Delaware medical journal
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Delaware medical journal · Apr 2012
Cardiopulmonary resuscitation inpatient outcomes in cancer patients in a large community hospital.
Patients and clinicians have unrealistic expectations when it comes to cardiopulmonary resuscitation (CPR). Only a small percentage of patients survive a cardiopulmonary arrest and those that do live, still have a high likelihood of dying in the hospital. The quality of life for those patients who do survive to discharge is often severely diminished. For cancer patients, the statistics may be even worse. ⋯ Overall the rate of survival of cancer patients in a community hospital after undergoing CPR is similar to what is described in the recent literature. The prognosis remains poor for cancer patients undergoing CPR. Therefore, clinicians should and are now mandated by law (in certain states) to engage in honest discussions using data concerning end of life care and expectations.
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Delaware medical journal · Apr 2012
CMS final rule requires NPI submission for Medicare and Medicaid provider enrollments and orders.
Despite the recent debate in the U. S. Supreme Court regarding the constitutionality of the health care reform act, CMS published a final rule related to several provisions from the Affordable Care Act (the Act).
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Delaware medical journal · Jun 2011
Case ReportsDrug overdose with refractory bradycardia and hypotension.
In the emergency department physicians are often called upon to make decisions with limited information. Often the correct diagnosis and treatment hinge on one piece of information, which may be the key to the entire presentation. ⋯ We present a case of refractory bradycardia and hypotension in a patient who had overdosed on calcium channel blockers as well as beta blockers. Paying close attention to all the details of the case eventually uncovered the underlying severe hypothyroidism and myxedema. In the emergency department we are always called upon to make decisions with limited information. It is also paying close attention to all of the information presented that allows one to not miss any key pieces central to the final diagnosis.
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Delaware medical journal · Apr 2011
Massive postpartum hemorrhage: recombinant factor VIIa use is safe but not effective.
Postpartum hemorrhage is a leading cause of maternal mortality. Massive transfusion in obstetric patients is rare. Recombinant Factor VIIa (rFVIIa) use in trauma patients with massive transfusion is efficacious. Our goal was to evaluate the safety and efficacy of rFVIIa use in obstetric patients with massive postpartum hemorrhage (MPH). ⋯ Recombinant Factor VIIa use in MPH is safe, improves coagulopathy, was not effective in decreasing blood product transfusion requirements, and may contribute to an improved predicted mortality.