Emergency Medicine - Adult and Pediatric
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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.
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Cardiology-Related Misdiagnoses Frequently Alleged in ED Malpractice Claims
In an analysis, 58% of claims against emergency physicians resulted from misdiagnosis. Diagnosis-related allegations were more common in emergency medicine-related claims (58% of claims) than in claims involving internists (42% of claims). The most common final diagnoses were myocardial infarction, pulmonary embolus, and cardiac arrest.
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Controversial ‘Public Charge’ Rule Under Further Review
Scrutiny on DHS policy that targeted immigrants using government benefits such as Medicaid.
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Arterial Ischemic Stroke: Mechanisms and Management
Stroke is a common problem, affecting nearly 800,000 people annually in the United States and serving as a leading cause of significant long-term disability. This article begins with a brief discussion of stroke epidemiology and then provides an overview of the various stroke mechanisms, setting a framework for which to consider etiology-specific stroke management.
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Pediatric Drowning
Pediatric drowning events are associated with consequences varying from transient pulmonary symptoms to devastating neurologic disability. All acute care providers need to be prepared to diagnose and effectively manage a child with this type of injury.