1 EMTALA & PATIENT- CENTEREDNESS Week 9 .docx

1
EMTALA & PATIENT- CENTEREDNESS
Week 9 Assignment
Faridah Mohammad
HA330-44
06/22/2019
1
Justin Doheny @ 2019-07-09T08:40:10-07:00

This needs to be including at the top left of every page of this
paper
2
1. What was the reasoning for enacting the Emergency Medical
Treatment and
Active Labour Act?
EMTALA is a form of activism that has been implemented to
perform different functions in
the healthcare section. Major reasoning for engaging the
EMTALA includes the stabilization
of critical patients in emergent situations before being taken to
any medical center as needed.
This is done through proper evaluation of the condition and
determining the best way of
responding to a critical state of affairs of the patient. Key other
reasons will include the
aspect of preventing more damage and impairment of one's
health and also gives room to
determine the best receiving hospital with the necessary
facilities, skills, and medical
capabilities. Also in addition to that, there is a chance to record
every step of the patient's

state of health (Jeremy &Julia, 2016).
2. Should medical advice be dispensed on the Telephone?
Explain your opinion.
In this case, medical advice can be dispensed over the phone
depending on what the situation
entails. If it's on general medical situations, then it's ok as this
has few of its benefits.
Through the telephone, one can have excellent advice as in most
cases, skilled medical
expertise is the ones allowed to give the advice hence
dependable information is provided.
Also, its time saving as there are cases where the patient has
doubts and instead of meeting up
with doctors can consult through the phone. In the case of the
emergent situations, life could
be saved through first aid performance before urgent help is
availed. Such medical advice
involves privacy between the client and doctor and it's cost-
effective. However, it's key to
have a disclaimer of the medical situation to maintain strictly a
doctor-patient relationship
(Ellen, 2014).

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5
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Justin Doheny @ 2019-07-09T08:41:29-07:00
Which case are you referring to here?
Justin Doheny @ 2019-07-09T08:42:12-07:00
Not sure what you are trying to say here
Justin Doheny @ 2019-07-09T08:43:20-07:00
Do you mean "experts"? Proofread
Justin Doheny @ 2019-07-09T08:44:56-07:00
I really have no idea what point you are trying to make here.
Justin Doheny @ 2019-07-09T08:55:48-07:00
It is not a form of activism, it is a Federal Law!
Justin Doheny @ 2019-07-09T08:56:32-07:00
This is the wrong word to use in this sentence.
Justin Doheny @ 2019-07-09T08:58:06-07:00
This response does not really address the question. It does not
really explain why it was passed,which is the question.

3
3. Why prescribing, control, administration, and monitoring of
medication is a
major area of legal concern for healthcare professionals?
Legal concerns analyze the legitimacy of conducting certain
duties as needed by the
authority. Thus most healthcare professionals are greatly
concerned with the law since it
helps in dealing with medical crises like the misused
prescription rate of medicines and drugs
thus avoidance of overdosing. It helps to make sure the
medication given is utilized and used
for the right purposes. Legal concerns are there to guide them to
avoid imprisonment as a
consequence of medication misuse. Lastly, it's part of
professionalism and has ethical
standards. Patients too are empowered in understanding the
legal way of accessing medical
attention (Mary, 2018).

9
Justin Doheny @ 2019-07-09T08:46:55-07:00
This sentence is poorly written. I have no idea what point you
are trying to make.
4
References
Ellen, H. - Medical-Legal Attorney (2014). What are the legal
ramifications of giving
medical advice online? https://www.quora.com/topic/Medical-
Malpractice-and-
Medical-Law-Suits
Jeremy, S. L. & Julia, F. (2016). Why it’s important to follow
EMTALA, the "anti-dumping"
law. Providence, Oregon. https://oregon.providence.org/forms-
and-
information/w/why-its-important-to-follow-the-emtala-anti-
dumping-law/
Mary D. (2018). Legal & Ethical Issues that Health Care

Professionals Face.
https://work.chron.com/personal-care-service-job/
10
11
https://www.quora.com/topic/Medical-Malpractice-and-
Medical-Law-Suits
https://www.quora.com/topic/Medical-Malpractice-and-
Medical-Law-Suits
https://oregon.providence.org/forms-and-information/w/why-its-
important-to-follow-the-emtala-anti-dumping-law/
https://oregon.providence.org/forms-and-information/w/why-its-
important-to-follow-the-emtala-anti-dumping-law/
https://work.chron.com/personal-care-service-job/
Justin Doheny @ 2019-07-09T08:49:48-07:00
This link no longer works.
Justin Doheny @ 2019-07-09T08:52:45-07:00
You use an author's LAST name, not their First name, when you
list them in the Reference List.
Comment Summary
Page 1
1. This needs to be including at the top left of every page of this
paper
Page 2
2. Which case are you referring to here?
3. Not sure what you are trying to say here
4. Do you mean "experts"? Proofread
5. I really have no idea what point you are trying to make here.

