Emergency Medicine - Adult and Pediatric
RSSArticles
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Targeted Management of Headaches for Emergency Physicians
Headaches are one of the most prevalent and disabling categories of disorders worldwide. Emergency healthcare providers are in a unique position to provide management of acute attacks, exclude emergent causes, educate patients, initiate some forms of preventive treatment, refer patients for appropriate outpatient workup and management of chronic headaches, and clarify and provide feedback regarding diagnostic criteria.
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Approach to Pediatric Eye Discharge and Periorbital Swelling
Eye problems, particularly conjunctivitis and periorbital swelling, are very common. The majority are managed easily, but more serious disease processes must be considered. Early recognition and prompt treatment of more serious etiologies, such as gonococcal conjunctivitis and herpes simplex virus, can prevent vision loss.
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Take Steam Out of Plaintiff’s Missed Fracture Claim
About 2% of minor trauma patients presenting to a Belgian ED leave with a missed diagnosis, according to a recent study. Of 56 minor trauma patients with missed diagnoses, the most frequently missed diagnoses were ankle, wrist, and foot fractures.
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Excessive ED Waits Are Trigger for Malpractice Lawsuits
EPs can expect wait times to become an issue in any litigation in which an ED patient was diagnosed with a time-sensitive disease process.
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Some Plaintiffs' ‘Experts’ Have Never Worked in ED
It’s never easy for an EP to listen to an expert witness testify that their care was negligent, but it’s harder to take coming from someone who hasn’t worked in an ED in many years — or ever.
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ECG Overload? EP Might Miss Subtle STEMI
It’s not uncommon for EPs to be presented with dozens of ECGs during a shift. The large number of ECGs performed at triage could lead to an unintended legal consequence: increasing the possibility of missed ST-elevation myocardial infarction (STEMI), especially those that are subtle or atypical presentations.
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Surprising New Data on Missed Acute Coronary Syndrome in EDs
Lack of “typical” symptoms cannot rule out acute coronary syndrome, and “atypical” symptoms should raise the EP’s index of suspicion, according to a recent review of the literature.
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Did ED Prescription Spark Opioid Addiction? Causation Tough to Prove
Plaintiff attorneys may try to link a patient’s addiction to an ED prescription, but linking causation to one specific EP is difficult. EPs can reduce legal risks by checking available registries to identify high-risk patients, posting clear guidelines on prescribing practices in ED waiting rooms, and using caution about referring screening to social workers or behavioral health specialists.
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ED Claims Involving High-dose Analgesics Carry Jury Appeal
Recent successful ED claims involving high-dose analgesics focused on failure to monitor patients and improper discharge. The malpractice lawsuits alleged that a patient was seriously injured because he or she was allowed to leave the ED while sedated, a patient went into respiratory arrest because of unsafe discharge, and the ED failed to monitor a patient adequately, resulting in the patient’s death.
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Emerging Infectious Disease and Emergency Medicine
There are many emerging infections for which the emergency physician must remain clinically vigilant. Although many infections may not represent true emergencies, it is important for ED providers to understand the epidemiology, presentation, and treatment of some of today’s common and life-threatening infections.