Emergency Medicine - Adult and Pediatric
RSSArticles
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Study: More Than Half of DNR ED Patients Resuscitated Against Their Wishes
Of 419 cardiac arrest patients, 65 were DNR status. Of this group of DNR patients, 38 were resuscitated against their wishes. Not adhering to a patient’s wishes not only violates their autonomy, but it is arguably not acting in the patient’s best interest — and may in fact be causing them harm.
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Approaches to the Hemorrhaging Pediatric Trauma Patient
Clinicians might be surprised to learn that after central nervous system injury, hemorrhage/hemorrhagic shock is the second most common injury complex resulting in death for pediatric trauma patients. A thorough understanding of subtle presentations and management is essential to improve the outcome for these children.
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Health Disparities in the Emergency Department
Overall health is a result of the interactions between a complex set of social, economic, cultural, educational, and healthcare-related variables. To properly care for a wide range of patients, emergency department clinicians must understand how these variables affect our individual patients, our practices, and the communities we serve.
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Notify Patient if Initial Radiology Read Is Incorrect
Failure to notify the patient about a new result can come back on the ED provider if it can be shown that earlier notification could have changed the patient’s outcome.
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Police Transport More Patients with Mental Health Needs to ED
Annual rates of adults transported to EDs by law enforcement increased by almost 50% from 2009 to 2016, according to the authors of a recent study. Of the 136,240 patients brought to EDs by law enforcement during the study period, 43.1% had a mental health diagnosis; 22% of all visits were for involuntary commitments.
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For Some Patients with Valid DNRs, Confusion Results in Unwanted CPR
Some DNR orders were not documented anywhere in the medical record. ED staff sometimes failed to recognize DNR orders that were documented. Other patients had advance directives, but no valid DNR order.
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SPADE Method Quantifies Potential Harm of Misdiagnosis
Methodology improves accuracy of diagnostics for sepsis and acute myocardial infarction, lowers malpractice risk.
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Certain Patients Might Meet Criteria, Still Do Not Receive Formal Sepsis Diagnosis
This study highlights two competing risks: The risk of undertreating sepsis and the risk overresuscitating a patient with another cause of their symptoms.
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Two Similar Studies, Two Different Conclusions: What Is the Best Way to Treat Sepsis?
The authors of two recent studies of the performance of the Epic Sepsis Model (ESM), a commonly used early warning tool for sepsis, reached different conclusions: One research group found ESM fails to predict many sepsis cases beyond what clinicians detect on their own, but another research group reported the tool enhances care.
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Acknowledge Pandemic-Driven Moral Distress, Mitigate Harmful Effects
Clinicians experience a high level of moral distress when they know they are not providing optimal care to patients. However, investigators have found leaders can mitigate the effects of moral distress. Such information could not arrive at a better time as hospitals in many regions cope with surging COVID-19 case volumes amid a shortage of skilled nurses.