6. It is not a form of activism, it is a Federal Law!
7. This is the wrong word to use in this sentence.
8. This response does not really address the question. It does
not really explain why it was passed,which is the
question.
Page 3
9. This sentence is poorly written. I have no idea what point
you are trying to make.
Page 4
10. This link no longer works.
11. You use an author's LAST name, not their First name, when
you list them in the Reference List.
ECOSYSTEMS AND ENERGY FLOW - Moore
*
LIVING WITH THE EARTH
*
Objectives for this ChapterA student reading this chapter will
be able to:1. Discuss and define the concepts of biosphere and
climate. 2. List and explain the factors influencing climate. 3.
Define the term biome. List the major global biomes and discuss
their primary features.

*
Objectives for this Chapter4. Describe the flow of energy
through ecosystems. Describe and explain the various trophic
levels. 5. List and explain the various nutrient cycles including
the carbon, nitrogen, and phosphorous cycles. 6. Define the
term succession, explain the mechanisms of succession, and
discuss the types of human intervention that interfere with
succession.
*
LIVING WITH THE EARTH ECOSYSTEMS AND ENERGY
FLOW
INTRODUCTIONWe are immersed in life.Conditions for most
life are found in a layer about the globe that extends from
approximately 5 miles in the atmosphere (where some microbial
spores and insects may be found) to 5 miles below the ocean
surface.
*
BIOSPHEREThis theoretical “layer of life”, is called a
biosphere because life is thought not to exist outside this
area.Most life occurs in a narrow layer extending from about a
600 foot depth in the ocean where sunlight is able to penetrate,

to the summer snow line of high mountain peaks where a thin
layer of soil supports plant life such as lichens and mosses.
*
BIOMESBiomes are based on the dominant types of vegetation
which are strongly correlated with regional climate patterns.
*
CLIMATE - What is it? Climate can be viewed as average
weather within a geographical area viewed over years, or even
centuries.Climate, like weather, includes temperature,
precipitation, humidity, wind velocity and direction, cloud
cover, and associated solar radiation.
*
What Causes Climate?(1) changes in ocean temperatures; (2)
changes in the earth’s orbital geometry; (3) volcanic activity
with increased atmospheric dust and reduced sunlight
penetration; (4) variations in solar radiation; or (5) increases in
atmospheric gases that absorb heat energy.

*
How is Climate Affected?Climate is most affected by
temperatureThe amount of sunlight striking the earth varies by
region and time.The seasons are caused by the tilt of the earth
on its axis as it revolves around the sun. (Figure 1-1).
*
Fig. 1-1
*
How is Climate Affected?The sun impacts the earth in bands of
decreasing energy extending north and south from the equator
(Fig. 1-2).
Fig. 1-2
*
Arctic- Mostly subzero weather, very little precipitation.
Tundra- 6-10 months winter, mean temperature <0 degrees

Celsius, <5 inches/year precipitation
Taiga- Subpolar, severe winters up to 6 months long.
Temperatures below freezing to 32.5 degrees Celsius. 15-20
inches/year of precipitation, winter drought.
Temperate- Warmer continental and humid subtropical climates,
20-60 inches a year of precipitation
Tropical- Mean monthly temp >17.8 degrees Celsius, >100
inches a year of precipitation
*
*
*
How is Climate Affected?More recent models show that there
are multiple Hadley cells known as the three-zone model (Fig.
1-3a and Fig. 1-3a).
*
Fig. 1-3A, 1-3B
Hadley model on the left contrasted with the Three-Zone Model
on the right. Three-Zone model has multiple smaller versions of
Hadley cells along with various winds: the polar easterlies,
westerlies, Northeast tradewinds, equatorial doldrums, and
southeast tradewinds.
*
*

