Emergency
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Saline vs. Balanced Crystalloids in Critically Ill Adults
Balanced crystalloids appear to reduce in-hospital mortality in critically ill patients with sepsis or without traumatic brain injury and may reduce in-hospital mortality in the entire cohort of critically ill patients.
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Presepsis Pathways: Can We Predict Mortality After Sepsis Hospitalization?
Using a latent profile analysis in observational cohort studies of patients hospitalized for sepsis, investigators identified subtypes of patients based on inpatient healthcare facility use in the year prior to sepsis hospitalization and correlated to 90-day mortality.
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Ventilator-Associated Pneumonia and Hospital-Acquired Pneumonia: Prevention and Treatment
Ventilator-assisted pneumonia and hospital-acquired pneumonia pose significant risks to hospitalized patients and increase the cost of care. It is essential to institute measures to reduce the risk of these pneumonias and to recognize and treat them early when they occur. Treatment is a balance of ensuring adequate antimicrobial coverage in those who already are seriously ill while not unduly exposing them to the risks of medication side effects and higher rates of resistant organisms that come with the use of broad-spectrum antibiotics.
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Sleep Tight, and Don’t Let the Ectoparasites Bite: Part 1
Providers in the pediatric emergency department frequently encounter ectoparasitic infestations. Lice and scabies require early recognition and knowledge of effective treatment strategies. This month, the author reviews scabies, chiggers, and lice. Next month, the bed bugs and ticks will come biting!
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Non-ED Providers Have Surprisingly Low Risk Tolerance
When it comes to acceptable miss rates of low-probability, high-risk diagnoses, non-ED providers have a surprisingly low tolerance for risk. This finding conflicts with clinical practices one researcher recently observed.
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Testicular Torsion Claims Continue Despite Better Awareness
A closer look at some common fact patterns in missed testicular torsion cases.
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Higher Premiums and Payouts Possible for EPs With Restrictive Scope-of-Practice Laws
Will the EP be held liable for malpractice committed by a nurse practitioner (NP) in the department? It is more likely if the state has instituted restrictive scope-of-practice laws governing NPs, according to the authors of a recent analysis.
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When ED Is Crowded, Hospital Admission Becomes Less Likely
Patients are less likely to be admitted when the ED is crowded, according to the authors of a recent study. However, patients discharged during periods of crowding are not more likely to return to the ED within two weeks of discharge.
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Multiple Allegations Against EPs in Airway Management Cases
Airway management cases involving devastating outcomes are a significant source of liability for EDs. Some common allegations include using wrong-sized equipment and failure to verify tube placement after transport.
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Patients Want a Diagnosis, But a Premature One Can Fuel Lawsuit
Patients do not like leaving the ED without receiving a definite diagnosis. However, this kind of closure is not always possible in the ED, where many people are sent home with a symptom-based diagnosis.