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While emergency department (ED) volume is always going to be somewhat unpredictable, ED operations at Ochsner Medical Center in New Orleans, LA, used to hum along so optimally that there was no reason to rethink the way things were done.
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As reform helps more Americans gain access to health coverage, experts predict that the nation's EDs will be bulging at the seams.
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Did an ear, nose and throat consultant refuse to come in for a critical-airway patient, a neurosurgeon for an intracranial bleed, or a hand surgeon for a patient with a tendon rupture? "Any of these instances could lead to poor or unsafe patient care and strained future relationships," says Chad Kessler, MD, FACEP, FAAEM, section chief of emergency medicine at Jesse Brown VA Hospital in Chicago.
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Corey M. Slovis, MD, professor and chairman of the Department of Emergency Medicine at Vanderbilt University Medical Center in Nashville, says to remember that requirements of the Health Insurance Portability and Accountability Act (HIPAA) apply not only to words, but also to images.
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Given the fact that almost every patient, family member, and ED staff member is carrying a cell phone, it's not surprising that inappropriate photos or videos have been posted online which means increased legal risks for EDs.
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Case: A 40-year-old man with a history of hepatitis C and alcoholism presents to the ED with dental caries. A brief history and unremarkable physical examination is documented. The patient is discharged and fills his prescription for hydrocodone 5 mg/acetaminophen 500 mg (1-2 tablets every 4-6 hours as needed, #25).
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Michael Blaivas, MD, RDMS, professor of emergency medicine in the Department of Emergency Medicine at Northside Hospital Forsyth in Cumming, GA, says he has reviewed multiple cases involving consultants refusing to come to the ED, with a bad outcome resulting. "Mostly, this means an unhappy patient, but in critically ill ones can mean a lawsuit," he says.
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Exertional heat-related injuries are on the rise in EDs, with an estimated 54,000 patients treated over a 10-year period a 133% increase that was not linked to increased seasonal temperatures, according to a new study.
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Dosages based on the color-coded Broselow Pediatric Emergency tape will soon be displayed on a large LCD monitor for all ED staff to see, says Andre A. Muelenaer Jr., part of the product's developmental team and an associate professor of pediatrics at the Virginia Tech Carilion School of Medicine in Roanoke.
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Paramedics arrive with a man you recognize instantly from his many previous visits to your ED, always intoxicated. You learn that his vital signs are stable, and he was found on the ground by bystanders, says Tia Valentine, RN, CEN, clinical nurse educator for the ED at University of California-San Diego Medical Center.
