Why the US Should Adopt a Universal Health Care Coverage Program - eScholarship
Bibliographic record
Abstract
The California Journal of Emergency Medicine V:3, Jul-Sep 2004 Page 59 between practitioners, it is not surprising that their recommendations will also vary. We additionally suggest that the very nature of a telephone survey to determine PCC recommendations could artificially highlight any differences, when, in fact, clinical practice is more consistent. C ONCLUSION Considerable variation exists among the recommendations given by PCCs in the United States and Canada regarding the management of pediatric benzocaine exposures. The general consensus among our survey respondents was that: 1) the need for observation or any interventions is related to the estimated ingested dose, 2) patients evaluated in a healthcare facility should receive some kind of gastrointestinal decontamination, 3) patients should be observed for several hours (between 2 to 4 hours), 4) the primary signs to observe for are cyanosis, respiratory distress, and altered level of consciousness, 5) arterial blood gas sampling should be obtained on cyanotic patients, even if asymptomatic, and 6) antidotal treatment with methylene blue should be given for methemoglobin levels at or above 20%. R EFERENCES 1. Spiller HA, Revolinski DH, Winter ML, Weber JA, Gorman SE. Multi-center retrospective evaluation of oral benzocaine exposure in children. Vet Hum Toxicol 2000;42:228-31. 2. Curry S. Methemoglobinemia. Ann Emerg Med 3. Guertler AT, Pearce WA. A prospective evaluation of benzocaine associated methemoglobinemia in human beings. Ann Emerg Med 1994;24:626-30. 4. Rodriguez LF, Smolik LM, Zbehlik AJ. Benzocaine-induced methemoglobinemia: report of a severe reaction and review of the literature. Ann Pharmacother 1994;28:643-9. 5. POISINDEX ® System: POISINDEX ® Editorial Staff: Benzocaine (Management/Treatment Protocol). In: Klasco RK (Ed): POISINDEX ® System. Thomson MICROMEDEX, Greenwood Village, Colorado. 6. Lagutchik MS, Mundie TG, Martin DG. Methemoglobinemia induced by a benzocaine-based topically administered anesthetic in eight sheep. J Am Vet Med Assoc 1992;201:1407-10. 7. Juurlink DN, McGuigan MA. Gastrointestinal decontamination for enteric-coated aspirin overdose: what to do depends on who you ask. J Toxicol Clin Toxicol CaJEM PRO/CON This is a forum for the discussion of controversial topics in emergency medicine. Views expressed in this series are those of the discussants and may not reflect those of the editors. We asked, “should the United States adopt a universal health care coverage system?” Why the US Should Adopt a Universal Health Care Coverage Program Lance Brown, MD, MPH, FAAEM Chief, Division of Pediatric Emergency Medicine Associate Professor of Emergency Medicine and Pediatrics Loma Linda University Medical Center and Children’s Hospital Loma Linda, California LBROWNMD@aol.com There has been increasing interest in the development of universal health care coverage in the United States. 1- The most prominent of these calls has come from a recent Institute of Medicine (IOM) report calling for universal health care coverage in the United States by 2010. 4 There are several key points made in this report that are clearly worth consideration. Over a series of five reports, the IOM Committee on Consequences of Uninsurance made the following conclusions: 4 • The number of uninsured individuals under age 65 is large, growing, and has persisted even during periods of strong economic growth. • Uninsured children and adults do not receive the care they need; they suffer from poorer health and development, and are more likely to die early than are those with coverage. • Even one uninsured person in a family can put the financial stability and health of the whole family at risk. • A community’s high uninsured rate can adversely affect the overall health status of the community, its health care institutions and providers, and the access of its residents to certain services. • The estimated value across the population in healthy years of life gained by providing health insurance
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.034 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.005 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.008 | 0.007 |
| Insufficient payload (model declined to judge) | 0.048 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".