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Heel and ankle pain was the only complaint of a patient being triaged by ED nurses at Edward Hospital in Naperville, IL, with no history of injury and no obvious signs of trauma or infection, when they learned an additional piece of information.
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Eye infections are common among emergency department (ED) pediatric patients and can lead to significant morbidity if not properly managed.
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Procedural sedation and analgesia (PSA) has been provided to children in the emergency department for decades. When patients are evaluated properly, and adequate equipment, personnel, and medications are utilized, effective and safe PSA is delivered by the emergency physician, whether in a university or community setting, over a wide range of ages, and with a broad selection of medications.
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Lawsuits for "loss of chance" involving ED care are increasing, reports Jennifer L'Hommedieu Stankus, MD, JD, a medical-legal consultant, former medical malpractice defense attorney, and a senior emergency medicine resident at the University of New Mexico Health Sciences Center in Albuquerque. "This is a tricky legal concept that is gaining in popularity, particularly for things such as failure to offer [tissue plasminogen activator] to patients with acute ischemic stroke," she says.
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Imagine finding a note in your ED patient's chart from a consultant, which recommends care that you believe is totally inappropriate. Should you quietly seethe, or report it to a higher-up?
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If nursing assessment conflicts with an emergency physician's (EP), the ED nurse should speak privately with the EP about this, advises Mariann Cosby, MPA, MSN, RN, LNCC, principal of MFC Consulting in Sacramento, CA. Document subjective and objective patient data, what was communicated to the EP and other providers, their response, and then the nurses' actions, she recommends.
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As the number of mid-level providers (MLPs) staffing EDs increases, the number of lawsuits involving them is also increasing, reports Jennifer L'Hommedieu Stankus, MD, JD, a medical-legal consultant, former medical malpractice defense attorney, and a senior emergency medicine resident at the University of New Mexico Health Sciences Center in Albuquerque.
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A patient treated and discharged for pneumonia several times at an ED is later diagnosed with acquired immunodeficiency syndrome (AIDS). Could the ED be successfully sued for failing to test for human immunodeficiency virus?
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What if the emergency physician (EP) strongly believes a patient needs to be admitted, but a consultant gives a recommendation over the phone to discharge the patient?
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Have you ever made an honest mistake that a family member caught before you did, or given the wrong dose of a medication? "These scenarios, unfortunately, can make the news, and they make us look careless," says Michelle Myers Glower, RN, MSN, LNC, a health care consultant based in Grand Rapids, MI. "But how we handle them can make or break us."
