Emergency
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Tissue Plasminogen Activator Decision Remains Legal Landmine for EDs
Most lawsuits involving tissue plasminogen activator (tPA) allege the EP failed to give the drug, or that the drug wasn’t given quickly enough. In reality, a minority of stroke patients receive tPA. Almost all are outside the treatment window or don’t meet the criteria for another reason.
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Lack of Discussion With Supervising EP Key Focus of PA Lawsuits
"An emergency physician who has agreed to supervise a PA may be sued, even when she never saw the patient, never reviewed the record, and does not remember the patient," one expert warns.
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Case Law Expanding ED’s Legal Exposure if Discharged Psychiatric Patient Commits Violence
Healthcare providers’ liability exposure for potentially violent ED patients could be expanding nationally.
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Court Applies EMTALA to Hospital’s Urgent/Walk-in Care Center
A Rhode Island federal court determined that under the Centers for Medicare and Medicaid Services Emergency Medical Treatment and Labor Act regulations, a walk-in urgent care center was a “dedicated emergency department” because it held itself out “as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment.”
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Mammalian Bites
Bites, whether dog, cat, or human, are a common reason for emergency department visits.This article reviews the complexities of different types of bites ED providers may encounter and issues regarding closure and antibiotic prophylaxis, in addition to vaccination concerns.
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Injectable Opioid Shortages Causing Adverse Consequences for Some Physicians, Patients
It’s ironic that even while the country is confronting a dangerous opioid epidemic, providers report that they are having trouble getting their hands on the powerful pain killers — a situation that is dangerous as well. The shortage, which primarily involves injectable opioid painkillers, is reportedly caused by drug manufacturing difficulties as well as the government’s efforts to address addiction by clamping down on drug production. However, the problem is resulting in adverse consequences for clinicians and patients.
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Colorado Program Significantly Reduces Opioid Prescribing in 10 EDs During Six-month Period
A pilot group of 10 EDs in Colorado has shown impressive reductions in opioid prescribing by encouraging the use of alternatives to opioids (ALTO) in the care of five key pain pathways. Between June and November 2017, the pilot sites reduced the use of opioids by 36% when compared to the same six-month period in 2016. The Colorado Hospital Association, which championed the initiative, is moving to expand the ALTO approach used in the pilot to other hospitals in the state.
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Surgeon General: Clinicians Must End Addiction Stigma, Use Evidence-based Care
During a recent town hall, the surgeon general stressed the importance of recognizing that substance use disorder is a chronic disease that must be treated with the same skill, compassion, and urgency that clinicians use to treat other chronic health conditions.
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Alarming Increases in ED Visits for Opioid Overdoses Highlight Need for Robust Solutions
While it is clear that more action must be taken to address the problem, some states already have taken steps to respond to the epidemic in a coordinated way.
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Skin Infestations: Fungal and Scabies
Although cutaneous fungal infections rarely are life-threatening, they are common, and they are irritating. This article provides an in-depth look at common rashes caused by fungi and scabies.