*
How is Climate Affected?The deflection of air masses to the
east or west is a result of the earth’s rotation, causing the
deflection of air from its northerly or southerly path and this is
known as the Coriolis effect (Fig. 1-4).
*
Fig. 1-4
Adapted from Godish, 1
Air is deflected from its direct southerly direction to the
southwest in the northern subtropical Hadley cell. This
deflection is caused by the Earth’s rotation along with friction.
Image shows rotation of earth and wind’s changing path.
*
*
*
ECOSYSTEMS AND BIOMESEcosystemsEcosystems are often
a component of a biome. The relationship of biosphere, biomes,
ecosystems and populations is shown in Figure 1-5.Ecosystems

refers to identifiable areas within nature where the organisms
interact among themselves and their physical environment and
exchange nutrient.
*
Fig. 1-5
*
*
*
EcosystemsThe biotic components include living organisms and
the products of these organismsThe abiotic components of the
ecosystem include such things as water, air, sunlight, minerals,
and their interaction.
*
BiomesBiomes may be seen as groupings of plants and animals
on a regional scale whose distribution patterns depend heavily
on patterns of climate.The biome is identified by the climax

vegetation or community.A climax community forms in an
undisturbed environment and continues to grow and perpetuate
itself in the absence of further disturbance.
*
BiomesTundra (Fig. 1-6)Limited to the upper latitudes of the
northern hemispheres and forms a belt around the arctic ocean.
Barren, treeless, low-lying shrubs, mosses and lichens.Long
winters, short growing season, little precipitation.Little soil
under permafrost.
*
Tundra (Fig. 1-6)
Photo purchased from Photodisc, Inc. Seattle, WA 08124
*
BiomesTaiga (Fig. 1-7)Coniferous (cone-bearing) trees
extending in a giant arc from Alaska, North America and
Canada, through Europe and Siberia.Rainfall 15-20 inches
annually, long severe winters. Conical, needleleaf trees adapted
to harsh winter.Moose, elk, deer, snowshoe hare: Predators
whose coats become white in winter.

*
Taiga (Fig. 1-7)
*
BiomesTemperate Broadleaf Deciduous Forest (Fig. 1-
8)Broadleaf deciduous forests are located in western and central
Europe, eastern Asia and eastern North America.Receive 20 to
60 inches of precipitation distributed evenly throughout the
year.Carnivores have been mostly eliminated by habitat
destruction and hunting. Nut-eaters such as squirrels and
chipmunks; omnivores such as raccoons, skunks, black bear and
opossum.
*
Temperate Broadleaf
Deciduous Forest (Fig. 1-8)

*
BiomesTemperate Evergreen ForestWhere soil is poor and
droughts and fires are frequent, the predominant species tend to
be evergreens.Cool coastal climates where there is considerable
rainfall or frequent heavy fogs may produce temperate
rainforests (redwoods).
*
BiomesChaparralsModerately dry climate characterized by small
(3-15 foot) shrubs with leathery leaves that contain aromatic
and flammable substances.
*
BiomesTemperate Grasslands (Fig. 1-9)Includes prairies,
steppes, veldt, pampas.10 to 20 inches of precipitation a year,
much of which falls as snow.Predominant plant forms are
perennial grasses, forbs, and members of the sunflower and pea
families.Ground squirrels, prairie dogs, and pocket gophers.
*
Temperate Grasslands
(Fig. 1-9)

*
BiomesThe Tropical Rainforest (Fig. 1-10)Constant warmth,
with average monthly temperatures above 17.8ºC.There are no
seasons in the rainforest.Precipitation greater than 100 inches
per year.More than 40 percent of world’s plant and animals
grow in the tropical rainforest. The life of the forest occurs in
the canopy.
*
The Tropical Rainforest (Fig. 1-10)
Canopy
Emergent trees
Understory
*
BiomesDeserts (Fig. 1-11).Defined by arid climates averaging
less than 10 inches of precipitation a year and where
evaporation exceeds this precipitation.Can reach temperatures
higher than 37.8°C (100°C) on summer days while some
plummet to -6.7°C (20°F) at night.

*
Deserts (Fig. 1-11)
*
BiomesConditions Creating DesertsEasterly winds keep moist
air rising off the oceans from reaching the coast.Near the 30°
latitude, subtropical air descends in association with the Hadley
cell, then compresses causing the formation of heat and dry,
warm air.Temperate deserts are generally located in areas
known as rain shadows (Fig. 1-12).Located in the interiors of
continents.
*
Rain Shadows (Fig. 1-12)
Adapted from Turk & Turk. 3
Air flow from ocean toward shore. Moisture from the ocean
cools and condenses to form rain on the windward side of the
mountains. Dry air falls on the leeward side. The air compresses
as it falls, and so it warms and then absorbs moisture.

