Articles Tagged With:
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Nursing Notes Can Become Unexpected Problem for EP During Med/Mal Litigation
A triage nurse’s note stating that a patient had fever and hip pain in his prosthetic hip became a key area of focus during a recent malpractice trial. At deposition and at trial, the emergency physician (EP) claimed to have examined the hip, and found that the patient did not have increased pain with range of motion.
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Take Me Out of the Ball Game: Acute Management and Long-term Consequences of Concussion in Childhood
The developing brain of a child may be particularly susceptible to injury from mild traumatic brain injury, such as a concussion. Recommending a longer period of strict rest after a concussion does not provide additional benefit when compared to consensus guidelines for care after a concussion in children and adolescents. However, in retired former NFL players, exposure to tackle football prior to age 12 is associated with executive dysfunction, memory impairment, and lower estimated verbal IQ later in life. -
ED setting poses unique challenges in palliative care delivery
It is very easy for emergency department (ED) providers to “err on the side of caution” when deciding whether to institute life-sustaining therapies. “But this, in fact, may not be the best course of care,” says Tammie E. Quest, MD, director of Emory Palliative Care Center and associate professor in the Department of Emergency Medicine at Emory University School of Medicine in Atlanta.
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Use proven strategies when conflicts arise over withdrawing futile treatments
Conflict surrounding withdrawal of futile treatments is one of the most common reasons for ethics consults being called.
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Are consultants called the “ethics police?” What’s behind clinicians’ attitudes
At times, providers react negatively to the involvement of ethics; “ethics police” is an often-used derogatory term reflecting this attitude.
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Report: Bioethics programs’ reproductive education doesn’t reflect needs of practicing OB/GYNs
Researchers conducted parallel surveys of directors of graduate bioethics training programs and obstetrician-gynecologists (OB/GYNs) in order to learn whether reproductive health education in bioethics programs reflected real-life concerns for practicing physicians.
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“Don’t worry about the cost” doesn’t reflect patients’ reality
"Don’t worry about the cost. All that matters is getting you well.” Well-meaning physicians frequently say this, but in fact, patients have good reason for wanting to know what care will cost them.
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Ethical controversy erupts over minors’ autonomy
In the controversial “Cassandra C” case, a 17-year old Connecticut girl diagnosed with Hodgkin’s lymphoma was ordered by the state Supreme Court to undergo chemotherapy against her will. The girl refused further treatment after undergoing surgery to remove a lymph node, but as of press time is being kept in a hospital room under court order.
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Endometrial Protection: Which Progestogen Is Best?
After a lost decade, increasing numbers of women and providers are recognizing the benefits of postmenopausal hormonal therapy. For women with an intact uterus, endometrial protection is required when systemic estrogen therapy is used. Since activity at the glucocorticoid and androgen receptor may lead to adverse health effects in some women, use of pure progesterone receptor agonists may offer advantages. However, the use of natural progesterone is problematic due to low potency and poor bioavailability with oral dosing. Local therapy with the levonorgestrel intrauterine device (off-label) may be an excellent choice for many women. -
Delayed Cord Clamping
Although a recent study has failed to show major benefit from delayed umbilical cord clamping, others have suggested neonates having delayed cord clamping have less need for transfusion, higher hematocrits, less neonatal morbidity, and diminished risk of intraventricular hemorrhage.