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Pediatric Emergency Medicine

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  • What If Patient Threatens to Sue If Test Isn't Ordered?

    After the actress Natasha Richardson died in 2009 from an epidural hematoma that media reports emphasized could have been diagnosed with a head CT scan, EPs were flooded with requests for the test, even for patients with very minor head injuries, recalls John Burton, MD, chair of the Department of Emergency Medicine at Carilion Clinic in Roanoke, VA.
  • Florida Set for Showdown on Constitutionality of Noneconomic Damages Caps in Medical Malpractice Cases

    The 11th Circuit Court of Appeals ruled Florida's cap does not violate the federal Constitution, but punted whether the cap violates the Florida Constitution to the Florida Supreme Court.
  • Will Future Suits Allege Cancer From Needless ED CT Scans?

    This is the second of a two-part series on liability risks involving ordering of diagnostic tests in the ED. This month, we report on possible lawsuits for future cancers, strategies if patients threaten to sue because a test wasn't ordered, and liability risks specific to pediatric patients.
  • Abdominal Pain and Vomiting in the Infant

    Abdominal pain with vomiting is a common presenting complaint to the emergency department (ED) in infants. In the majority of cases, the patient's symptoms come from a benign cause such as gastroenteritis. However, it remains essential for the emergency physician (EP) to thoroughly understand the differential diagnosis of abdominal pain and vomiting in infants, particularly identifying those causes requiring surgical intervention.
  • Pulmonary Contusions

    Pulmonary contusions are a frequent complication of chest trauma and may have serious morbidity and mortality associated with them. Early recognition, aggressive management, and a targeted diagnostic approach may optimize outcomes for these patients. The authors present a concise, comprehensive review of the current status of identification and management of pulmonary contusions.
  • CT use more than triples in the ED, but use of the technology may be linked with a significant drop in hospitalizations

    All of the discussion in recent years about the risks from exposure to radiation from computed tomography (CT) scans has hardly dampened enthusiasm for the technology in the ED. To the contrary, a new study suggests that CT use in the ED increased by a whopping 330% between 1996 and 2007, according to a retrospective look at data from the National Hospital Ambulatory Medical Care Survey, which is a national survey of services in emergency departments conducted by the Centers for Disease Control in Atlanta, GA. However, the study also suggests that the increase in CT use may be associated with a dramatic reduction in hospitalizations.
  • High-tech approach to medication reconciliation saves time, bolsters safety at hospital in northern Virginia

    There is no question that hospitals face innumerable challenges in meeting the "meaningful use" of health information technology (HIT) criteria established by the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009.
  • Evolution in testing technology enables some urban EDs to implement HIV screening at relatively low cost

    Five years after the Centers for Disease Control (CDC) in Atlanta issued recommendations calling for all health care settings to routinely screen patients for HIV in areas where HIV prevalence is at 0.1% or higher, the practice has failed to take hold in most EDs, even though many obstacles to testing, such as burdensome informed consent requirements, for example, have been cleared away.
  • Take steps to curb violence, improve safety for ED personnel

    The potential for violence in the ED is well-recognized and often discussed. Several organizations such as The National Institute for Occupational Safety and Health at the Centers for Disease Control in Atlanta, GA, for example, cite the ED as being one of the most dangerous places in health care to work, and a study completed last year by the Des Plaines, IL-based Emergency Nurses Association noted that every week, between 8% and 13% of ED nurses experience some type of physical violence in the course of doing their jobs.
  • Quality Measure Brings Additional Risks for ED

    Quality measures from the Centers for Medicare & Medicaid Services (CMS) and other groups are putting EPs "in a huge bind," according to Sandra Schneider, MD, professor of emergency medicine at University of Rochester (NY) Medical Center.