo/no treatment 73 Table 21. Quality of life outcomes for pharmacological versus pharmacological interventions . 75 Table 22. Adverse events reported for anticholinergics 78 Table 23. Adverse events reported for drugs other than anticholinergics 81 Table 24. Quality of life outcomes for nonpharmacological versus pharmacological interventions 89 Table 25. Comparisons of cure, improvement, and satisfaction rates between (...) ) comparisons with no treatment (or sham or placebo), 2) comparisons of first- and second-line interventions together (since only behavioral therapy is categorized as a first-line intervention, and second-line interventions may also be used as initial treatment), and 3) comparisons of third-line interventions. Furthermore, where relevant, we provide summaries for both analyses based specifically on studies that included women with either stress or urgency UI (“stress UI studies” and “urgency UI studies

2018 Effective Health Care Program (AHRQ)

86. Targeted Immunomodulators for the Treatment of Moderate-to-Severe Plaque Psoriasis: Effectiveness and Value

therapy. Problems with coverage • Requirements for “step therapy” forcing patients to start treatment with less efficacious medications. • Lack of clarity in the exception process and timing for physicians and patients. • Patients have to “start over” with “step therapy” of previously-tried medications after switching insurance. • High out of pocket costs hindering treatment or leading to undertreatment. Potential Cost-Saving Measures in Psoriasis As described in its Final Value Assessment Framework (...) 7.17 51.1 74.1 * Time spent in PASI health states is discounted at the same rate at costs and other outcomes. Note that the results above should not be interpreted as treatments with a single targeted drug, but as sequences of targeted drugs (including ‘step therapy’). For example, treatment beginning with guselkumab continues to IL-17 and/or non-targeted drugs upon discontinuation, and treatments beginning with IL-17 drugs continue to guselkumab and/or non-targeted drugs upon discontinuation. All

2018 California Technology Assessment Forum

87. Calcitonin Gene-Related Peptide (CGRP) Inhibitors as Preventive Treatments for Patients with Episodic or Chronic Migraine: Effectiveness and Value

typically try multiple therapies, including non-pharmacologic therapies (e.g., exercise, changes in diet, relaxation techniques, cognitive behavioral therapy 6 ) and pharmacologic therapies. Pharmacologic therapies can be categorized broadly into those used for treatment once symptoms have started (“acute” or “abortive” medications) and those used to decrease the frequency or severity of migraines (“preventive” or “prophylactic” therapies). Although there are no strict guidelines on who should receive (...) migraine. 19 The calcitonin gene-related peptide (CGRP) pathway is important in pain modulation, and CGRP has been observed to increase during a migraine. 20-22 In May 2018, erenumab (Aimovig™ Amgen, Inc. and Novartis AG), a fully human monoclonal antibody that binds to the CGRP receptor, was approved by the US Food and Drug Administration (FDA) as a preventive therapy in both episodic and chronic migraine patients. 23,24 Fremanezumab (Teva Pharmaceuticals) and galcanezumab (Eli Lilly and Company), two

2018 California Technology Assessment Forum

88. Shoulder Conditions Diagnosis and Treatment Guideline

-arthroplasty urgently or emergently is reasonable. I. Manipulation under anesthesia/arthroscopic capsular release Manipulation under anesthesia, or arthroscopic capsular release, may be considered if a patient has persistent stiffness, typically after a procedure that has not responded to at least 12 weeks of physical therapy and/or directed home exercises. Washington State Department of Labor and Industries Medical Treatment Guideline for Shoulder Diagnosis and Treatment –updated May 2018 J. Diagnostic (...) and teres minor 6 weeks of physical therapy Note: A steroid injection may be considered prior to physical therapy if no contraindication and clinically appropriate Washington State Department of Labor and Industries Medical Treatment Guideline for Shoulder Diagnosis and Treatment –updated May 2018 A request may be appropriate for If the patient has AND the diagnosis is supported by these clinical findings: AND this has been done Surgical Procedure Diagnosis Subjective Objective Imaging Non-operative

