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If a patient comes to your ED with a pre-existing infection that goes unnoticed, the insurer likely will to refuse to pay for treatment because it will presume wrongly that the condition was acquired in the hospital.
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(Editor's note: This is the second of a two-part series on prevention of hospital-acquired infections in the ED. This month, we give strategies to improve compliance with hand hygiene, tips for cleaning the equipment you use and tell you how to determine if your patient has arrived at the ED with an infection. Last month, we covered avoiding infections when invasive procedures are performed, reducing the risk of infection with peripheral IV insertion, using alternatives to invasive procedures, giving central-line education to ED nurses, and decreasing the use of central lines and urinary catheters.)
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If your patient tells you he's had asthma since he was a teenager, don't assume that he must already know how to self-manage his condition.
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More than 100,000 prosthetic heart valves are implanted each year in North America, and another 300,000 are done annually worldwide.
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A CT scan of your abdominal pain patient is negative for appendicitis, but the radiologist finds a cystic lesion in the kidneys.
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When a woman presented to an ED complaining of a migraine and requesting a narcotic injection, two nurses and a physician advised this patient she would need a ride home if she received a narcotic.
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The cervical spine x-rays of a motor vehicle accident victim with a chief complaint of neck pain appear normal, but fractures are later picked up by a computed tomography (CT) scan.
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When contacted by the radiologist with a discrepancy, what should you do first?
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A patient presents with a traumatic dirty wound which is not cleaned completely, and is closed by the ED physician with contaminant still present. The debris in the wound causes an infection resulting in tissue loss, which must be repaired by a plastic surgeon with an extensive skin graft.