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While the Centers for Disease Control (CDC) in Atlanta has been calling on EDs to routinely test patients for HIV since 2006, the practice is hardly widespread.
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Noting that opioid analgesics are among the drugs most often associated with adverse drug events, the Joint Commission has issued a Sentinel Alert, urging hospitals to step up their efforts to prevent complications and deaths from use of these powerful drugs.
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People understand that natural disasters like floods, hurricanes, or tornadoes are going to happen every year. That's why EDs across the country routinely conduct practice drills so that they have plans in place to deal with mass-casualty events.
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Abnormal movements, outside of seizure and ataxia, are an uncommon chief complaint among children presenting to the emergency department. A working knowledge of movement disorder phenomenology, etiology, differential diagnosis, and associated potentially life-threatening conditions is essential for emergency physicians. Each movement disorder and its clinical considerations will be discussed in detail in the article.
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Coughs and hiccups are common emergency department complaints. While the majority of their causes are benign, patients with these symptoms can suffer from significant distress and impaired quality of life. Most patients with these symptoms can be effectively managed by understanding the pathophysiology and differential diagnosis of these symptoms and by using evidence-based therapy. It is important for the physician to be aware of the emergent conditions that may present with these seemingly benign complaints.
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When an ED patient is being held while waiting for an inpatient bed, Rolf Lowe, JD, an attorney with Rogers Mantese & Associates in Royal Oak, MI, says "there is no bright line cut off for liability. Substandard care in the ED that has an effect on the patient's outcome can result in liability for the EP and the ED staff."
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Some emergency physicians (EPs) have admitted that they don't take time to read the nursing notes, according to J. Tucker Montgomery, MD, JD, a health care attorney in Knoxville, TN. "Complaints recorded there that go unaddressed, or a particular abnormal vital sign, can come back to bite an EP," he says.
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While unauthorized videotapes made by a patient in your ED may seem highly inappropriate, those recordings can often be introduced as evidence in medical malpractice lawsuits, according to William Sullivan, DO, JD, FACEP, an emergency physician at University of Illinois Medical Center in Chicago and a practicing attorney in Frankfort, IL.
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Admitted ED patients are "definitely in a gray zone," according to William C. Gerard, MD, MMM, FACEP, chairman and professional director of emergency services at Palmetto Health Richland in Columbia, SC. "Fortunately, they are admitted, and that takes your [Emergency Medical Treatment and Labor Act] risk away. But then you get into the malpractice risks," he says.
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In some states, only one party to a conversation has to consent for a recording to be legal, while in other states, both parties have to consent unless one of several exceptions to the law is present, such as anticipation that a crime is going to be committed or use by law enforcement, says William Sullivan, DO, JD, FACEP, an emergency physician at University of Illinois Medical Center in Chicago and a practicing attorney in Frankfort, IL.