2018 Washington State Department of Labor and Industries

89. Targeted Immunomodulators for the Treatment of Moderate-to-Severe Plaque Psoriasis: Effectiveness and Value

of phototherapy and infused therapy. Problems with coverage • Requirements for “step therapy” forcing patients to start treatment with less efficacious medications. • Lack of clarity in the exception process and timing for physicians and patients. • Patients have to “start over” with “step therapy” of previously-tried medications after switching insurance. • High out of pocket costs hindering treatment or leading to undertreatment. Potential Cost-Saving Measures in Psoriasis As described in its Final Value (...) of targeted immunomodulator therapy was assessed at the end of the induction period (between 10 and 16 weeks after initiation, depending on agent), after which treatment crossover was typically allowed. Because of this, we could only confidently compare the comparative efficacy of targeted immunomodulators at the end of the induction period. Long-term effectiveness and safety data were variably reported by individual drug. Table ES2. Certolizumab Pegol, Guselkumab, Tildrakizumab and Risankizumab Phase III

2018 California Technology Assessment Forum

90. Preterm Labor (Treatment)

disease. Magnesium sulfate should not be used in conjunction with select medications, such as calcium channel blockers, or when myasthenia gravis or neuromuscular disorders exist. In addition, the US Food and Drug Administration (FDA) has warned against extended magnesium sulfate injections in pregnancy. In 2013, the FDA issued a safety alert advising against the off-label administration of magnesium sulfate injections to pregnant women for more than 5-7 days as a means of stopping preterm labor (...) Preterm Labor (Treatment) Preterm Labor: Practice Essentials, Overview, Risk of Preterm Labor 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjYwOTk4LW92ZXJ2aWV3 processing > Preterm Labor Updated: Dec 17, 2018

2014 eMedicine.com

91. Management of the Third Stage of Labor (Treatment)

of Obstetrical Emergencies . 3rd ed. Bristol, UK: Clinical Press; 1999. 196-201. Sleep J. Physiology and management of the third stage of labour. Bennett VR, Brown LK, eds. Myles' Textbook for Midwives . 12th ed. London, UK: Churchill Livingstone; 1993. 216-29. Dupont C, Ducloy-Bouthors AS, Huissoud C. [Clinical and pharmacological procedures for the prevention of postpartum haemorrhage in the third stage of labor.]. J Gynecol Obstet Biol Reprod (Paris) . 2014 Nov 6. 43(10):966-997. . Prendiville WJ (...) Management of the Third Stage of Labor (Treatment) Management of the Third Stage of Labor: Overview, Clinical Presentation, Management 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjc1MzA0LW92ZXJ2aWV3 processing

2014 eMedicine.com

92. Consultation for Simple Laceration Repair When On-Call in the Emergency Department: Potential Quagmire Full Text available with Trip Pro

in the case of a simple laceration; or is it subservient to either the discretion of the requesting health-care provider or even the patient? Do federal statutes such as the Emergency Medical Treatment and Labor Act, or perhaps more local rules apply, such as the by-laws of the hospital? It would behoove all medical practitioners to familiarize themselves with both the legal and moral implications of these issues. Having legitimate policies in place which actively address those situations where (...) Consultation for Simple Laceration Repair When On-Call in the Emergency Department: Potential Quagmire What are the forces obligating a plastic surgeon who is on-call for the emergency department to respond to a consultation request for repair of a simple laceration? Although the duties are clear in cases of obvious surgical emergency, ambiguity and subsequent conflict may arise when the true nature of the emergency is less clear. Does the consultant's clinical discretion dictate the obligation

