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Complications of sickle cell disease are a common presentation to the emergency department. Emergency physicians and nurses must treat complications of this disease process aggressively.
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The Centers for Disease Control and Prevention note that fractures were the fourth-leading cause of injury-related emergency department visits in 2000, accounting for 3.8 million visits. Patients may develop serious and life-threatening complications of orthopedic trauma. Because signs and symptoms of these complications may not be readily apparent when patients present, emergency physicians and nurses need to be cognizant of high-risk presentations. This months issue focuses on these high-risk presentations, including open fractures, compartment syndromes, malignancies, and septic joints.
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Low back pain is a frequent patient complaint in the emergency department. In fact, the same patients may visit the ED repetitively with the same complaint. It is easy to be assuaged into thinking that these patients are merely seeking drugs, but to make that assumption can lead a clinician to miss the cauda equina syndrome and may result in a malpractice action if efforts are not taken to identify any new symptoms and signs in a patient with low back pain. This issue provides the reader with a solid understanding of diagnosing and caring for patients with cauda equina syndrome in the ED and the medicolegal issues that arise from failing to diagnose and appropriately treat these patients.
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Public awareness of the symptoms of stroke has increased the frequency of emergency department visits by patients with this complex chief complaint. Often, subtle symptoms may or may not represent a cerebral infarct. This issue of ED Legal Letter will review the diagnosis, management, and follow-up of patients with both transient ischemic attack and cerebral vascular accidents. Appropriate diagnosis and treatment will prevent subsequent permanent disability and potential litigation.
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This months issue of ED Legal Letter will discuss the medicolegal risks to the physician, nurse, and hospitals associated with a patient leaving against medical advice and provide strategies to prevent patients from leaving.
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This issue discusses some of the pitfalls that may arise in the care of the psychiatric patient. The lessons learned may assist EPs and nurses in reducing their malpractice risk, but more importantly, assist them in providing a safe disposition for these patients.
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The outcome of a medical malpractice case often depends on an experts opinion and how well that expert conveys that opinion to a jury. Despite the important role that experts play within the medical malpractice system, until recently, there has been little oversight of expert witness actions. With the increasing number of professional and legal actions against expert witnesses, it appears that the same experts hired to review the actions of their peers are starting to be scrutinized themselves. This months issue of the ED Legal Letter will address some of these issues that relate to the role of the expert witness.
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Since 1985, the Emergency Medical Treatment and Labor Act (EMTALA) has provided patients with care regardless of their ability to pay. Horror stories of the dumping of indigent trauma patients prompted federal intervention and subsequent regulation to protect patients. It has been both a blessing and burden for emergency physicians.
