Emergency Medicine Topics
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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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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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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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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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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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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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Fracture-Related Complications
The goal of this review is to familiarize emergency physicians with the initial assessment of fractures as well as the identification and management of immediate, early, and late-stage fracture complications.
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Despite Some Progress, Pediatric Readiness Continues to Lag in Many EDs
EDs showed improvement on five of the six domains evaluated in the survey-based assessment, completed by the National Pediatric Readiness Project. However, there was a significant decline from the 2013 assessment regarding administration and coordination, a heavily weighted domain.
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More Support Needed for Pediatric Emergency Care Coordinators
Considering professional organizations view the pediatric emergency care coordinator role as essential to pediatric readiness in U.S. EDs, there is concern about health system commitment to the role, based on the results of a survey of the physicians and nurses serving in those positions.
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Attorneys Will Scrutinize ED Preparedness for Pediatric Emergencies
Litigation will center on training, experience, and facility resources.