Emergency Medicine Topics
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Poll: Many Americans Delay Emergency Care Over Boarding Concerns
A survey by the American College of Emergency Physicians reveals nearly half of U.S. adults worry they will have to wait many hours before admission or transfer.
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Tachycardia in the Emergency Department: Part I
This issue is the first of a two-part discussion of tachycardia, the most common rhythm abnormality seen in the emergency department. Part I will discuss the epidemiology, etiology, and characteristics of the different tachycardic arrhythmias. Part II will discuss conditions affecting other organ systems that can produce tachycardia, then finish by reviewing the assessment and management of these patients. We hope these two issues will be useful to your clinical practice.
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Clinicians Consider Many Factors When Deciding on Mechanical Ventilation After Sepsis
Identifying patients at high risk and crafting timely, targeted interventions can improve outcomes.
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Emergency Medicine Residents Should Be Aware of Legal Exposure
To alleviate malpractice risks involving residents, attendings should implement a reasonable and adequate plan for the patient along with the resident; review the patient’s lab and imaging results; and, ultimately, be the decision-maker as to the patient’s ultimate disposition.
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Is ED Patient Rude or Insulting? Risk Mitigation Needed
Patients who behave in this manner could be at risk for a missed diagnosis caused by poor communication with the treatment team. They may be so difficult to tolerate that they receive less attention and nursing care than they would have otherwise. The best approach is to recognize the risks with these types of patients and mitigate them.
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Irritable Patient Behavior Affects Emergency Nursing Assessments
For encounters during which the patient exhibited irritable behavior, nurses reported more anger and unease. They also judged the patients as likely to exaggerate pain, as poorer historians, and less likely to cooperate and return to work and recover. In their documentation, nurses were more likely to use negative descriptions of patients and more likely to omit information, such as whether tests were ordered.
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Onsite Pharmacies Can Boost Medication Access to Patients, Surrounding Communities
There are some other possible workarounds, such as leveraging electronic prescribing from the ED so providers will know quickly whether medications are available in a specific outpatient pharmacy, administering first antibiotic doses in the ED, and providing a few days’ worth of medication to patients about to be discharged.
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Was Child Brought to ED by EMS? Medication Dosages May Be Incorrect
ED personnel should ensure a good handoff report is received from EMS providers, and that the dose of any medications administered by EMS is recorded. ED personnel should be mindful in carrying out weight-based dosing calculations, and should follow recommendations of national guidelines.
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EDs Can Make Discharges Against Medical Advice Safer
Recognizing a discharge as higher risk could encourage physicians and care providers to engage in risk assessment and risk reduction.
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Housing Instability Increases Likelihood of Discharge Against Medical Advice
It is important for emergency medicine providers to recognize that patients facing housing instability might be more inclined to self-discharge, even when dealing with severe medical conditions.