ED management : the monthly update on emergency department management
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As of Jan. 10, 2001, Emergency Medical Treatment and Active Labor Act regulations apply to hospital outpatient facilities. Staff at these locations must provide anyone with a potential emergency condition with a medical screening exam and stabilization, and, if necessary, must transfer the patient. The ED is responsible for helping remote site staff provide good patient care and comply with EMTALA. Remote sites cannot delay treatment for an EMTALA-related service by collecting copays.
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To improve patient flow in the ED when resources are overwhelmed, a "Code Purple" mini-disaster mode was implemented at William Beaumont Hospital in Royal Oak, MI. When a "Code Purple" is called, the inpatient units immediately begin accepting ED patients waiting for beds by creating short-term hall spots. Non-stat, diagnostic studies are held by the radiology department until the ones from the ED have been completed. The system is used only when the ED environment might place patients at risk.
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When caring for local or national VIPs, take extra steps to ensure the correct diagnosis is made without giving preferential treatment. Consult with colleagues to double-check your decision making in person or over the telephone. When asking for a second opinion, don't give the consultant your diagnosis. If you fill out an incident report, never allude to that in the patient's chart.