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Emergency Department Management & Law

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  • Are you sedating agitated psychiatric patients safely?

    A man walks into your ED screaming at the top of his lungs and waving his arms wildly. Its clear that sedation is needed, but the safety of this patient and the ED staff is very much at risk.
  • Cost-Saving Tip

    Overworked ED nurses at McKay-Dee Hospital Center in Ogden, UT, were frustrated with spending hours looking through charts to figure out charges for procedures.
  • 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.
  • 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.
  • 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.
  • 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.)
  • 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.
  • 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.
  • 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."
  • Disciplined Expert May Countersue

    The fact that an expert witness recently prevailed after suing a specialty society for suspending him for allegedly giving improper testimony in a medical negligence case wont affect the ability of the American College of Emergency Physicians (ACEP) to discipline unethical expert witnesses, according to Louise B. Andrew, MD, litigation stress counselor, founder and principal of www.MDMentor.com, and former chair of ACEPs Professional Liability Task Force Expert Witness subcommittee.