Emergency Medicine - Adult and Pediatric
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Did EP Decide Not to Follow Recommendation of Computer Decision Aid?
The medical record should demonstrate the clinician saw the recommendation, thought about it, and decided what to do. The clinician still may be wrong. But now, it is more of a judgment error than simple carelessness.
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Med/Mal Claims Focus on Decision Aid Findings from ECGs, Radiology Tests
If the radiologist does not address computer findings directly, the ED clinician is left to make assumptions about what the radiologist has found significant or insignificant. If radiologists are not routinely addressing computer findings, emergency providers will spend resources attempting to sift through reports and images, trying to rule in or out what the computer has found. Radiologists should acknowledge computer findings, and comment on why or why not the finding is accurate and significant to the patient’s care.
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Diagnosing and Treating Pediatric Urinary Tract Infections
Urinary tract infections can be challenging to suspect and diagnose in young patients. Unfortunately, devastating consequences, such as pyelonephritis and bacteremia, are a real risk. It is critical for clinicians to have a high degree of suspicion, obtain optimal urine samples, and be aware of the best practices for treatment in this unique population.
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Emergency Department Evaluation of Vertigo and Dizziness
Vertigo can be a complicated complaint for emergency medicine physicians to manage. The differential for this is broad, ranging from benign processes, such as BPPV, to more devastating causes, such as posterior strokes.
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New Ethical Guidance on End-of-Life Nutrition Therapy
The guidance is intended to help clinicians understand what medically assisted nutrition and hydration can and cannot accomplish for different groups of patients.
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Ethicists Can Resolve Conflicts Over Nutrition Therapy at End of Life
When deciding whether to administer, withhold, or withdraw end-of-life nutrition and hydration therapy, ethicists can help clinicians, patients, and families reach an equitable agreement.
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Ethicists’ Role if Clinicians Disregard Documented End-of-Life Wishes
Early involvement of the ethics team can be helpful. After an initial assessment, the healthcare team should arrange a family meeting with surrogates, clinicians, the ethics team, social workers, and other appropriate individuals (e.g., clergy). This should happen as soon as possible, no later than the following day. The ethics team should facilitate an honest and compassionate discussion about the plan to best honor the patient’s end-of-life decisions.
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Wrongful Prolongation of Life Suits Persist, Even When a Patient’s Status Was DNR
Regardless of training or good intentions to preserve life, at the end of the day, this is the patient's choice.
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Intimate Partner Violence
Domestic violence and abuse is a national and global healthcare problem with massive consequences, affecting men, women, and children, which worsened during the COVID-19 pandemic. Awareness, recognition, and resource allocation, in addition to trauma management, is an important aspect of emergent care of the trauma patient possibly injured in a domestic violence incident.
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Health Systems Look to Duplicate California Substance Use Disorder Treatment Model
Administrators in several states want to leverage their EDs as a critical point of access to identify and treat substance use disorder.