ABSTRACT
This article describes one renal disease management organization's experience in implementing a pre-dialysis care management program to improve outcomes in patients who develop end-stage renal disease (ESRD). Optimal Renal Care, a national renal disease management company, has implemented care management programs for 600+ ESRD patients and 600+ pre-ESRD patients in Oregon (1998) and Hawaii (1999). This article describes our Oregon pre-ESRD program's start-up experience.
Subject(s)
Disease Management , Kidney Failure, Chronic/therapy , Patient Care Planning , Renal Dialysis , Humans , Patient Advocacy , Patient Care Team , Patient Education as Topic , Patient Selection , Program Development , Treatment OutcomeABSTRACT
A 74-year-old man presented with bradycardia, diaphoresis, mental confusion, and slurred speech. He developed asystole and was managed successfully with temporary emergency transvenous pacing and support of ventilation and blood pressure. He later was found to have ingested approximately 1,500 mg diltiazem, apparently as the result of an error created by his blindness and chronic confusion.
Subject(s)
Benzazepines/poisoning , Diltiazem/poisoning , Heart Arrest/chemically induced , Aged , Heart Arrest/therapy , Humans , Male , Medication Errors , ResuscitationABSTRACT
Nitrous oxide levels of 300 to 500 ppm occur when nitrous oxide is administered in the emergency department using the Nitronox machine without use of the scavenger device, which traps expired nitrous oxide gases and vents them to the outside environment. A scavenger device that can limit nitrous oxide gas to zero ppm in the emergency department setting has been developed. We think that development of the scavenger device is a significant advance for the safe administration of nitrous oxide in the emergency department.
