Mary San Juan Hospital is in receipt of a denial letter dated December 26, 2016 for acute inpatient care provided on the above dates. The denial is based on the premise that it was medically unnecessary. However, the hospital has determined that this acute inpatient admission was warranted and supported by clinical documentation in the medical chart. The treating physician exercised their expert opinion in electing to admit this patient out of concern that his symptoms were attributed to an acute or escalating clinical condition.…
OBJECTIVE #1 - The clinical manifestation of, and risk factors for, rhabdomyolysis • Rhabdomyolysis is a condition of skeletal muscle breakdown due to the release of intracellular components into the bloodstream, including myoglobin, creatine kinase, aldolase, lactate dehydrogenase, and electrolytes (DynaMed Plus, 2016). • The patient may experience systemic symptoms that may include fever, malaise, nausea, dyspepsia, emesis, muscle pain, weakness and swelling of injured muscles, tea-colored urine (DynaMed Plus, 2016). • High statin dosage and renal disease combined are associated with an increased risk for developing rhabdomyolysis (Wiley, 2006, p. 357). Other high risk factors include the use of drugs and/or alcohol, high body temperature,…
I found it very difficult to find a code for "mosh" or "mosh pit" so I am hoping that I did this correctly. I chose to code it this way: S00.83xxA Contusion of other part of head S20.21xxA Contusion of front wall of thorax S40.021xA Contusion of right upper arm S40.022xA Contusion of left upper arm W52.xxxxA Crushed, pushed or stepped on by crowd or human stampede Y93.41 Activity, dancing (all types) By using these codes, I first read the Official Guidelines for Chapter 19 Injury, Poisoning, and other Consequences of External Causes.…
In Celine Gounder’s article Who is Responsible for the Pain-Pill Epidemic? we see one doctors’ search for who is to blame for the current state of opioid dependency in America. What happened and how it happened occupy the first few pages of her article. In 1980 and in 1986 “two small accounts in medical journals” (Gounder) seemed to suggest that opioids weren’t that bad.…
The claimant has a past medical history of depression and anger. He had suicidal thoughts and felt desperate but unable to function. He reported obsessive repetitive thoughts and hopelessness. He had tried Lexapro, but had a negative reaction, including uncontrolled rage and attacking his girlfriend. He was unable to make some follow-up visits and to have psychiatric evaluation due to insufficient funds.…
I encountered situations ranging from a bloody nose to an unconscious guest. While each situation has a basic procedure we follow, the case at hand must be uniquely evaluated. One incident I faced required a treatment strategy for an unconscious guest plus the factor of a seizure. A younger woman passed out waiting in line for a slide and collapsed to the ground. While unconscious, I assessed her breathing and pulse.…
In her book “Opening Skinner’s Box,” Lauren Slater invites us in this book to reflect on human nature by describing, commenting and inquiring about classic experiments in psychology. In chapter 7: “Rat Park” The Radical Addiction Experiment. She brings up an experiment that Bruce Alexander, a psychologist; made with rats. He decided to build a colorful park where he put from 16 to 20 rats of both genders with abundant food, balls and wheels to play. On the other hand, he isolated other ones into the cage, which are forced to consume morphine for 57 days.…
Patient is a 42-year-old male who presented to the ED with an alleged overdose on 50-60 prescribe pills of 450mg PO Daily Trileptal. Patient stated: "I took pills because I was having mood swings." Step- father brought patient into the ED. At the time of assessment, patient endorses feeling suicidal without a plan. Patient reports not being able to go see his son as the primary factor contributing to his current distress.…
In 2015, Victoria, BC saw an increase in drug overdoses throughout the city including one death occurring in Esquimalt (news source). Drug-related fatalities are preventable if the population has access to services that would minimize the risk of an overdose. Through an assessment of the community of Esquimalt, I am proposing that there is a need to build a safe injection site to prevent accidental overdoses, as well as provide social services for detoxification and rehabilitation programs. It is important to note that Victoria and Esquimalt are not distinguished communities when studies are done. Therefore, the extrapolation of exact drug use statistics for Esquimalt is not available.…
Electronic Medication Administration Record and Patient Safety One of the reason medication related deaths occur are due to medication errors (Karen, 2011, p. 1). In fact, within the United States, approximately 7,000 people die each year due to medication errors (Karen, 2011, p. 1). According to Karen (2011) 1.3 million medication errors occur yearly, which relates to several injuries and approximately one death a day related to medication errors in the Unites States (Karen, 2011, p. 1). One major cause of medication errors can be explained using the medication administration process (Mccomas, 2014, p.590). When a health care provider is responsible to administer a medication, there are approximately 50 to 100 steps involved in this process…
Recognize the effects of unsafe drug labeling practices on patients, health care professionals, and health care organizations. Identify at least three common drug labeling errors that can lead to an adverse drug event. Describe ways health care professionals can contribute to the decrease of medication errors due to inappropriate drug labeling practices.…
Introduction Unintentional poisoning is now the leading cause of injury death in the United States affecting those age 15-64 (CDC WISQARS, 2014). Unintentional poisoning includes all drug overdoses; however, of particular concern currently in the United States is prescription opioid overdose. Opioids are a class of drug that are designed to relieve pain. Prescription opioids include brands such as Vicodin, OxyContin, Percocet, Duragesic, Demerol, and Dilaudid, amongst others.…
Within the past year, eleven million Americans abused an opioid pain reliever and two million became dependent on them. Opioids are one of the most accessible drugs because of how often they are prescribed and are often seen as a gateway to other drugs. Seeing that most opioid abusers are aged twenty-five to forty, it is safe to say that many have children or will have children. As with any type of drug, opioid use has a significant effect on the daily life of the user, which in turn, affects their loved ones. Children whose parents are abusing opioids have shown to be more delinquent, have more mental health problems, and have a higher chance of accidental overdose.…
Conclusion Since the beginning of the twenty-first century, the total prescriptions per year in United States have increased rapidly, and the study done above confirms that these increasing prescribing rates are causing significant damage to the country’s health. As the number of prescriptions increase, the amount of prescription harm recorded not only follows but increases at a significantly higher rate. This disproves my original hypothesis and indicates that the prescription process is currently flawed, and this flaw primarily originates within the drug monitoring systems. Improving Prescription Drug Monitoring As explained by Dr. William Yang, the increasing prescription rates alone should not be alarming as they can be attributed to the advancements in diagnostic technology, but the current drug monitoring systems are incapable of managing the superior number of prescriptions. As highlighted by the recent efforts of INSPECT, the drug harm trends can be reversed by improving prescription drug protocols.…
This world is a harmful place. There are many bad things in this world, but one thing that greatly affects the U.S. is drug abuse. There are a lot of different consequences for drug abuse, but the greatest one is death. A lot of drug overdoses and deaths are caused by prescription drugs. Ironically, a lot of doctors in the U.S. are giving these deadly prescription drugs.…