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Routine laboratory tests (RLT) and chest radiographs (CXR) are a source of considerable expense in the care of ICU patients.
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I remember when the Goldman myocardial infarction (MI) algorithm came out, quickly followed by a seven-button hand-held "calculator." It promised to reduce all decision-making regarding ED chest pain patients to seven yes or no questions. But when you looked into the mathematics, if you answered no or negative to all of the questions, it indicated a 4% chance of acute cardiac ischemia. So, what would you do with this information? Could you tell the patient that there was only a 4% chance of a heart attack, so it was OK to go home?
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In this issue: Clopidogrel and proton pump inhibitors; adverse events with tamsulosin after cataract surgery; new guidelines for persistent pain in the elderly; and FDA Actions.
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Does the electrocardiograph in your emergency department include a computer-generated interpretation on every electrocardiogram printed? Like me, do you often find them less than helpful? Occasionally troubling?
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Asthma is the most common chronic childhood illness; it is estimated that it currently affects 6 million children in the United States.
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In light of the existing health care crisis, patients who leave the emergency department (ED) against medical advice (AMA) will foreseeably represent an increasing population of emergency patients. Despite this, these patients have attracted little academic interest within the emergency medicine literature.
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Four blood cultures come back positive, but when an ED nurse contacts the woman's husband, he says she's doing much better. Neither the ED nurse nor the physician asks the patient to return to the ED, and she returns two days later with altered mental status and partially treated meningitis. An adverse outcome results. Could your ED be sued?
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Your own personal notes about a patient's care. Incident reports if a patient is harmed. Information given verbally or in writing to the hospital's risk managers. Conversations or e-mails with other ED physicians about the patient's care. E-mails or conversation with physicians who don't work in your ED. Personal correspondence with non-involved parties.