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The recognition of non-accidental injury is critical for a pediatric
trauma patient. In the year 2000, almost 3 million reports of child
abuse were made to social service agencies. Forty-four percent of the
fatalities were children younger than 1 year of age. Not only are these
statistics alarming, but they point out the need for emergency
department and trauma physicians and nurses to recognize non-accidental
injury and aggressively protect the children who seek our medical
expertise and protection.
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Although spinal injuries occur infrequently, a delay in the detection of thoracolumbar trauma may have devastating consequences for a child. It is critical that the emergency physican be familiar with injury patterns that may result in this type of injury.
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The skyrocketing cost of medical malpractice insurance has affected physicians throughout the nation. Many emergency physicians (EPs) have seen the costs of insurance nearly double in the past three years. Some insurers have deemed EPs with three claims against them in a five-year period as uninsurable. This months ED Legal Letter will provide insight into the malpractice crisis by looking at the cause, effect, and potential solutions to the problem. Furthermore, it will review why past legislative attempts to remedy previous malpractice crises have failed.
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When does critical care become just another emergency department (ED) visit? When you fail to document it properly. You may do all the right things and have a patient in crisis, but if the paperwork isnt done properly, you dont get paid for your efforts.
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Two severely ill patients in the emergency department of your hospital need admission to the ICU, but only one bed is available. Who gets admitted first? Another critical care patient is severely ill, with several coexisting conditions.
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Inhaled drugs are commonly used during mechanical ventilation. The physiologic effects of bronchodilators delivered by nebulizer or pressurized metered dose inhaler (pMDI) are virtually equivalent.
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In this study of a large nationwide database, mortality during hospitalization for acute exacerbation of COPD was 2.5%, which is substantially lower than that reported in previous studies.
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In a cohort of 91 ICU patients without known causes for hemoglobin decline other than blood draws and critical illness, serum hemoglobin levels declined by an average of 0.52 g/dL/d. The decline was more rapid during the first 3 days in the ICU and among patients who were septic.
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