Abstract:
:This article examines the role and impact of EMTALA on the ethical delivery of hospital-based emergency services, primarily through close inspection of three of the core EMTALA mandates: the medical screening examination, the duty to accept patients in transfer from less capable facilities, and the requirement that the hospital provide on-call physician services to the emergency department to help stabilize patients with emergencies or help accept patients in transfer. Hospital and physician responses to these mandates, such as triaging/screening patients away from the emergency department, avoiding the application of EMTALA, refusing to accept inpatients with emergencies in transfer, and devising ways to avoid on-call duties, are analyzed in some detail.
journal_name
Emerg Med Clin North Amjournal_title
Emergency medicine clinics of North Americaauthors
Bitterman RAdoi
10.1016/j.emc.2006.05.003subject
Has Abstractpub_date
2006-08-01 00:00:00pages
557-77issue
3eissn
0733-8627issn
1558-0539pii
S0733-8627(06)00031-9journal_volume
24pub_type
杂志文章,评审abstract::Health care professionals often encounter patients who refuse a recommended treatment plan. Overriding a patient's right to autonomy has ethical, legal, and moral consequences. Incapacity is the determination by a physician that a patient lacks the ability to make informed decisions about his or her health care. The f...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70120-6
更新日期:2000-05-01 00:00:00
abstract::Acutely agitated or psychotic patients are particularly challenging to manage in the emergency department. Often these patients present with little or no history, and an adequate assessment may initially be difficult because of the condition of the patient. This article discusses basic concepts regarding agitation, an...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2015.07.003
更新日期:2015-11-01 00:00:00
abstract::This article discusses the management of clinical problems encountered particularly in disasters. These include the principles of multiple-casualty triage, and field and hospital management of blast injury, crush syndrome, compartment syndrome, particulate inhalation, and traumatic asphyxiation. The indications for ex...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70253-4
更新日期:1996-05-01 00:00:00
abstract::Determining the appropriate immunizations for international travelers is a complex, multifaceted process. This article proposes a stepwise and systematic approach to the immunization needs of the traveler-patient. Vaccines for routine health maintenance as well as special issues of the elderly, pregnant, immunocomprom...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70285-6
更新日期:1997-02-01 00:00:00
abstract::This article reviews some common illnesses and conditions that prompt traveling patients to seek medical care in the emergency department in the United States. It also presents an emergency department approach to the initial diagnosis and treatment of travelers who are experiencing adverse side effects from pretravel ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70295-9
更新日期:1997-02-01 00:00:00
abstract::The interrelationships between biomedical ethics and the law are perhaps nowhere as starkly apparent as in the realm of medical malpractice. Although ethical and legal conduct and practices are often in harmony, in many areas ethical principles and the issues surrounding medical liability appear to come into conflict....
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2006.05.017
更新日期:2006-08-01 00:00:00
abstract::Patients with human immunodeficiency virus, those who are posttransplant, and those undergoing chemotherapy are populations who are immunocompromised and present to the emergency department with abdominal pain related to their disease processes, opportunistic infections, and complications of treatment. Emergency depar...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2015.12.002
更新日期:2016-05-01 00:00:00
abstract::In recent years, health care providers have sounded the call that the US mental health system is in crisis. With decreases in funding and eroding access to care, the availability of psychiatric services has become increasingly limited, failing to meet growing needs. This article provides a brief history of mental heal...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2015.07.013
更新日期:2015-11-01 00:00:00
abstract::The spectrum of acute coronary syndromes (ACS) includes several clinical complexes that frequently cause critical instability in affected patients. This article focuses on several critical care aspects of these unstable ACS patients. The management of cardiogenic shock can be particularly challenging because the mecha...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2008.04.002
更新日期:2008-08-01 00:00:00
abstract::Despite the improvement of medical treatment for acute coronary syndromes throughout the 20th century, the authors believe that many cases of life-threatening coronary events could be avoided through early detection of CAD and the use of preventive strategies. Establishing chest pain units that are linked to the ED is...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70195-4
更新日期:2001-05-01 00:00:00
abstract::Pulmonary edema is differentiated into two categories--cardiogenic and noncardiogenic. Noncardiogenic pulmonary edema is due to changes in permeability of the pulmonary capillary membrane as a result of either a direct or an indirect pathologic process. It is a spectrum of illness ranging from the less severe form of ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(03)00020-8
更新日期:2003-05-01 00:00:00
abstract::As more Americans venture into the wilderness, physicians will be called upon to provide care in the backcountry or austere setting. Additionally, more isolated regions of the world are becoming accessible for trekking and mountaineering. These facts imply a higher rate of injuries and medical problems within a distin...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:10.1016/j.emc.2004.01.012
更新日期:2004-05-01 00:00:00
abstract::Because of the altered physiology of the elderly population, either as a result of aging or as a result of other disease processes, many illnesses may present with features that are either atypical or nonspecific in nature. Difficult and nonspecific complaints such as weakness in an elderly patient must be handled in ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70056-0
更新日期:1999-02-01 00:00:00
abstract::Heat-related illness represents a continuum of disorders from minor syndromes such as heat cramps, heat syncope, and heat exhaustion to the severely life-threatening disorder known as heat stroke. It represents an important cause of wilderness-related morbidity and mortality. ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2004.01.004
