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AIDS- and HIV-related infections have changed significantly over the last decade. Although the overall incidence has declined, young adults have shown an increase in AIDS, with 50% of all new HIV infections in this age group. Many of these new HIV infections are in patients who are late presenters. These patients have received less care and are more likely to have unknowingly transmitted the infection. Routine screening identifies patients earlier, decreases the stigma associated with HIV testing, and increases the likelihood of future testing during risky behavior periods. The authors review the current role of the ED provider in identifying and managing patients with potential HIV.
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All across the country, states, hospital associations, communities, and emergency departments (EDs) are attempting to deal with the growing incidence of prescription pain medication abuse, overdoses, and deaths.1 Opioid pain medications now kill more Americans than cocaine and heroin combined, and over the past five years, there have been more drug-induced deaths than motor vehicle accident deaths.2
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Consent to an intervention or treatment is generally implied when a patient comes to the ED, but there are some exceptions to this, according to Andrew H. Koslow, MD, JD, an assistant clinical professor of emergency medicine at Tufts University School of Medicine in Boston, MA, and an emergency physician (EP) at Steward Good Samaritan Medical Center in Brockton, MA.
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Diagnostic errors are the most common, most costly, and most deadly medical errors, according to a recent analysis of 25 years of malpractice payouts from the National Practitioner Data Bank.1
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Too often, ED staff dont report violence due to onerous reporting processes, according to Terry Kowalenko, MD, clinical associate professor in the Department of Emergency Medicine at University of Michigan Health System in Ann Arbor. Research suggests that violent incidents occurring in EDs are far more frequent than statistics reveal.1-3
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Pediatric burns, with all of their challenging aspects, are a common injury faced by emergency medicine physicians. Burn injuries are painful for the patient, distressing to the parent, and often raise some difficult questions for the physician in regard to recognition and assessment of non-accidental trauma and the clinical dilemma of disposition. The authors review the current standard for recognition, evaluation, and management of pediatric burn injuries.
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Were you called by the intensive care unit (ICU) because a patient needs emergent intubation due to a dislodged tube or deterioration of the patients status?
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Does a malpractice suit filed by a boarded ED patient allege he or she was being monitored differently in the ED than would have occurred in the intensive care unit (ICU)? In one claim that included this allegation, the ED nurses notes clearly showed that the same standard was followed in the ED.
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If a nurse asks the emergency physician (EP) whether an arterial blood gas (ABG) is needed because a boarded patients pulse oximetry is dropping, a busy EPs response might be to tell the nurse to order the test and let the admitting physician know about it.
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A new peer review and quality improvement process at the University of Michigan Hospital and Health Systems in Ann Arbor methodically samples patient safety indicators in the emergency department (ED) to spot trends that signal problems.
