Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Feb 1990
Emergency medical services legal issues for the emergency physician.
This article discusses the elements of the legal system that impact emergency physicians and their legal responsibilities. It addresses the specific responsibilities of the emergency physician providing on-line direction to EMS units in the field, and the legal principles that control. Special emphasis is placed on compliance with new federal legislation and addressing medical-legal issues presented by field personnel during patient care situations.
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Emerg. Med. Clin. North Am. · Feb 1990
ReviewCommunication with emergency medical services providers.
Communication between the emergency medical services provider and the emergency physician can be either a rewarding or a frustrating experience. As many emergency physicians have found to their chagrin, the EMS provider has a memory for mistakes or bad tidings. This article discusses the relationship between EMS providers and emergency physicians.
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EMS quality assurance programs can help guarantee that the provision of prehospital care is medically accountable. The establishment and management of such a program, although time consuming, are critically important. It is essential that the medical director or a designee responsible for quality assurance activities be allotted the necessary time to carry them out properly. ⋯ The quality assurance program forms a continuous action loop starting and ending with protocols and education. Documentation of variance or compliance with protocols forms the basis for analysis of the quality of care delivered. Any intervention must be based on carefully documented information and should include praise for good work, as well as education when needed, and restriction of function when necessary.
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Emerg. Med. Clin. North Am. · Feb 1990
ReviewThe impact of emergency medical helicopters on prehospital care.
Emergency medical helicopter services have grown exponentially over the past seventeen years. These services offer rapid transport by flight crews to tertiary care centers with a higher level of medical capabilities. An impact because of helicopters on survival has been well-documented for trauma patients. Assessing usage for other critical care patients remains to be delineated further.
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Emerg. Med. Clin. North Am. · Nov 1989
ReviewThyroid disease in the emergency department. Thyroid function tests and hypothyroidism and myxedema coma.
The recognition of hypothyroidism may not always be easy in the emergency department setting. Laboratory evaluations of thyroid function are not usually performed on a 24-hour basis, and therefore the emergency physician, although suspecting the presence of hypothyroidism, may be unable to confirm the diagnosis while the patient is in the Emergency Department. ⋯ Myxedema coma is potentially fatal and must be recognized and treated emergently, usually prior to laboratory confirmation. Ventilatory support and thyroid hormone replacement are the two most important therapeutic maneuvers in the treatment of myxedema coma.