2017 Plastic and Reconstructive Surgery Global Open

93. Complexities of Consent: Ethics in the Pediatric Emergency Department. (Abstract)

Medical Treatment and Active Labor Act, in emergent situations, consent may not be necessary. Finally, adolescents are often deeply concerned about privacy-their acceptance of appropriate care is often based on this promise of confidentiality. In the emergency department, adolescents can therefore be treated for issues relating to reproductive care without parental consent. It is important for the emergency department physician to understand the rules surrounding the care of pediatric patients (...) autonomy through allowing him or her to be an active part of the decision-making process. Consent in the pediatric emergency department can be a complex process. Parental consent is generally required for medical evaluation and treatment of pediatric patients, but in the pediatric emergency department, there are exceptions to this rule. If the provider determines that a parent's refusal of consent places the child at risk of harm, then consent is not necessary. By using the concepts of Emergency

2017 Pediatric Emergency Care

94. Exenatide Inpatient Trial: A Randomized Controlled Pilot Trial on the Safety and Efficacy of Exenatide (Byetta®) Therapy for the Inpatient Management of Patients With Type 2 Diabetes

of hypoglycemia. The investigators will compare the efficacy and safety of exenatide alone or in combination with basal insulin to control high blood glucose levels resulting in a lower risk of hypoglycemia. Condition or disease Intervention/treatment Phase Type 2 Diabetes Drug: Exenatide Drug: Glargine Drug: Oral antidiabetic drugs Drug: Rapid-acting insulin analogs Phase 4 Detailed Description: The association between hyperglycemia and poor clinical outcomes in patients with diabetes is well established (...) : None (Open Label) Primary Purpose: Treatment Official Title: Exenatide Inpatient Trial: A Randomized Controlled Pilot Trial on the Safety and Efficacy of Exenatide (Byetta®) Therapy for the Inpatient Management of General Medicine and Surgery Patients With Type 2 Diabetes Actual Study Start Date : September 2015 Actual Primary Completion Date : March 2018 Actual Study Completion Date : March 2018 Resource links provided by the National Library of Medicine related topics: related topics: available

2015 Clinical Trials

95. Neonatal infection: antibiotics for prevention and treatment

Capacity Act. In Wales, healthcare professionals should follow advice on consent from the Welsh Government. If the woman is under 16, healthcare professionals should follow the Department of Health's guidance in Seeking consent: working with children. Sometimes if a baby appears to have a serious illness that could indicate the need for urgent treatment the medical staff may not have time to fully discuss what is involved in that treatment beforehand. In an emergency, if the person with parental (...) treatment 10 Care setting 11 1 Guidance 12 1.1 Information and support 12 1.2 Risk factors for infection and clinical indicators of possible infection 15 1.3 Intrapartum antibiotics 19 1.4 Avoiding routine use of antibiotics in the baby 19 1.5 Investigations before starting antibiotics in the baby 20 1.6 Antibiotics for suspected infection 21 1.7 Duration of antibiotic treatment 22 1.8 Therapeutic drug monitoring for gentamicin 24 1.9 Care setting 25 2 Notes on the scope of the guidance 27 3

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

96. Emergency medical technician

"Emergency Medical Technician", or 'EMT', for the Primary Care Paramedic; and 'Paramedic' only for those qualified as Advanced Care Paramedics (ALS) providers. Only someone registered in Alberta can call themselves an EMT or Paramedic in Alberta, the title is legally protected. Almost all other are gradually moving to adopting the new titles, or have at least recognized the NOCP document as a benchmarking document to permit inter-provincial labour mobility of practitioners, regardless of how titles (...) recognized under the National Occupational Competency Profile, although unlike the next three successive levels of practice,The high number of EMRs across Canada cannot be ignored as contributing a critical role in the chain of survival, although it is a level of practice that is least comprehensive (clinically speaking), and is also generally not consistent with any medical acts beyond advanced first-aid and oxygen therapy,administration of ASA and oral glucose and administration of narcan

