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Clinical Accuracy Spoken Here
Impending RF: Intubate Without Delay

A small minority of Asthma patients will show signs of worsening ventilation, whether from worsening airflow obstruction, worsening respiratory muscle fatigue, or a combination of the two. Signs of impending respiratory failure include a declining mental clarity, worsening fatigue, and a PCO2 of ≥ 42 mm Hg.  Because respiratory failure can progress rapidly and can be difficult to reverse, early recognition and treatment are critical. The Expert Panel Report 2 recommends that intubation not be delayed once it is deemed necessary.

Asthma: Module B, Complications www.athenaforum.com

Pain Assessment Intervals

Failure to assess pain is a critical factor leading to under-treatment. Assessment involves both the clinician and the patient. Assessment should occur at:

  • Regular intervals after initiation of treatment.

  • Each new report of pain.

  • A suitable interval after pharmacologic or non-pharmacologic intervention, e.g., 15 to 30 minutes after parenteral drug therapy and 1 hour after oral administration.

Identifying the etiology of pain is important to its management. Clinicians treating patients with cancer should recognize common cancer pain syndromes, since prompt diagnosis and treatment reduces the morbidity associated with unrelieved pain.

Pain Management: Module E, Cancer Pain
Excellence in Case Mgmnt
Commercial Payers Use Predictive Modeling

Predictive modeling applies a statistical methodology to clinical and administrative data to forecast medical outcomes and costs for a given population. Commercial payers use predictive modeling extensively to price their premiums and to budget for hospital costs. Commercial payers can improve disease management and care management programs through predictive modeling and thus can improve health quality and control utilization.

[Reference: Hospital Revenue Cycle: Module A, Industry Cash Flow]

In the Headlines . . .
CAD hospitalizations drop 32%

Over the last decade, the number of Medicare patients hospitalized for cardiac issues dropped more quickly than those attributed to other causes. Among heart health issues coronary artery disease hospitalizations dropped 32 percent, followed by heart attacks down about 22 percent. Heart failure hospitalizations also fell by nearly 17 percent, according to a study at New York University School of Medicine. Conversely, hospitalizations because of an irregular heartbeat (cardiac arrhythmia) bucked the trend, going up by more than 10 percent. (HealthDay News, May 11, 2011)

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The look of confidence
  CM Excellence® Series: 
  » Principles of Case
  » Patient Advocacy
  » Utilization Management
  » Discharge Planning
  » Hospital Revenue Cycle

  Clinical Series: 
  » Asthma
  » Behavioral Health
  » Colorectal Cancer
  » COPD
  » CV Risk: Stroke & MI
  » Diabetes
  » EOL & Palliative
  » GI Disorders
  » Heart Failure
  » Multiple Sclerosis
  » Obesity Management
  » Pain Management
  » Rheumatoid Arthritis
  » Women’s Health



Cathy Wright Cathy Wright, BSN, RN
Clinical Editor
Athena Forum


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