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Emergency Medicine - Adult and Pediatric

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  • Measles Case in Waiting Room? Liability Exposure if Diagnosis Missed

    Measles outbreaks have alarmed public health officials in many states. Many infected people end up in ED waiting rooms. If providers miss the measles diagnosis, there are potential liability risks for both ED providers and hospitals.

  • ED Violence Often Unreported, Ignored by Prosecutors, Dismissed by Judges

    Assaulting ED providers is a felony in many states. However, it is rare for anyone to press charges against assailants.

  • Hypothermia and Frostbite

    All emergency providers should be familiar with hypothermia regardless of the climate in which they practice. Hypothermia can occur in a variety of climates, indoors or outdoors, and in patients of all ages regardless of health status. Frostbite, chilblains, trench foot, and cold urticaria are cold-related injuries that may present to any emergency department during any time of year.

  • Blunt Pelvic Trauma

    The management of pelvic trauma has evolved significantly in the last 20 years, with advances in devices and procedures. The key to success is having a team of physicians, including specialists in emergency medicine, interventional radiology, and surgery, who can work together to provide each patient the best outcome possible.

  • Managing Complications of New-Age Cancer Therapy

    Cancer patients undergoing treatment are immunocompromised and at high risk for developing early complications leading to critical illness. Compared to complications encountered with conventional chemotherapy, new-generation immunotherapies pose unique diagnostic challenges because their presentation can be vague and nonspecific or can mimic autoimmune diseases.

  • Acute Treatment of Pediatric Migraine

    Migraines occur in young children, but may be challenging to diagnose. Migraines can have a great impact on pediatric patients’ quality of life with school absence and limitations on extracurricular activities. Treatment of pediatric migraines or possible migraines is difficult secondary to the lack of evidence for effective therapies in pediatric patients. Treatment includes traditional therapy with dopamine receptor antagonists (DRAs), nonsteroidal anti-inflammatory drugs (NSAIDs), triptans, and combination therapies. Newer therapies include magnesium, valproic acid (VPA), and peripheral nerve blocks. The authors review the clinical presentation of migraines in children, guidelines for diagnosis, and therapeutic options.

  • EPs, Hospitals Face Liability for ED Nurse Practitioners’ Negligence

    If an ED nurse practitioner is sued for malpractice, the hospital will “almost always” be named, says one attorney. However, the hospital may not rally behind the care given by the nurse defendant. For this reason, nurse practitioners should carry their own malpractice insurance.

  • Vague Symptoms Trigger Sepsis Care Delays and Lawsuits

    More than one-third of ED patients with septic shock reported only vague symptoms at presentation, according to the authors of a recent study of septic shock patients discharged from a large urban ED. These patients had delayed antibiotic administration and were at a higher risk of mortality compared to patients with explicit infection symptoms. Another recent analysis revealed that a faster completion of a three-hour bundle of sepsis care and quick administration of antibiotics — but not rapid completion of an initial bolus of IV fluids — were associated with lower risk-adjusted, in-hospital mortality rates.

  • High Policy Limits Make EP a ‘Deep Pocket’ for Plaintiff

    One insider recommends emergency physicians spend money ensuring their assets are protected from third parties rather than on "higher premiums for larger limits."

  • Was ED Unprepared for Critically Ill Child? Guidelines Could Help Prove It

    The risk of a poor outcome for a critically ill child is high when a system is not ready to meet the emergency needs of that child. New guidelines from the National Pediatric Readiness Project can be used to prove that an ED fell short in this regard.