Lecture 1: Principles of EM Flashcards
What 3 things can be given in practically any undifferentiated situation?
- Dextrose
- Narcan
- Thiamine
They have no negative effect essentially
What is the other reason to admit a patient other than them having a serious condition?
They need to be able to f/u outpatient on their own adequately.
AKA do they have sufficient resources to manage at home?
Social work admit
What is EMTALA?
- Emergency Medical Treatment and (Active) Labor Act
- Duty to provide emergency care (stabilize)
Who does EMTALA apply to?
Any facility that has a medicare contract
Pretty much all hospitals in the US.
When does EMTALA no longer apply?
- Patient is now in stable condition
- Patient’s emergent condition is ruled out
What is the duty of a receiving hospital when receiving a transfer?
If the receiver has the capabilities to currently treat and there is no closer facility.
Cannot deny based on insurance.
Only way to deny would be to lack the specialty or lack beds.
What are the exceptions to informed consent?
- Medical emergencies with inability to communicate
- Recurrent tx (dialysis)
- Pt waives their right to be informed
- Doctrine of therapeutic privilege
The doctrine of therapeutic privilege is invoked when there is a serious concern that full disclosure of a procedure might cause serious emotional or physical harm.
Who obtains informed consent?
Person ordering/doing the procedure
How long do we hold an opioid OD post narcan admin before they can leave?
1-1.5 hours to wait out half-life of narcan.
Opioid prob lasts longer, so they can undergo resp depression after
How does informed consent vary for an adult Jehovah’s witness pt vs a minor?
- Adult can refuse tx even if life-threatening.
- If minor, involve hospital legal counsel, as a parent cannot refuse life-saving tx for a minor.