更新日期:2004-05-01 00:00:00
abstract::Pneumonia remains one of the most common reasons for admission of emergency department (ED) patients to the hospital. Pneumonia also remains one of the most common causes of death in our patients. As with many emergent conditions, the ED management of these patients initiated by ED physicians contributes greatly to th...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2008.02.005
更新日期:2008-05-01 00:00:00
abstract::The porphyrias are a group of disorders involving enzymatic defects in heme synthesis. The porphyrias classically manifest neuro-visceral or photocutaneous symptoms based on which enzyme in the heme metabolic pathway is deficient. Although rare, the porphyrias would most likely be encountered in the emergency departme...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2005.03.014
更新日期:2005-08-01 00:00:00
abstract::This article reviews current issues regarding the Focused Assessment with Sonography for Trauma (FAST) examination. Technical performance issues, decision-making and practice algorithms, fluid volume and scoring systems, proficiency and training, and the role of the FAST in pediatric trauma are covered. This article e...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2004.04.007
更新日期:2004-08-01 00:00:00
abstract::Injury to the chest accounts directly or indirectly for up to 50 per cent of deaths secondary to trauma. Eighty-five per cent of patients with chest injury may be managed by minor procedures available to the emergency physician. The indications for surgery in the remaining 15 per cent of patients with chest injury mus...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract::Acid-base disorders should be considered a process with the goal being to treat the patient and the underlying condition, not the numbers. A good understanding of the normal acid-base regulation in the body, as well as the most common derangements can prepare the emergency physician for this very common disorder that ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2014.01.002
更新日期:2014-05-01 00:00:00
abstract::International EM development requires a comprehensive assessment of the current system and careful planning to ensure that the most important needs are addressed. Modeling a country's EM system after an existing foreign system underestimates the complex needs for instituting appropriate system interventions. Planning ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2004.09.005
更新日期:2005-02-01 00:00:00
abstract::Neurologic complications are unfortunately common in oncology patients, with many presenting to the emergency department for diagnosis and management. This case-based review provides a brief overview of the key points in pathophysiology, diagnosis, and management of 2 oncologic central nervous system emergencies: mali...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2018.04.010
更新日期:2018-08-01 00:00:00
abstract::Headache continues to be a frequent cause of emergency department (ED) use, accounting for 2% of all visits. Most of these headaches prove to be benign but painful exacerbations of chronic headache disorders, such as migraine, tension-type, and cluster. The goal of ED management is to provide rapid and quick relief of...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2008.09.005
更新日期:2009-02-01 00:00:00
abstract::Despite recent advances, care of the post-cardiac arrest patient remains a challenge. In this article, the authors discuss an approach to the initial care of post-cardiac arrest patients with particular focus on targeted temperature management (TTM). The article starts with history, physiologic rationale, and the majo...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2019.03.002
更新日期:2019-08-01 00:00:00
abstract::The patient with severe head injury is a therapeutic challenge and demands all of the skills of the emergency medical specialist to manage traumatic injuries to the head, chest, abdomen, and limbs, as well as the specialized problems associated with respiratory care in a patient with raised ICP. The initial treatment ...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::Tumor lysis syndrome is most often seen after the treatment of blood and solid malignancies. The resultant hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia can lead to life threatening complications. Expeditious evaluation and therapy are paramount in preventing the most serious sequelae of acute renal...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章
doi:10.1016/j.emc.2009.04.010
更新日期:2009-08-01 00:00:00
abstract::Elderly trauma patients present unique challenges and face more significant obstacles to recovery than younger patients. Despite overall higher mortality, longer length of stay, increased resource use, and higher rates of discharge to rehabilitation, most elderly trauma patients return to independent or preinjury func...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2007.06.005
更新日期:2007-08-01 00:00:00
abstract::Bradydysrhythimas include sinus bradycardia, junctional brady-cardia, and idioventricular rhythm, which can be distinguished by examining the tracing for the presence or absence of P waves,noting the morphology of these P waves, and determining the width of the QRS complex. Sinoatrial blocks may occur in either first,...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2005.08.006
更新日期:2006-02-01 00:00:00
abstract::Pulmonary embolism (PE) remains one of the most challenging medical diseases in the emergency department. PE is a potentially life threatening diagnosis that is seen in patients with chest pain and/or dyspnea but can span the clinical spectrum of medical presentations. In addition, it does not have any particular clin...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.emc.2011.12.004
更新日期:2012-05-01 00:00:00
abstract::Dissections of the carotid and vertebral arteries are a common cause of stroke in young adults. The diagnosis may be missed because the typical signs and symptoms are often delayed in onset, or easily confused with other more commonly encountered entities. Dissections of the carotid and vertebral arteries may occur sp...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0733-8627(05)70325-4
更新日期:1997-08-01 00:00:00
abstract::LSD is still readily available in the United States as a street drug of abuse. Emergency physicians may be called on to diagnose acute LSD intoxication in cases in which the history is unavailable. The typical LSD intoxication syndrome causes marked illusions of color and sound, along with a feeling of "cosmic awarene...
journal_title:Emergency medicine clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-08-01 00:00:00