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Knee and ankle injuries are very common in pediatrics. Sports and recreational activities are frequent sources of injury, hence are sources of typical emergency department (ED) visits. Although sprains and contusions frequently occur, it is critical that the unique aspects of the pediatric skeleton and its associated vulnerability are considered. Imaging and treatment are focused on identification of fractures and associated injuries; correct immobilization and appropriate follow-up, based on the injury, are necessary to maximize the outcome for each injury.
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An emergency physician (EP) diagnoses pneumonia in a 40-year-old male and treats appropriately. Later, the radiologist agrees with the pneumonia diagnosis, but suggests that "a small nodule in the left upper lobe should be evaluated with a chest CT." Somehow, that report never gets read by the ED staff, and the patient's cancer progresses until it is too late for effective treatment. A lawsuit is filed.
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Hospital emergency departments (EDs) interact with police on a daily basis with varying degrees of cooperation, but whether the cooperation is good or bad, many police interactions raise risks of violating federal EMTALA and other regulations.
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There is a growing trend of specialty organizations coming out with guidelines and recommendations, but in some cases, these are inappropriate for ED patientsand may even be harmful.
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Belligerent behavior, communication problems, inconsistent responses to questions, and lack of competency to refuse treatment: Any of these factors can get in the way of obtaining a good history and physical for a patient with psychiatric complaints, according to Barbara E. Person, an attorney with Omaha, NE-based Baird Holm.
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An emergency physician is managing an acute myocardial infarction, arranging for a patient transfer, sewing up a laceration, and putting in a chest tube, with 20 people still waiting to be seen in the waiting room.
