Emergency
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EP Failed to Obtain Consult? ED Malpractice Claims Can Include This Allegation
It turns out that a significant number of ED claims involve this scenario — about one in five, according to an analysis of closed malpractice claims. These are some relevant case examples.
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Uncommon Diagnoses That Cannot Be Missed
Pediatric patients present to the emergency department (ED) with a variety of issues ranging from benign upper respiratory infections to life-threatening anaphylaxis. Many emergent conditions may mimic the common and nonthreatening ailments of normal childhood. Emergency physicians must be able to recognize and treat uncommon but emergent illnesses quickly and accurately. In addition, providers must be aware of those illnesses that look serious but warrant only supportive care. This article will focus on the assessment, evaluation, differential, and treatment of uncommon but can’t-miss diagnoses that clinicians should consider in the emergency setting.
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CDC: Naloxone Prescribing Has Increased, Still Room for Improvement
While prescriptions for naloxone have increased markedly in recent years, researchers at the CDC report that the overdose reversal drug is not prescribed enough in many areas of the country that need it most. Further, the agency reports that too few physicians are prescribing naloxone in accordance with the CDC’s Guideline for Prescribing Opioids for Chronic Pain.
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Study: Nurses at Higher Risk of Suicide Than General Population
Investigators reported that nurses are at significantly higher risk of suicide than the general population. Many issues common to nursing contribute to symptomatic stress, including conflict in the workplace, lateral violence, a hefty workload, blame for a negative outcome, and witnessing death repeatedly.
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CMS Aims to Slash Inappropriate Use of Advanced Diagnostic Imaging
Beginning in January 2020, the Centers for Medicare & Medicaid Services will require healthcare providers to consult appropriate use criteria through a qualified decision support mechanism before ordering advanced diagnostic imaging tests for Medicare patients.
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Michigan EDs Collaborate to Reduce Excess Use of Certain Imaging Tests
The Michigan Emergency Department Improvement Collaborative has identified low-value imaging as one area that is ripe for improvement across many of its sites. The group is developing and implementing interventions that will improve practice in this area.
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Unique Approach Helps Address Volume, Higher-Acuity Patient Challenges
A multifaceted triage process is credited with helping a California-based ED slash turnaround times and the left-without-treatment rate without requiring additional spending or resources. The approach integrates elements of the provider-in-triage and split-flow models while also using waterfall-style shifts for certain physician/nurse teams.
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Sports-Related Concussion
Concussion is now known to be a significant public health issue, with high rates of emergency department visits and hospitalizations. Much of the current concern surrounding concussions revolves around recognition, early diagnosis, treatment modalities, return-to-play, and prevention of recurrent concussions.
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The Capacity Conundrum in Emergency Medicine
A patient’s capacity to give informed consent or to leave the emergency department against medical advice is a topic of great relevance to emergency clinicians. This article discusses the difference between competence and capacity and highlights the four essential elements involved in the assessment of a patient’s capacity.
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Decision-Making Capacity in the ICU
A multicenter, one-day prevalence, prospective, observational, double-blind study in 19 ICUs revealed that the decisionmaking capacity of ICU patients was widely overestimated by all clinicians as compared with a capacity score measured by the Mini-Mental Status Examination and the Aid to Capacity Evaluation.