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Emergency Department Management & Law

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  • Other 2006 changes will potentially impact EDs

    While the two new requirements involving hand-offs and medication labeling are the most obvious changes in the 2006 National Patient Safety Goals just released by the Joint Commission on Accreditation of Healthcare Organizations, there are other, more subtle changes that also are critically important for nurse managers to know about.
  • Is it CHF? A new blood test can tell you

    When a patient complains of shortness of breath, congestive heart failure (CHF) may be one of the first things you suspect, but a definitive diagnosis can be difficult. Now a new blood test that measures a cardiac biomarker, the terminal prohormone of B-type natriuretic peptide (NT-proBNP), can give you an answer within minutes.
  • ECG Review: What a Difference a Lead Makes

    The telemetry rhythm strip shown in the Figure was obtained from a 67-year-old woman who presented with heart failure. A permanent pacemaker had been implanted a number of years earlier. Interpret the tracing initially by looking only at lead MCL1. How does the addition of a second simultaneously recorded lead (lead II) help in your interpretation? How many findings can you identify on this two-lead telemetry tracing? (Hint: Some of these findings are very subtle.)
  • Special Feature: Neuroleptic Malignant Syndrome

    Neuroleptic malignant syndrome is a disease process usually occurring in patients who use neuroleptic agents; classically, it is characterized by altered mental status, muscular rigidity, fever, and autonomic instability.
  • GIK Infusion Ineffective in Acute MI

    In this study, investigators conducted a large, international, randomized controlled clinical trial (as a part of the CREATE trial) to determine the effect of glucose-insulin-potassium infusion on mortality in patients presenting with acute ST-segment elevation MI.
  • Elderly patients in the ED: Be wise in their care

    With our aging population, emergency medicine practitioners increasingly will face the challenges of care for the elderly in the emergency department. A new report from the Centers for Disease Control and Prevention notes that visits to U.S. EDs reached a record high in 2003 and attributes this rise to increased use by adults, especially those ages 65 and older. Elderly patients have higher risks for presenting to the ED.
  • The Clostridial Connection

    Public health officials from the California Department of Health Services have recognized epidemics of three types of Clostridium-associated diseases: wound botulism, necrotizing soft-tissue infections, and tetanus. These emerging infections and intoxications have been associated with the use of contaminated black tar heroin, an association known as "the clostridial connection."
  • Prehospital Intubation with Neuromuscular Blockade: The Pendulum Swings Again?

    This is a retrospective study of consecutive head injury patients admitted to a single Level 1 trauma center.
  • MRI Finds Hip or Pelvic Fractures After Initial Negative Plain X-rays

    The purpose of this study was to evaluate the incidence of hip fractures presenting to the emergency department with negative initial radiographs.
  • Unavailable Specialist = Legal Woes for EPs

    In one case that was eventually settled, an on-call specialist admitted making no effort to come in promptly, stating that traffic would be untenable for an hour because it was near the end of a Chicago Bulls playoff, recalls Tom Scaletta, MD, FAAEM, chair of the ED at Edward Hospital in Naperville, IL, and the emergency physician (EP) quoted the specialist verbatim to make it clear why a transfer was initiated.