*
*
*
ENERGY FLOWEnergy SourceThe energy comes from the sun.
99.9 % of the sun’s energy reaching the earth is reflected into
space, absorbed as heat, or evaporates water (Fig 1-13).0.1 % of
sun’s energy used by plants for photosynthesis to create simple
sugars from carbon dioxide and water with the release of
oxygen.
*
Energy Flow (Fig 1-13)
Figure 1.13- 99.9% of sun’s energy striking the earth is
reflected to space, absorbed, or used to evaporate water, 0.1%
of sun’s energy is absorbed by plants. Most is in the visible
blue and red spectrum.
At 180,000 miles a second, the sun’s rays take less than 10
minutes to reach the earth.
Sunlight: 6CO2+ 6H20---C6H12O6 + 6O2
The energy is used to create high energy sugars in a process
called photosynthesis
*
*

*
ENERGY FLOWEnergy SourceHeterotrophs convert about 10 %
of the consumed Kcalories into flesh or organic matter (Fig. 1-
14). 90 % of consumed energy used in respiration necessary for
the energy of motion.As energy is transferred through the food
chain, about 90 percent of that available energy is lost with
each transfer.
*
Energy Flow and Hetero-trophs (Fig. 1-14)
99.9% of the sun’s energy reaching the earth is reflected to
space, or absorbed, or evaporates waters. .1% of this energy is
used by plants. About 20% of this used in plant respiration, 50-
80% used for plant growth. Plants are autotrophs and are first
trophic level producers.
About 10% of available energy in plants is used by herbivores.
A small amount is used for growth, most is used for respiration.
Herbivores are in the second trophic level, are primary
consumers, and are heterotrophs/
About 10% of available energy in herbivores is used by flesh-
eating animals (carnivores). A small amount is used for growth,
most used for respiration. Carnivores are in the third trophic
level, are secondary consumers or higher, and are heterotrophs.
*
*

*
ENERGY FLOWA wolf which consumes deer or rabbits that eat
grass would be a secondary consumer and would receive (1/10
x 1/10 = 1/100) of the available energy in the plant. 3,000 lbs.
of corn would feed one steer which would feed one person,
while the grain would feed 20 people. (Fig. 1-15).
*
Efficiency of Primary Consumers (Fig. 1-15)
3,000 pounds of corn and grain may be used to feed one cow.
The meat from one cow may feed one person over the same time
period.
3,000 pounds of corn and grain may be used to feed about 20
people over the same time period.
*
*
*
Consumption TypesAnimals that eat only plants are
herbivores.Animals that eat primarily animal flesh are called

carnivores.Animals that eat plants and animals are termed
omnivores and include rats, bears, humans, hogs, and foxes.
*
Trophic LevelsPlants are producers and belong to the first
trophic level.Primary consumers or herbivores belong to the
second trophic level. Secondary consumers (carnivores) belong
to the third trophic level (or higher).
*
Trophic LevelsPatterns of consumption tend to be complicated
and the term food web has been used to refer to these complex
patterns (Fig 1-16).
*
Food Web (Fig 1-16)
Food web with plants, iherbivores, omnivores, and carnivores.
Plant producer has arrows to all omnivores and herbivores,
herbivores have arrows to carnivores.

*
*
*
NutrientsRecyclingNutrients are recycled in a process called
biogeochemical cycling.Scavengers prefer to feed upon the dead
remains of animals. Decomposers are insects, bacteria, fungi,
and protozoans that SEQUENTIALLY break down complex
organic materials into low energy mineral nutrients that once
again may be reabsorbed and used by plants.
*
RecyclingSulfur, phosphorous, carbon, oxygen, hydrogen, and
nitrogen are known as macronutrients.Elements required in tiny
amounts such as zinc, manganese, chlorine, iron, and copper
that are termed trace elements.
*
Nutrient CyclesCarbon CycleIncludes physical states of gas,
liquid, or solid, and chemical forms include organic and
inorganic (Fig 1-17).CO2 comes from respiration, combustion
of fossil fuels, and decomposition of organic matter.

*
Carbon Cycle (Fig 1-17)
Carbon Cycle. (1.5% in land organisms). CO2 is released from
human and animal respiration and decomposition of dead
animals and animal waste. CO2 gasses dissolve in atmosphere.
CO2 is used by plants in photosynthesis. O2 is released by
healthy plants, CO2 is released by cutting and burning forests.
CO2 is 2.5 % decayed material and 21% in fossil fuels- coal
and oil. CO2 is released by combusted fossil fuels, Ca2+ is
dissolved and released from rocks by acidity in rain. Rain made
slightly acidic by CO2 dissolved in clouds. CO32- + Ca2+
Makes CaCO3.
There is 71% carbon in oceans, 3 % in organic matter at bottom
of oceans. CO2 in oceanse is source of CO 32-. When dissolved
CO2 evaporates, cycle perpetuates with acid rain falling once
mpre/
*
*
*
Nutrient CyclesCarbon CycleHighest levels of carbon are found
in oceans.Plants convert inorganic carbon to carbohydrates by
photosynthesis. The plants may be consumed, decompose, or
eventually converted to fossil fuels.

