Articles: patients.
-
To describe the socio-demographic characteristics and clinical outcomes of patients who leave the emergency department (ED) without being seen by a physician. ⋯ Patients who leave the ED without being seen have different socio-demographic features, methods of accessing the health care system, affiliations and expectations than the general ED population. They are often socially disenfranchised, with limited access to traditional primary care. These patients are generally low acuity, but they are at risk of important and avoidable adverse outcomes.
-
Reg Anesth Pain Med · Mar 2005
Review Case ReportsDealing with difficult patients in your pain practice.
Pain patients can be difficult. They can provoke negative feelings of frustration and anger among clinicians and damage the doctor-patient relationship. ⋯ Issues of comorbid psychopathology, hostility, suicidality, aberrant drug behavior, and chronic noncompliance are discussed. Specific recommendations are also given of the best ways to manage patients with difficult behavior.
-
Aesthetic surgery journal · Mar 2005
Ambulatory abdominoplasty tailored to patients with an appropriate body mass index.
The office-based surgery setting potentially offers advantages to both the patient and the plastic surgeon, but some patients may not be considered good candidates for abdominoplasty or combined abdominoplasty/lipoplasty performed in the ambulatory setting. ⋯ BMI evaluation, and in some cases additional risk assessment by a qualified anesthesia provider, can be helpful in determining proper candidates for ambulatory abdominoplasty and combined abdominoplasty/lipoplasty procedures.
-
Ion selective electrodes (ISE) measure electrolytes by two different technologies, direct and indirect. We wished to investigate the effect of total plasma protein concentration on the plasma sodium, potassium and chloride measurements by indirect ISE compared with measurements by direct ISE. ⋯ The plasma sodium, potassium and chloride measurements are effected by changes in plasma protein concentration when measured by indirect ISE systems. Clinicians must be aware that differences exist between the ISE technologies and in border-line clinical situations, the direct ISE systems provide a more accurate estimate of plasma sodium, potassium, chloride, anion gap, osmolality and strong ion difference calculations, and should be used for clinical decision-making.
-
Availability of opiate substances through physicians and on the street has led to a rise in dependence and in addiction resulting in countless numbers of people hooked on these drugs. Long-term use of these agents results in reduction of endogenous supply of opiate replaced by these exogenous compounds. A technique known as Ultrarapid Detoxification (UROD) has been developed and appears more promising than conventional modalities. ⋯ Though techniques vary from center to center, safety should be paramount with the technique performed in an intensive care unit with trained professional anesthesiologists. Psychosocial issues should be evaluated by a trained addictionalist and most people will succeed from the UROD procedure without experiencing the horrible withdrawal syndrome. Patients must have realistic goals and be prepared to deal with psychosocial issues post-procedure.