Emergency Department Management & Law
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Safety Protocol Can Prevent Self-Harm Incidents
Precautions include a focus on creating safe bathrooms, increasing the number of trained observers to monitor patients at risk, and managing access to belongings and clothing.
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TJC: Support Healthcare Workers During COVID-19 Pandemic
The Joint Commission has issued the first in a series of special bulletins aimed at addressing concerns raised by healthcare workers as they respond to the continuing COVID-19 pandemic.
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Surge of HIV Patients Present to EDs, Leaders Call for Expanded Screening
Investigators discovered a more than twofold increase in cases of acute HIV during the COVID-19 pandemic as part of an ED-based screening program at UChicago Medicine. The cause of the increase remains unknown, but it underscores the importance of screening despite the fact the pandemic has strained all resources.
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EDs Administer Monoclonal Antibody Therapy to High-Risk COVID-19 Patients
Clinicians can use new monoclonal antibody therapies to treat high-risk patients presenting with mild to moderate COVID-19 symptoms. However, despite the promise to depress viral loads, logistical and other challenges continue to stand in the way of larger-scale use. Still, some EDs are trying the therapeutics, with promising results.
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Providers’ Misconceptions About ‘Duty to Warn’
If a patient expresses intent to harm an individual or a group while in visiting an emergency provider, that provider should try to warn the individual or group of possible harm and also contact law enforcement.
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Finger-Pointing in Nurse Charting Is Opportunity for Plaintiff
Emergency nurses and physicians may not understand the liability implications of using charts to air grievances. A unified defense is recognized as the best approach for all defendants in ED malpractice claims, but finger-pointing notes make it difficult. Physicians and nurses should meet briefly before each shift to discuss the importance of teamwork, not only regarding patient care but also documentation.
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Misdiagnosis Top Allegation in Aortic Dissection Malpractice Claims
Failure to timely diagnose, failure to order diagnostic tests, and failure to interpret diagnostic tests were the most frequent allegations in malpractice claims involving aortic dissection, according to an analysis of claims filed between 1994 and 2019.
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Overusing CT Scans: Evidence of Decision-Making Helps Defense
Make it clear to patients, families, and anyone who reviews the chart later why a CT was not ordered during the initial visit. If the provider takes the time to explain this, the family is less likely to be angry if there is a delayed diagnosis. Without a discussion at the first visit, the family may believe a CT scan was not ordered because the physician did not take the complaint seriously.
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Knowing More About Super-Users Prevents Unnecessary ED Visits
Frequent ED visitors account for 10% to 26% of all ED visits, and are responsible for a growing proportion of healthcare expenditures. The risk of ED super-use is more likely for older patients and those in poorer health. The most common diagnoses were low back pain, nausea and vomiting, chest pain, headache and migraine, urinary tract infection, and abdominal pain.
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Documentation Can Determine Outcome of Missed Myocardial Infarction Lawsuit
Some charts might indicate there was chest pain and an abnormal ECG, but the patient was discharged with no explanation. Plaintiffs can use this to make a case the emergency physician missed classic presentation of myocardial infarction. Counter this allegation with specific documentation outlined here.