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ACEP, AAP, and several other prominent pediatric and critical care organizations have endorsed the practice of offering parents the choice about being present during invasive procedures and resuscitations.
The majority of the literature supports providing the parents the choice to be able to remain with their children during procedures, including resuscitative efforts.
There have also been psychological benefits with family members who remained present during resuscitations by lowering their anxiety and depression scores, having fewer disturbing memories, and lowering degrees of intrusive imagery and post-traumatic avoidance behavior.
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There are several relatively new adjuvant treatments for patients with massive hemorrhage. Of these, TXA is most widely recommended. It is inexpensive and has been shown to reduce mortality when given within three hours of injury.
A new test, viscoelastic hemostatic assay, identifies the patient's stage of coagulability and fibrinogen status. The result of the test is a curve, which can help determine the need for fibrinogen, clotting factors, and platelets.
Massive transfusion is an independent predictor of increased mortality, increased infection rate, SIRS, andmulti-organ failure.
Complications of massive transfusion include acid/base derangement, electrolyte abnormalities (particularly hyperkalemia with rapid infusion), immune system changes, acute lung injury, and fluid overload.
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Kawasaki disease, first described by Dr. Tomisaku Kawasaki in 1967, is a self-limited systemic inflammatory vasculitis characterized by fever and a variety of mucocutaneous manifestations. Surpassing rheumatic heart disease, it is now the leading cause of acquired cardiac disease in children.
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In a continuing effort to ease demand on busy EDs, some communities are coming up with new ways to leverage paramedics.
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In its latest round of report cards on the emergency care environment, the American College of Emergency Physicians (ACEP) gave the nation an overall ranking of D+, a slight decline from the rankings unveiled in 2009.
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A new study suggests that introducing palliative care consultations while patients are still in the ED, rather than waiting until after patients have been admitted, can significantly reduce inpatient length of stay.
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The official countdown for ICD-10 implementation is well underway.
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An inebriated frequent emergency department (ED) patient, discharged after a cursory examination and no treatment, was found dead in the hospital's parking lot a few hours later.
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Two years ago, a Texas court, in the case of Dr. Zawislak v. Memorial Hermann Hospital, determined that emergency physicians were "employees" of the hospital for determining whether they could sue the hospital under the Emergency Medical Treatment and Labor Act's (EMTALA) whistleblower provision for retaliatory termination (see the February 2012 ED Legal Letter).
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"If the EP had only told me, I would have come right in and admitted the patient," is what a consultant is almost certain to claim if named in a lawsuit resulting from a bad outcome that occurred after a patient was discharged from the ED.
