-
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.
-
The "second-look EKG" is a good risk-management strategy, according to Robert Broida, MD, FACEP, chief operating officer of Physicians Specialty Limited Risk Retention Group in Canton, OH. If you are the treating physician for any patient with chest pain being considered for discharge, it is a good practice to have another physician review and initial the EKG before discharge, he advises.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
Imagine a plaintiff's lawyer poring over stacks of documents provided by the defense as a result of a lawsuit alleging ED malpractice, and finding the statement, "This nurse will eventually kill a patient."
-
If you don't believe a diagnostic test is truly necessary but you order it anyway, you must be prepared for results to come back unexpectedly abnormal, even if these "incedentalomas" have nothing to do with what brought the patient to the ED, warns Bruce Janiak, MD, professor of emergency medicine at Medical College of Georgia in Augusta.