*
Nutrient CyclesNitrogen Cycle (Fig. 1-18)Atmospheric nitrogen
must be converted to nitrates, nitrites, or ammonia before used
by plants or animals.Conversion to these forms is natural or
synthetic.
*
Nitrogen Cycle (Fig. 1-18)
Atmospheric Nitrogen is converted in multiple ways. Lightning
combines nitrogen with oxygen to form nitrates after a series of
steps. The rain produced contains nitrates (Nox). Fixed nitrogen
is used by plants to synthesize amino acids which are consumed
by animals, who produce urea which goes through microbial
decomposition, producing amino acids and then ammonia. The
runoff from urea and amino acids leads to denitrifying bacteria
under anaerobic conditions in sediment and mud, which
combines with lightning to repeat the cycle. It also gets
absorbed by roots and soil.
Additionally, Nox produced by combustion process in factories,
vehicles. Factories produce nitrogen fertilizers adding NO2 and
NH4+ to soil, water. This is absorbed by soil and roots as well.
Atmospheric nitrogen also goes into soil and roots where it is
met with nitrogen-fixing bacteria.
*
*

*
Nutrient CyclesNatural Nitrogen ConversionBy nitrogen-fixing
bacteria (Rhizobium spp.) or some species of organobacteria.By
lightning.Released from erosion of nitrate-rich rocks
*
Nutrient CyclesMan-made Nitrogen ConversionManufacture of
fertilizersNOx created in boilers and internal combustion
engines , then converted to nitrates and nitrites in the
atmosphere.
*
Nutrient CyclesRecycledConverted from complex organics back
into to atmospheric nitrogen by denitrifying bacteria.The
bacteria are anaerobic and live in mud and sediment of lakes,
streams, and ponds.
*
Nutrient CyclesPhosphorousGradually leached from
sedimentary rock by the actions of rain or erosion, in a process

referred to as the sedimentary cycle.Phosphorous is the main
element in compounds such as adenosine triphosphate
(ATP).Animal wastes and decomposing animals release
phosphorous back to the soil for reuse by plants .
*
Nutrient CyclesPhosphorousMining and agriculture can erode
soil and carry phosphorous into streams, etc.Phosphate rocks
are a non-renewable resource that were created millions of years
ago. Phosphate being rapidly depleted. Infertile soils likely to
develop.
*
SUCCESSIONSuccession refers to the predictable and gradual
progressive changes of biotic communities toward the
establishment of a climax community.A climax community is
one which perpetuates itself with no further succession within
an undisturbed ecosystem.
*
SUCCESSIONPrimary succession must take place by first
creating soil on the barren lava or exposed rock surfaces.Dust is
captured in cracks and crevices along with microscopic
organisms and seeds carried by the wind or deposited by small

animals and birds. Mixtures of fungi and algae grow together
and are known as lichens.
*
SUCCESSIONWhen soil conditions are disrupted but there
remains topsoil and some limited vegetation, succession can
take place much more quickly. This process has been termed
secondary succession.Early plants are also known as pioneer
plants, and may include wildflowers, followed by tall grasses
and compact woody bushes.
*
SUCCESSIONStable ecosystems are ones in which materials are
constantly recycled within the system through growth,
consumption and decomposition. These processes tend to
balance each other so that there is little net loss over long
periods of time in a process called dynamic equilibrium.
*
SUCCESSIONPoor land management techniques may result in
fewer overall species in a process called retrogression. The
species remaining may be less desirable from a human point of
view.

*
THE CONCLUSIONThe human population is exerting enormous
pressure upon ecosystems throughout the world as it continues
to multiply in logarithmic proportions and develop energy
intensive technologies resulting in the discharge of dramatic
levels of toxic substance into the air, water, and land.
*
THE CONCLUSION Most biotic communities are proving
unable to respond to the unrelenting pressures of disruption
causing major losses in species, soil degradation,
desertification, contaminated water, possible climate changes,
and other changes in global ecosystems that are not in the best
interests for human survival or quality of life.

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