ED Management
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With ED Provider at Triage, Fewer Patients Leave Without Being Seen
Leaders are trying to find effective ways to prevent high-risk patients from waiting too long for critical treatment — or from simply walking out the door forever.
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Legal Exposure Regarding Recurrent Low-Risk Chest Pain
The most important actions an emergency physician can take are to gather a thorough medical history and correctly interpret the ECG.
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Updated Guidelines on Recurrent, Low-Risk Chest Pain Fill in Some Treatment Gaps
Eight specific recommendations can help emergency providers make good decisions for patients who have visited the ED and undergone a diagnostic workup that showed no evidence of coronary stenosis, only to return with similar complaints within 12 months.
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Emergency Care Improvement Needed for Patients with Sickle Cell Disease
Every patient with sickle cell disease (SCD) should be evaluated by an expert in SCD care who can develop a patient-specific treatment plan that can be used in the ED. Without such a resource, caring for SCD patients will continue to be challenging for emergency providers.
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Notify Patient if Initial Radiology Read Is Incorrect
Failure to notify the patient about a new result can come back on the ED provider if it can be shown that earlier notification could have changed the patient’s outcome.
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Police Transport More Patients with Mental Health Needs to ED
Annual rates of adults transported to EDs by law enforcement increased by almost 50% from 2009 to 2016, according to the authors of a recent study. Of the 136,240 patients brought to EDs by law enforcement during the study period, 43.1% had a mental health diagnosis; 22% of all visits were for involuntary commitments.
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For Some Patients with Valid DNRs, Confusion Results in Unwanted CPR
Some DNR orders were not documented anywhere in the medical record. ED staff sometimes failed to recognize DNR orders that were documented. Other patients had advance directives, but no valid DNR order.
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SPADE Method Quantifies Potential Harm of Misdiagnosis
Methodology improves accuracy of diagnostics for sepsis and acute myocardial infarction, lowers malpractice risk.
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Certain Patients Might Meet Criteria, Still Do Not Receive Formal Sepsis Diagnosis
This study highlights two competing risks: The risk of undertreating sepsis and the risk overresuscitating a patient with another cause of their symptoms.
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Two Similar Studies, Two Different Conclusions: What Is the Best Way to Treat Sepsis?
The authors of two recent studies of the performance of the Epic Sepsis Model (ESM), a commonly used early warning tool for sepsis, reached different conclusions: One research group found ESM fails to predict many sepsis cases beyond what clinicians detect on their own, but another research group reported the tool enhances care.