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One of the problems associated with the boarding of admitted patients in the ED is that the practice inevitably leads to increased diversion when the ED's capacity to care for new patients is diminished.
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Emergency department administrators are well aware that crowding in the ED is associated with poorer patient outcomes, longer hospital stays, and decreased patient satisfaction.
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Pertussis, commonly known as the "whooping cough," is an infection of the upper respiratory tract leading to a protracted cough illness. Emergency physicians should become familiar with the diagnosis and management of this disease, given the potential of pertussis to cause serious morbidity and mortality in young infants and protracted illness in adolescents and adults. Furthermore, diagnosing and treating pertussis in a timely manner has a large public health impact, given its extremely contagious nature.
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Tort reform advocates and legislators need to better understand the impact of the common law when drafting language to curtail frivolous litigation or establish damages caps.1 Two recent state Supreme Court cases, one from South Carolina and one from Missouri, dampen the cause of medical malpractice liability reform.
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When a teenage patient presented to the ED at University of Michigan Health System (UMHS) in Ann Arbor with unexplained pain in her thigh, the emergency physician (EP) did all the appropriate things to make her comfortable, stabilize the situation, and get her a referral quickly to other specialists, but did not arrive at a definitive diagnosis.
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An EKG revealed a womans obvious ST-elevation myocardial infarction, but she refused to go to the cardiac catheterization lab before speaking to her husband, who proved difficult to reach by phone.
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There is significant variation in emergency physicians ordering of head CT scans for trauma patients, according to a survey of 37 attending EPs conducted during 2009, which quantified their risk tolerance and malpractice fear.1
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As part of the workup for a young woman with abdominal pain, the emergency physician (EP) ordered radiographic studies of the patients abdomen, and general surgery and OB/GYN consults. The on-call radiologist first read the studies as unremarkable.
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A young man presented to an emergency department (ED) and reported hallucinations after taking over-the-counter herbal stimulants and diphenhydramine. The ED diagnosis was acute psychosis resolved.