2012 Wikipedia

97. Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version

of Medicine. A risk-based medical follow-up is recommended, which includes a systematic plan for lifelong screening, surveillance, and prevention that incorporates risk estimates based on the following:[ ] Previous cancer. Cancer therapy. Genetic predisposition. Lifestyle behaviors. Comorbid conditions. Sex. Part of long-term follow-up is also focused on appropriate screening of educational and vocational progress. Specific treatments for childhood cancer, especially those that directly impact nervous (...) Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version Late Effects of Treatment for Childhood Cancer (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf Warning: The NCBI web site requires JavaScript to function. Search database Search term Search NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. PDQ Cancer Information

2018 PDQ - NCI's Comprehensive Cancer Database

98. Diagnosis, Staging and Treatment of Patients with Prostate Cancer

cancer The diagnosis, staging and treatment of patients with prostate cancer requires multidisciplinary care in an acute hospital setting. The majority of patients will require diagnostic tests (radiology, pathology) and depending on the treatment plan may require surgery, chemotherapy and radiation therapy. A proportion of patients may also require palliative care. A recent population-based cost analysis (Luengo-Fernandez et al., 2013) illustrated the economic burden of cancer on the European Union (...) , in cancers with costs that can accrue over several years (e.g. prostate cancer). In Ireland, inpatient care costs were estimated to account for €417 million of cancer-related healthcare costs out of a total of €619 million. Drug expenditure accounted for a further €127 million, while primary, outpatient and emergency care were estimated at €32 million, €30 million and €13 million, respectively (Luengo-Fernandez et al., 2013). 1.3 Objectives of the National Clinical Guideline The overall objectives

2016 National Clinical Guidelines (Ireland)

99. Diagnosis and Treatment of Primary Adrenal Insufficiency

of glucocorticoid replacement therapies, with doses adjusted according to individual need. (2|⊕⊕⚪⚪) 3.19 In children with PAI, we suggest avoiding synthetic, long-acting glucocorticoids (eg, prednisolone, dexamethasone). (2|⊕⊕⚪⚪) 3.20 We suggest monitoring glucocorticoid replacement by clinical assessment, including growth velocity, body weight, blood pressure, and energy levels. (Ungraded best practice statement) 3.21 In children with PAI and confirmed aldosterone deficiency, we recommend treatment (...) and adrenal crisis-prevention strategies including parenteral self- or lay-administration of emergency glucocorticoids. (Ungraded best practice statement) 4.5 We recommend that all patients should be equipped with a steroid emergency card and medical alert identification to inform health personnel of the need for increased glucocorticoid doses to avert or treat adrenal crisis and the need of immediate parenteral steroid treatment in the event of an emergency. (Ungraded best practice statement) 4.6 We

2016 The Endocrine Society

100. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations

populations 24 4 HEALTH SECTOR INVERVENTIONS 26 4.1 Prevention 26 4.1.1 Comprehensive condom and lubricant programming 26 4.1.2 Harm reduction for people who inject drugs 29 4.1.3 Behavioural interventions 40 4.1.4 Prevention of transmission in health-care settings 43 4.1.5 ARV-related prevention 44 4.1.6 Voluntary medical male circumcision for HIV prevention 48 4.2 HIV testing and counselling 50 4.3 Linkage and enrolment in care 54 4.4 HIV treatment and care 55 4.4.1 Antiretroviral therapy 55 4.4.2 (...) HCV hepatitis C virus HIV human immunodeficiency virus HIVST HIV self-testing HPV human papillomavirus HTC HIV testing and counselling IPT isoniazid preventive treatment LPV/r lopinavir/ritonavir M&E monitoring and evaluation MAT medically assisted treatment MMT methadone maintenance treatment NNRTI non-nucleoside reverse transcriptase inhibitor NSP needle and syringe programme OST opioid substitution therapy PEP post-exposure prophylaxis PEPFAR United States President’s Emergency Plan for AIDS

2016 World Health Organisation HIV Guidelines

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