Burn injuries account for half a million visits to the emergency department each year and present numerous challenges in management. The spectrum of burn injuries is immense, ranging from simple first-degree burns with no sequela to third-degree burns with hypermetabolic response. In addition, pediatric patients add unique challenges to providing optimal care.
You have just taken sign-out when a nurse comes up to you and says that there is a 64-year-old man in the critical bay who took an overdose of his medications. The patient has a history of hypertension, atrial fibrillation, and depression. The patient is lethargic but arousable, and reports he took about 40 tablets of immediate-release metoprolol three hours ago in an attempt to "end it all." The nurses are starting IV lines, checking vitals, and putting the patient on the monitor. You wonder, "Is it too late for gastric decontamination? If he is symptomatic, which therapy will I try first, and what are my options?"
"It's too bad someone didn't give you thrombolytics, because you probably wouldn't be paralyzed now." Whether it's a nurse, doctor, or someone else making that statement to a stroke patient cared for in your ED, you could end up named in a lawsuit.
