What if the patient says “No!” in the ambulance: An ethical perspective for assessment of capacity in the prehospital emergency setting

2014 ◽  
Vol 2 (3) ◽  
pp. 304 ◽  
Author(s):  
Hasan Erbay
Keyword(s):  
Emergency Setting ◽  
Ethical Perspective ◽  
Prehospital Emergency

Acute Pain and Availability of Analgesia in the Prehospital Emergency Setting in Italy: A Problem to be Solved

Pain Practice ◽  
2009 ◽  
Vol 9 (4) ◽  
pp. 282-288 ◽  
Author(s):  
Franco Marinangeli ◽  
Cristiano Narducci ◽  
Maria Laura Ursini ◽  
Antonella Paladini ◽  
Alberto Pasqualucci ◽  
...  
Keyword(s):  
Acute Pain ◽  
Emergency Setting ◽  
Prehospital Emergency

scholarly journals Management of Unanticipated Difficult Airway in the Prehospital Emergency Setting

2011 ◽  
Vol 115 (2) ◽  
pp. 441-442 ◽  
Author(s):  
Fu-Shan Xue ◽  
Xu Liao ◽  
Yu-Jing Yuan ◽  
Qiang Wang ◽  
Jian-Hua Liu
Keyword(s):  
Difficult Airway ◽  
Emergency Setting ◽  
Prehospital Emergency

scholarly journals Unanticipated Difficult Airway Management in the Prehospital Emergency Setting

2011 ◽  
Vol 114 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Xavier Combes ◽  
Patricia Jabre ◽  
Alain Margenet ◽  
Jean Claude Merle ◽  
Bertrand Leroux ◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Upper Airway ◽  
Simple Algorithm ◽  
Patient Characteristics ◽  
Emergency Setting ◽  
Early Intubation ◽  
Intubating Laryngeal Mask Airway ◽  
Proven Efficacy ◽  
Prehospital Emergency ◽  
Difficult Ventilation

Background Difficult intubation management algorithms have proven efficacy in operating rooms but have rarely been assessed in a prehospital emergency setting. We undertook a prospective evaluation of a simple prehospital difficult intubation algorithm. Methods All of our prehospital emergency physicians and nurse anesthetists were asked to adhere to a simple algorithm in all cases of impossible laryngoscope-assisted tracheal intubation. They received a short refresher course and training in the use of the gum elastic bougie (GEB) and the intubating laryngeal mask airway (ILMA), which were techniques to be used as a first and a second step, respectively. In cases of difficult ventilation with arterial desaturation, IMLA was to be used first. Cricothyroidotomy was the ultimate rescue technique when ventilation through ILMA failed. Patient characteristics, adherence to the algorithm, management efficacy, and early complications were recorded (August 2005-December 2009). Results An alternative technique to secure the airway was needed in 160 of 2,674 (6%) patients undergoing intubation. Three instances of nonadherence to the algorithm were recorded. GEB was used first in 152 patients and was successful in 115. ILMA was used first in 8 patients and second in the 37 GEB-assisted intubation failures. Forty-five patients were successfully mask-ventilated, and 42 were blindly intubated before reaching the hospital. Cricothyroidotomy was used successfully in a patient with severe upper airway obstruction as a result of pharyngeal neoplasia. Early intubation-related complications occurred in 52% difficult cases. Conclusion Adherence to a simple algorithm using GEB, ILMA, and cricothyroidotomy solved all difficult intubation cases occurring in a prehospital emergency setting.

No Country for Sick Men

2020 ◽  
pp. 91-96
Author(s):  
Diane L. Gorgas ◽  
Simiao Li-Sauerwine
Keyword(s):  
Emergency Medicine ◽  
End Stage Renal Disease ◽  
Chronic Treatment ◽  
Emergency Setting ◽  
Ethical Challenges ◽  
Ethical Perspective ◽  
High Resource ◽  
Active Labor ◽  
Stage Renal Disease ◽  
End Stage

Caring for undocumented immigrants in the emergency setting brings legal and ethical challenges. This chapter discusses the spectrum of these challenges, including duty to report to immigration authorities, the restrictions placed by the Health Insurance Portability and Accountability Act (HIPAA) on ability to report, and the ethical perspective on duty to provide compassionate care for undocumented persons. Providing emergency care is mandated under the Emergency Medical Treatment and Active Labor Act (EMTALA), but coordinating care for chronic medical conditions requiring high-resource treatments may fall under the venue of emergency medicine. This chapter reviews strategies for providing chronic treatment of end-stage renal disease (ESRD) among undocumented persons, and discusses the legal and ethical questions involving this patient population.

scholarly journals Feasibility of CardioSecur®, a Mobile 4-Electrode/22-Lead ECG Device, in the Prehospital Emergency Setting

2020 ◽  
Vol 7 ◽  
Author(s):  
Sebastian Spaich ◽  
Hanna Kern ◽  
Thomas A. Zelniker ◽  
Jan Stiepak ◽  
Michael Gabel ◽  
...  
Keyword(s):  
Emergency Setting ◽  
Prehospital Emergency
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