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					                              Medical Staff Guideline

             Emergency Department Use of Narcotics and Sedatives

CHRISTUS Spohn Hospital Corpus Christi (CSHCC) has adopted guidelines
relating to the writing of narcotic and sedative medication prescriptions by the
Emergency Department physicians. Because CSHCC is increasingly concerned
about the abuse of narcotics in our society, this Emergency Department
discourages the use of narcotics except when absolutely necessary.

The following guidelines are for patients seen in the CSHCC Emergency
Department who, after a medical screening exam, are found not to have an
emergency medical condition:

        Prescriptions for narcotic and sedative medications that have been lost or
        expired will not be refilled. It is the patient’s responsibility to maintain
        active prescriptions with his or her primary care physician, specialty
        physician, or pain control clinic that have regularly prescribed these
        medications. Patients who have chronic pain will now receive only
        non-narcotic pain medications as temporary treatment.

        Patients who have frequent or multiple visits to the Emergency
        Department seeking relief from painful conditions will be considered to
        have chronic pain syndromes. Painful conditions include (but are not
        limited to) migraine headaches, back pain, pelvic or ovarian pain, dental
        pain, kidney stones, and fibromyalgia. In these cases, non-narcotic pain
        medication should be prescribed.

In the event of an acute problem for which the Emergency Physician feels it is
appropriate that a patient be given a narcotic or sedating medication (either by
injection or by mouth), the Emergency Department requires that a driver for that
patient be physically present in the Emergency Department before administering
the medication. It is also required that the patient have a photo ID with them.

If a narcotic prescription is given for care of an acute painful condition, this
prescription will be for a limited number of pills to last until the patient can
follow-up with his or her primary doctor or specialist. Any patient returning
to the Emergency Department for refills of said prescriptions will be given a non-
narcotic prescription. Follow-up with a primary care physician or specialist for
definitive and continued care must be the approach the patient takes.

This process is subject to the requirements of the Emergency Medical Treatment and Labor Act
("EMTALA"), including but not limited to the requirements of EMTALA to provide medical screening
examinations and stabilizing treatment, and any actions under this process will be performed in
compliance with EMTALA.

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