ED Management
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Damages, Causation Are Obstacles in Abdominal Pain Med/Mal Cases
Many older ED patients are living with a host of preexisting conditions, which, coupled with the patient’s age, argue against investing the needed time and money to pursue a malpractice claim. Even if there is clear liability and causation, the case of misdiagnosed abdominal pain still might not be worth pursuing from a financial standpoint.
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Older Adults with Abdominal Pain Risk Mistriage, Inadequate Diagnostic Tests
ED providers should not think of abdominal pain in older adults as the same as abdominal pain in younger patients. At the department level, consider adding abdominal pain in older patients to the list of automatic ECG criteria.
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CT Scans Rarely Change Management of Acute Pancreatitis
For acute pancreatitis patients, efficient and clinically accurate triage is the singular most vital function to help eliminate potential claims — but more importantly, to provide safe and effective treatment to ED patients.
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Unexpected Gaps in Opioid Overdose Treatments
Patients presenting to EDs for opioid overdose should go home with a naloxone prescription or a naloxone take-home kit. Alternatively, these patients could start buprenorphine when it is clinically feasible, or they could be connected directly to outpatient treatment for opioid use disorder.
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Few EDs Screen Patients for Excessive Alcohol Use
The ED is where patients often go during their most vulnerable times. Emergency providers can help vulnerable patients prevent a future crisis if they can show patients that help is available and how to access it.
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Underpayment Is Major Concern for EDs with New Surprise Billing Law
This landmark consumer protection took effect Jan. 1, but litigation from advocacy groups is pending as insurers are jockeying with providers for reimbursement rate advantages.
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Legal Action Possible, But Not Always Advisable, for Bad Reviews of ED Visit
Providers must put emotions aside and make hard calculations on what they are looking to achieve — and how much they are willing to spend.
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In ED, Medication Harms Often Caused by Nontherapeutic Use
Of the 96,925 cases included in an analysis, 69.1% involved therapeutic use. Medication-related misuse, abuse, or self-harm caused approximately 62% of ED visits for medication-related harms in patients age 15-24 years, but only 22% of visits for patients age 55-64 years. For patients younger than age 45 years, 52.5% of ED visits involved nontherapeutic use.
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ED Plays ‘Central Role’ in STEMI Care
This includes prehospital cath lab activation, knowing when it is appropriate to bypass the ED, understanding the sequence of events for patients presenting to the ED, knowing what to do to shorten ED dwell time, and knowing what is best to do if awaiting cath lab arrival.
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Patients’ Involvement in Decision-Making Linked to Lower Malpractice Risks
When there is more than one reasonable treatment option, discussing the options with the patient and documenting the discussion may mitigate malpractice risk, especially in the event of a bad outcome.