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The neonatal population (birth to 1 month of age) provides a unique and difficult challenge for diagnosis and treatment in the emergency department, and a systematic approach is critical to allow for rapid diagnosis and subsequent therapy in the setting of a potentially sick neonate.
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Do you treat elderly patients waiting in the ED as you would expect your own family member to be treated as if they were the only ones there?
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Before ED nurses at Ridgeview Medical Center in Waconia, MN, administered tissue plasminogen activator (tPA) to a man in his 80s with obvious stroke symptoms, the neurologist was consulted and also the patient's family members, says Kathie Pulchinski, RN, ED nurse manager.
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Editor's Note: This is a two-part series on medication safety for inpatients being held in the ED. This month, we give strategies to reduce errors with inpatient medications. Last month, we gave strategies to avoid missed dosages.
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Is a cardiac-arrest patient failing to wake up and follow commands? "Therapeutic hypothermia is one of the few therapies we can offer," says Marion Leary, BSN, RN, assistant director of clinical research at the Hospital of the University of Pennsylvania's Center for Resuscitation Science in Philadelphia.
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If ED nurses believe a patient poses a risk of harm to themselves or others, a patient safety checklist is used for "closed-loop" communication with security, says Alexandra Penzias, RN, MEd, MSN, CEN, clinical nurse educator in the department of emergency medicine at Tufts Medical Center in Boston, MA. "This ensures that all members of the ED team are aware of the patient's status and plan of care," she explains.
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If your ED patient sustained a few rib fractures, would you expect this to lead to rapid respiratory decompensation, pneumonia, and death? Minor injuries can have profound effects in the elderly, warns Avery Nathens, MD, division head of trauma and general surgery at St. Michael's Hospital in Toronto, Canada.
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The U.S. Supreme Court declined to review the controversial 6th Circuit decision in the case of Moses v. Providence Hospital, where the federal appeals court rejected Centers for Medicare & Medicaid Services' (CMS) rule that EMTALA ends once a hospital admits a patient in good faith for further stabilizing care.
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If you have a conflict with a colleague, do you document only facts and objective observations or accusatory statements such as, "Despite my intervention, the doctor refused to acknowledge what I am telling him?"
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After the emergency physician's (EP) preliminary reading of a seizure patient's X-ray was negative, the patient was discharged, but the following day, the radiologist's report showed compression of the spine.
