Emergency
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An Update on Physical Abuse of Children
Approximately one in five children evaluated in the emergency department is physically abused. Emergency physicians have a responsibility to consider abuse in the differential of every injured child. Although there is increasing awareness of the emergency physician’s role in diagnosing abuse, emergency physicians frequently fail to recognize the more subtle presentations of abuse. This article reviews the identification, evaluation, and management of a child with possible physical abuse.
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Physician Health and Malpractice Risk: A Look at Holmes v. Lyons
If a state board licensing investigation is initiated, it is wise to immediately consult an attorney who is familiar with applicable law. Cases like these are a challenging factor in the tension between physician wellness and the shift to a culture of openness about physician wellness and medicolegal risk. Physician involvement in shaping how the states manage these issues has the potential to positively affect the health of both physicians and their patients.
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Shocking Injuries: Knowing the Risks and Management for Electrical Injuries
Approximately 5,000 patients present to the emergency department each year for evaluation and treatment of electrical injuries. This article will discuss the different classifications of electrical exposures and describe the recommended initial evaluation, diagnostic workup, and treatment. In addition, the authors also discuss special situations, such as lightning exposures, pediatric exposures, and electrical exposures during pregnancy.
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An Evidence-Based Review of Gastrointestinal Bleeding Evaluation and Management in the Emergency Department
Gastrointestinal bleeding is a common presentation to the ED, and patients can present at any age with varying complexity and severity.
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As Measles Cases Mount, Frontline Providers Urged to Remain Vigilant
As of late May, 940 measles cases had been confirmed in 2019, the most cases reported in the United States in 25 years.
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Trump Administration Outlines Steps Aimed at Eliminating HIV Epidemic
CDC Director: “This is going to be a whole-of-society initiative. We have an unprecedented opportunity to end the HIV epidemic in America, and that is why the time to act is now.”
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EDs, Community Partners Play Central Role in Slashing HIV Diagnoses in San Francisco
Emergency providers have played a strong role in helping San Francisco drastically reduce the number of new HIV infections as part of the city’s Getting to Zero initiative. In particular, the ED at Zuckerberg San Francisco General Hospital (ZSFGH) has identified 10% of all new HIV infections in the city. Working in partnership with Ward 86, the nation’s first HIV clinic, these patients and their partners have been connected to care quickly, greatly diminishing subsequent transmissions. It is a model that has been duplicated across the city to great effect.
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As Cannabis Use Proliferates, Investigators Probe What Brings Patients to the ED With Adverse Drug Events
Investigators are beginning to unearth important findings from a rich data set regarding cannabis-related ED visits at a large, academic medical center in Colorado. As states move to legalize recreational and/or medicinal cannabis use, the information is important to helping frontline providers understand how to recognize and treat such patients.
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Pilot Program in Pennsylvania Prompts EDs to Invest in Care Coordination
A more pronounced focus on care coordination is taking shape in the EDs at a cadre of rural hospitals that are participating in Pennsylvania’s new global budgeting pilot. The pilot is designed to provide a more secure revenue stream to hospitals that have been operating at a loss or with very small operating margins. However, it also signals a strong shift away from the traditional focus on volume toward value-based care and population health.
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Procedural Sedation and Analgesia in the Emergency Department
Procedural sedation and analgesia (PSA) is performed in the emergency department (ED) to alleviate anxiety, decrease pain, and provide amnesia to patients undergoing painful procedures or diagnostic imaging.This article will review guidelines for performing PSA in the ED, including suggested training, preprocedural assessment, and intraprocedural monitoring.