Emergency Medicine Topics
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Alleviate Risks if Patients Leave Without Being Seen
There is a tendency to assume that if someone left the ED, he or she probably was not that sick. That is a dangerous assumption. For all patients who leave without being seen, the nurse manager should follow up with a call within 24 hours.
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Some Psychiatric Patients Can Bypass ED Altogether
Researchers considered protocols that bypass the ED by allowing EMS to directly transport patients to a specialized regional center for evaluation of psychiatric emergencies. The protocols are somewhat controversial.
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Discharge of Psychiatric Patients Is Legal Landmine for EDs
If a patient with psychiatric symptoms experiences a poor outcome shortly after discharge from an ED, allegations of inadequate medical screening are possible. Good documentation is the best protection against these allegations.
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Better Patient Experience Mitigates Malpractice Risk
Any ED would benefit from teaching emergency physicians to be more aware of how patients perceive them. Engaging in role-playing exercises are helpful. Record the exercises so they can be critiqued.
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Incomplete Medication Lists Can Lead to Allegations of Negligence
Just 23% of older adults in the ED gave a medication list that mirrored pharmacy records, according to the results of an analysis. More than half the patients omitted antibiotics they were taking at the time of the visit. Not knowing about a medicine can lead to dangerous therapy or misdiagnosis.
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ED Nurses Also Face Liability for Misdiagnosis
The idea that it is not within the nurses’ scope of practice to contribute to diagnosis is both dangerous and wrong.
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Patients’ Easy Access to Records Means Complaints — and Chance to Avoid Litigation
Patients will no longer have to go through the discovery process during litigation to find out everything ED providers charted. Still, with patients reviewing all the clinical documentation, plenty of misunderstandings can happen.
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Heated High-Flow Nasal Cannula Oxygen Therapy and Noninvasive Positive Pressure Ventilation
Adequate oxygenation is a priority in all acutely ill emergency department patients. Oxygen may be delivered through a variety of devices, including low-flow systems or high-flow systems.
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AAP, PIDS Tailor Antibiotic Recommendations for Children
Policy statement underscores importance of creating stewardship programs.
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Diagnosis and Management of Supraventricular Tachycardia
Supraventricular tachycardia (SVT) usually presents to the emergency department as a result of a combination of symptoms, including palpitations, dyspnea, and chest pain. Less frequent symptoms include lightheadedness, near-syncope, or syncope due to reduced cerebral perfusion. Accurate diagnosis of SVT guides acute treatment. Although many doctors are good at pattern recognition on electrocardiograms (ECGs), having a methodical approach to think through SVT is extremely helpful.