Emergency Medicine - Adult and Pediatric
RSSArticles
-
A Critical Review of Potentially Deadly Pediatric Ingestions
It is imperative for the emergency provider to be aware of common agents that can cause life-threatening toxicity or death should accidental ingestions occur. This article focuses on substances that are potentially catastrophic if ingestions occur and how to manage them accordingly.
-
Venomous Bites
Humans increasingly invade the environments of venomous creatures. The authors provide a review of venomous creatures and what acute care providers need to manage the patients affected by them.
-
Researchers: Emergency Providers Missing Chances to Avert Future Opioid Disasters
Investigators express concern about prescribing rates for medication-assisted treatment after ED visits for opioid overdoses recorded between late 2019 and early 2021.
-
Legal Action Possible, But Not Always Advisable, for Bad Reviews of ED Visit
Providers must put emotions aside and make hard calculations on what they are looking to achieve — and how much they are willing to spend.
-
In ED, Medication Harms Often Caused by Nontherapeutic Use
Of the 96,925 cases included in an analysis, 69.1% involved therapeutic use. Medication-related misuse, abuse, or self-harm caused approximately 62% of ED visits for medication-related harms in patients age 15-24 years, but only 22% of visits for patients age 55-64 years. For patients younger than age 45 years, 52.5% of ED visits involved nontherapeutic use.
-
ED Plays ‘Central Role’ in STEMI Care
This includes prehospital cath lab activation, knowing when it is appropriate to bypass the ED, understanding the sequence of events for patients presenting to the ED, knowing what to do to shorten ED dwell time, and knowing what is best to do if awaiting cath lab arrival.
-
Patients’ Involvement in Decision-Making Linked to Lower Malpractice Risks
When there is more than one reasonable treatment option, discussing the options with the patient and documenting the discussion may mitigate malpractice risk, especially in the event of a bad outcome.
-
Effective Defense for ED if Allegation Is Failure to Rule Out Aortic Dissection
Aortic dissection is not an easy diagnosis to make, and providers cannot order advanced imaging on every person who comes through the ED. But the mere act of documenting why aortic dissection was thought to be unlikely could make the provider reconsider the decision to discharge — and end up saving a life.
-
No Reassessment of Patients in Waiting Room or Hallway Is Malpractice Risk
CMS has been clear: EMTALA applies no matter where a patient comes to the hospital, as well as no matter where the patient is seen. That includes the ED waiting room and hallways. Boarding in the hallway should include periodic checking in with the patient to be sure there has not been a significant adverse change that requires the patient to be moved to a higher level clinical setting.
-
EMTALA Violations, Malpractice Claims Possible if ED Goes on Diversion Inappropriately
Diversion procedures should include community-based policies, created in agreement with EMS and other area hospitals, so everyone is handling the issue similarly. Create a formal activation procedure that specifies who must order diversion, acceptable reasons for diversion, how it is handled, and how the diversion is communicated to fire/EMS/police dispatch and other facilities.