Emergency Medicine - Adult and Pediatric
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Ethical Considerations for Trauma-Informed Care
Use the tenets of trauma-informed care by realizing the widespread effects of trauma; recognizing signs and symptoms; responding by including knowledge about trauma in policies, procedures, and practices; and avoiding retraumatization.
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Pediatric Toxic Ingestions: Dangers at Home
It is critical for healthcare providers to be aware of household substances that pose a serious risk of illness or death upon exposure to a small child. Even seemingly innocuous substances may pose a serious risk of toxicity.
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Differentiating and Managing Pediatric Shock
Early recognition and management of pediatric shock is critical for acute care providers. The authors review the subtle presentations, different approaches, and management strategies to effectively manage the different types of pediatric shock.
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Evaluation of Trauma in Older Adults
The healthcare system is treating more older adults with unique physiologic and anatomic considerations that must be taken into account in trauma resuscitation to maximize each patient’s outcome.
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EDs Need Process for Incidental Radiology Findings
To lower the risks of “failure to notify” claims, institute clear protocols on who is responsible for dealing with abnormal test results. Educate patients on how to find out about their test results; this includes obtaining updated contact information. Finally, use electronic alerts to notify patients and providers when tests results are ready.
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Med/Mal Concerns if ‘Float’ Nurses Cover the Department
Of 2,575 nurses from 50 states and Washington, DC, 26.5% reported they were “floated” or reassigned to a clinical care area that required new skills or that was outside their competency, according to a survey. Almost half reported receiving no education or preparation before they were assigned to the new unit.
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Work on Improving the Care of Children with Medical Complexity
Emergency physicians identified significant challenges in providing high-quality emergency care to these patients. These include time constraints, the need to adequately review the expansive medical record for key information, and the need to contact known physicians when making treatment and disposition decisions. Respondents indicated communication with known providers and use of emergency information forms summarizing the child’s medical history were helpful.
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New Details Emerge About Acute Flaccid Myelitis, Cases Could Surge This Year
Researchers uncovered evidence indicating enterovirus D68 directly infects neurons in the spinal cord, prompting an immune response that leads to the limb weakness that is characteristic of acute flaccid myelitis. Investigators shed important light on the disease process that takes place in children who develop this polio-like illness. This is progress that can help lead to better treatments.
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Legal Risks if Psychiatric History Clouds Medical Decision-Making
Patients with these life-threatening medical conditions may report mood swings, personality changes, irritability or aggression, depressed mood, anxiety, or trouble concentrating. If appropriate history, physical exam, and diagnostic testing are not completed, medical emergencies can be missed. This is particularly common if physical exam findings are subtle.
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The Joint Commission Puts Providers on Notice Regarding Diagnostic Overshadowing
When patients present with existing diagnoses or disabilities, clinicians might attribute any symptoms to the existing condition. This is called diagnostic overshadowing, a type of cognitive bias that can cause unnecessary suffering, unsafe care, and adverse events related to missed or delayed diagnoses. Unfortunately, the problem occurs more often among groups already experiencing healthcare disparities.