Flashcards in Introduction to Emergency Medicine Deck (21):
Describe the role of a PA in an emergency room setting.
Primary mission = “evaluating, managing, and providing treatment to these patients with unexpected injury and illness.”
Wide skill base to treat variety of illness, ages, biohazard injury. Consider life-threatening pathology without necessarily aiming for a diagnosis. Recognize time constrants.
What is the EMTALA law:
The Emergency Medical Treatment and Active Labor Act was created in 1985 to protect the patient from being turned away during a state of emergency.
The basics of EMTALA requires the following:
Determining whether or not an ‘‘emergency medical condition’’ exists is by way of the ‘‘appropriate medical screening examination’’. If, after completing an adequate medical screening examination, it is determined that the patient is not suﬀering from an emergency medical condition, there is no further obligation under the Act on the part of the hospital or physician to that patient.
T/F: If there is no emergency medical condition, the Act does not apply. Any patient who is found to have an emergency medical condition must be stabilized.
T/F: The appropriate on-call physician is not required to be consulted in the administration of necessary stabilizing treatment in emergency situations.
False, If necessary, the appropriate on-call physician must be consulted to administer necessary stabilizing treatment.
T/F: Once the patient has been stabilized, the Act no longer applies.
T/F: If a hospital is un- able to provide the necessary stabilizing treatment, arrangements must be made for an appropriate transfer to a facility with the capacity to provide treatment.
T/F: A hospital with specialized capabilities or facilities may refuse to accept a transfer of an individual who requires such specialized capabilities or facilities even if the hospital has the capacity to treat the individual.
False, A hospital with specialized capabilities or facilities may not refuse to accept an appropriate transfer of an individual who requires such specialized capabilities or facilities if the hospital has the capacity to treat the individual.
T/F: If a woman is in active labor and there is insuﬃcient time to eﬀect an appropriate transfer safely, maternal and newborn care must be provided to the woman and her infant.
Patient has symptoms consistent with life-threatening illness or injury with high probability of death if immediate intervention is not begun.
Patient has symptoms of illness or injury that may progress in severity if treatment is not begun quickly.
Patient has symptoms that have a low probability of progression to a more serious condition.
Basic rule of thumb in emergency medicine is:
Look for symptoms of a life-threatening emergency, not a specific disease entity. Anticipate impending life-threatening emergencies in the apparently stable patient.
T/F: Small ERs may be staffed by PAs with supervising physician available only by phone
T/F: Many of the supervising ER physicians are board certified in Emergency Medicine.
False, Many of the supervising ER physicians are actually not board certified in Emergency Medicine
What are the triage levels?
Levels 1 – 5, with Level 1 being most acute and Level 5 being least acute.
May change triage level according to vitals (including pain scale)
Who determines the triage level?
Triage nurse determines level
What do EMTALA Laws determine?
Determines when and how a patient may be:
1. Refused treatment or
2. Transferred from one hospital to another
What hospitals are governed by EMTALA laws?
EMTALA applies only to participating hospitals, defined as those that are acceptors of Medicare and/or Medicaid. This excludes Shriners and Military hospitals.
What is an emergent condition?
An emergent medical condition manifests itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in: Placing the health of the individual or unborn child in serious jeopardy, Serious impairment to bodily function or Serious dysfunction of any body part or organ.