Biomedical subjects

K T Ghezzi

Publications and source records attributed to K T Ghezzi.

6 recordsLinked to original sources

PubMed2001

The Emergency Medical Treatment and Labor Act as a federal health care safety net program.

Despite the greatest economic expansion in history during the 1990s, the number of uninsured U.S. residents surpassed 44 million in 1998. Although this number declined for the first time in recent years in 1999, to 42.6 million, the current economic slow-down threatens once again to increase the ranks of the uninsured. Many uninsured patients use hospital emergency departments as a vital portal of entry into an access-impoverished health care system. In 1986, Congress mandated access to emergency care when it passed the Emergency Medical Treatment and Labor Act (EMTALA). The EMTALA statute has prevented the unethical denial of emergency care based on inability to pay; however, the financial implications of EMTALA have not yet been adequately appreciated or addressed by Congress or the American public. Cuts in payments from public and private payers, as well as increasing demands from a larger uninsured population, have placed unprecedented financial strains on safety net providers. This paper reviews the financial implications of EMTALA, illustrating how the statute has evolved into a federal health care safety net program. Future actions are proposed, including the pressing need for greater public safety net funding and additional actions to preserve health care access for vulnerable populations.

Delivery of Health Care↗

PubMed1995

General ophthalmologic examination.

Caring for patients with eye emergencies will always challenge even the most experienced emergency clinician. The threat of loss of sight is anxiety provoking for patients and requires the physician to act in an organized and expeditious manner. By avoiding these pitfalls and examining each patient in a systematic and comprehensive fashion, the physician can ensure the best possible outcome. The ensuing articles describe the approach to diagnosing and treating significant eye emergencies in greater detail.

Adult↗

PubMed1994

Effectiveness of transnasal butorphanol for the treatment of musculoskeletal pain.

A prospective, open-label study of the effectiveness of transnasal butorphanol in the treatment of pain resulting from musculoskeletal injuries. Twenty-eight patients with strains (n = 20), fractures (n = 6), contusions (n = 1), and stab wounds (n = 1) were included. All patients were examined by an attending level emergency medicine physician and deemed to have pain severe enough to warrant parenteral narcotic analgesia. All patients received an initial 1-mg dose of transnasal butorphanol. Subsequent dosing was flexible depending on response to the initial dose. All patients received pain relief from transnasal butorphanol, and only one requested alternative analgesic medication. Fifty-seven percent (n = 16) of patients noticed at least a little relief of pain within 5 minutes of administration and 93% (n = 26) received at least a little relief within 15 minutes. Seventy-one percent of the patients received a 50% reduction of pain within 60 minutes. No serious side effects were noted, but drowsiness occurred in 82% (n = 23) and dizziness in 54% (n = 15) of the patients. One patient discontinued participation in the study because of nausea. In this limited trial transnasal butorphanol proved to be a rapidly effective opioid analgesic. Further controlled studies comparing transnasal butorphanol with standard parenteral narcotics are needed.

Administration, Intranasal↗

PubMed1992

Accidental hypothermia.

Hypothermia continues to be a major public health problem and a challenge to health care providers. The very young, the very old, and the poor are at greatest risk. Life-threatening physiologic changes make rapid rewarming mandatory. Numerous rewarming methods have been described in the literature; the decision to use any of the methods available depends on the degree of hypothermia present, the condition of the patient, and the rewarming rate possible with the method chosen. Cardiopulmonary bypass, if available, is the optimal method for rewarming the severely hypothermic patient.

Algorithms↗

PubMed1989

Lightning injuries. A unique treatment challenge.

Care of victims of lightning injury is a unique challenge rarely encountered in most clinical practices. Victims may present without signs or symptoms or, conversely, may present in cardiac arrest. Many have chronic, debilitating sequelae. Physicians caring for these patients either in the field or in the emergency department should be prepared to institute aggressive management techniques. An understanding of lightning physics and injury patterns prevents costly and inappropriate diagnostic tests and treatment.

Electric Injuries↗

PubMedDate not supplied

Post-triathalon delirium.

This is a case presentation of acute delirium in a previously healthy man. It was originally discussed during Morbidity and Mortality Conference at The George Washington, Georgetown Residency Program in Emergency Medicine, December 1989.

Adult↗