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An ED's policy may state that reassessments should occur every 30 minutes, or that EKGs should be given within 10 minutes of the patient's arrival, but there will always be circumstances in which these timeframes aren't met.
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When experts on either side of a lawsuit alleging ED malpractice make misleading or false statements, this reflects badly on the whole legal system, according to Ken Zafren, MD, FAAEM, FACEP, FAWM, EMS medical director for the state of Alaska and clinical associate professor in the Division of Emergency Medicine at Stanford (CA) University Medical Center.
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If a parent objects to a medical evaluation or treatment of a child with a potentially life-threatening emergency, due to religious beliefs or any other reason, says Kevin M. Klauer, DO, EJD, FACEP, chief medical officer of Emergency Medicine Physicians in Canton, OH, the emergency physician (EP) can get a court order to get the child treated.
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Even though the admission handoff has occurred, the "boarded" ED patient is often still managed by the admitting emergency physician (EP) or another ED attending physician many hours after the shift has ended, warns Uwe G. Goehlert, MD, MPH, an ED attending physician at Northwestern Medical Center in St. Albans, VT, and principal of Goehlert & Associates in South Burlington, VT.
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Pediatric advanced airway management is a critical skill for the emergency medicine practitioner. Safe, effective, emergent intubation can be completed with the use of rapid sequence intubation (RSI). A multitude of alternatives are available with a variety of advantages and disadvantages based on the individual clinical scenario. This article provides a comprehensive review of the process and alternatives associated with pediatric RSI.
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Emergency physicians need to be able to treat a variety of clinical syndromes that occur in the setting of drug abuse.
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If an emergency department (ED) patient with impending sepsis is discharged, returns hours later in septic shock, and dies or develops organ failure, "you're likely to get sued," warns Bruce Wapen, MD, an emergency physician with Mills-Peninsula Emergency Medical Associates in Burlingame, CA.
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Waiting time has always been the number one complaint against hospital emergency departments (EDs). In an attempt to address the waiting issue, hospitals recently began allowing patients with nonemergency conditions to "schedule" their ED visits through the Internet and then wait at home until their "projected treatment time" in the ED.
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Emergency medical services (EMS) crews are all on assignments, it's rush hour, the cardiologist hasn't called back, or the transfer center is waiting for approval before assigning a bed. These are all valid reasons for delays in transfer of a patient with an ST-elevation myocardial infarction (STEMI), says Kevin Brown, MD, MPH, FACEP, FAAEM, principal with Brown Consulting Services in Armonk, NY, and former director of the department of emergency medicine at Greenwich (CT) Hospital, but if any of these delays occur, times should be documented by the emergency physician (EP).
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The ED nurse is the "first line of defense" against a malpractice lawsuit alleging missed or delayed diagnosis of sepsis, according to Paula Mayer, RN, LNC, a partner at Mayer Legal Nurse Consulting in Saskatchewan, Canada.
