Emergency
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Legal Risks if Psychiatric History Clouds Medical Decision-Making
Patients with these life-threatening medical conditions may report mood swings, personality changes, irritability or aggression, depressed mood, anxiety, or trouble concentrating. If appropriate history, physical exam, and diagnostic testing are not completed, medical emergencies can be missed. This is particularly common if physical exam findings are subtle.
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New Details Emerge About Acute Flaccid Myelitis, Cases Could Surge This Year
Researchers uncovered evidence indicating enterovirus D68 directly infects neurons in the spinal cord, prompting an immune response that leads to the limb weakness that is characteristic of acute flaccid myelitis. Investigators shed important light on the disease process that takes place in children who develop this polio-like illness. This is progress that can help lead to better treatments.
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Work on Improving the Care of Children with Medical Complexity
Emergency physicians identified significant challenges in providing high-quality emergency care to these patients. These include time constraints, the need to adequately review the expansive medical record for key information, and the need to contact known physicians when making treatment and disposition decisions. Respondents indicated communication with known providers and use of emergency information forms summarizing the child’s medical history were helpful.
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Med/Mal Concerns if ‘Float’ Nurses Cover the Department
Of 2,575 nurses from 50 states and Washington, DC, 26.5% reported they were “floated” or reassigned to a clinical care area that required new skills or that was outside their competency, according to a survey. Almost half reported receiving no education or preparation before they were assigned to the new unit.
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EDs Need Process for Incidental Radiology Findings
To lower the risks of “failure to notify” claims, institute clear protocols on who is responsible for dealing with abnormal test results. Educate patients on how to find out about their test results; this includes obtaining updated contact information. Finally, use electronic alerts to notify patients and providers when tests results are ready.
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Using Biomarkers to Predict Traumatic Brain Injury Outcomes
Measuring proteins on day of injury could help improve current predictive models.
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An ED-Friendly Screening Tool to Identify Potentially Violent Patients
Considering violence is a continuing concern in the emergency setting, there is high interest in new mechanisms that can identify potentially violent patients at the front end of their care encounters. This way, safeguards or preventive measures can be activated to keep providers and other patients safe. However, any such tool needs to be brief and easily integrated into the workflow of a busy ED.
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Educators Hope Emergency Nurse Residency Program Can Improve Retention, Prevent Burnout
What is the best way to prepare a new nurse for the challenges and requirements of an ED? This is a question the Emergency Nurses Association has been grappling with in recent years, particularly as the COVID-19 pandemic put unprecedented pressure on the profession. The answer might be a comprehensive emergency nurse residency program capable of providing graduates and nurses new to the emergency environment with the judgment, skills, and resilience to launch long and successful careers.
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Identifying Pediatric Cervical Spine Injuries
Cervical trauma in pediatrics is fortunately uncommon, but associated with significant morbidity. Early recognition and timely management are essential to optimize the child's outcome. Balanced against this is the need to minimize unnecessary radiation in young children. The authors comprehensively review identifying pediatric cervical spine injuries.
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The Case for a Team Approach to Manage Agitated Patients
While many EDs have instituted mechanisms to quickly trigger security staff, a Connecticut hospital created a unique team-based protocol that includes security and clinicians. Everyone works together to protect staff and prevent the need for restraints, sedatives, or other potentially harmful interventions. After three years, staff report they feel safer, and new data show the approach is associated with a lower rate of physical restraint use.