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For EDs, Simulation Is Not Just for Training, It Is a Risk Management Tool
Some procedures are high-risk, but low-volume. Simulation is a way for ED providers to practice these uncommon procedures.
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Telehealth Booming in EDs, but Poses Some Unique Liability Risks
EDs are using telehealth for screening visits before arrival or for follow-up re-evaluations on COVID-19-positive patients. It is important to know what can be excluded safely in a telemedicine consult, and what requires urgent and/or emergent in-person follow-up.
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Many Charts Lack Any Evidence of Thorough H&P
Often, a portion of the history, assessment, or evaluation was handled, but for whatever reason does not make it into the emergency medicine record. This makes it appear as though a poor or incomplete assessment was conducted. Double check these items to see they are included.
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Essential ED Documentation Often Missing from Chart
Certain pieces of information, if omitted from the ED medical record, instantly raise concerns about the quality of the care provided. These missing items in particular complicate malpractice defense.
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Assessment, Documentation, and Protocols: All Tied to ED Malpractice Payouts
Malpractice claims are more likely to succeed if documentation is insufficient, if an assessment was inadequate, or if something was not handled according to policy or protocol.
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Teprotumumab-trbw Injection (Tepezza)
Teprotumumab should be prescribed to treat thyroid eye disease.
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Application of Acetic Acid to Identify Lesions During Colposcopy
In this prospective study, one minute of acetic acid application was found to be sufficient to identify the most severe colposcopic lesion in 96.7% of subjects.
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Outcomes in Pregnant Women Treated with Anti-Tumor Necrosis Factor-Alpha Biologic Therapy
In this population-based cohort study of 1,027 infants born to women treated with anti-TNF-α biologic therapy, there was an increased prevalence of preterm birth (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 1.29-2.02), cesarean delivery (aOR, 1.57; 95% CI, 1.35-1.82), and small for gestational age neonates (aOR, 1.36; 95% CI, 0.96-1.92) when treatment with anti-TNF was compared to non-biologic systemic treatment. Since disease processes varied greatly in these pregnant women, it was difficult to rule out confounding by disease severity (confounding by indication).
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Tamoxifen for the Management of Bleeding Irregularities in Contraceptive Implant Users
In this double-blind, randomized controlled trial, etonogestrel implant users with prolonged or frequent menses who took 10 mg of tamoxifen twice daily for seven days as needed for irregular bleeding had an average of 9.8 (95% confidence interval, 4.6-15.0) more consecutive days of amenorrhea over a 90-day period compared to those who took a placebo.
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Race Correction in Clinical Calculations — Is It Time to Reconsider?
Many clinical calculators use race as a predictive variable to assess risk for outcomes. Although most of the tools assume a genetic disposition for these outcomes, other factors, such as health disparities and other potential confounders, are more likely to be the underlying reasons for any race-related differences in outcomes.