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An expert witness for the plaintiff takes the stand and proceeds to tell the jury patently false statements regarding the standard of care. While this problem is certainly not unique to emergency medicine, it is exacerbated by the number of experts allowed by judges to testify based on limited exposure to emergency medicine, who are not themselves emergency physicians, says Hugh F. Hill III, MD, JD, FACEP, an assistant professor in the School of Medicine at Johns Hopkins University in Baltimore, MD.
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The fact that an expert witness recently prevailed after suing a specialty society for suspending him for allegedly giving improper testimony in a medical negligence case wont affect the ability of the American College of Emergency Physicians (ACEP) to discipline unethical expert witnesses, according to Louise B. Andrew, MD, litigation stress counselor, founder and principal of www.MDMentor.com, and former chair of ACEPs Professional Liability Task Force Expert Witness subcommittee.
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A plaintiffs attorney in a missed myocardial infarction case showed the jury an EMR entry indicating the patients heart rate was within normal limits, as well as vital signs taken by a nurses assistant showing severe tachycardia.
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While rhythm disturbance may be a common presenting complaint among adult emergency department (ED) patients, the incidence of cardiac dysrhythmia among pediatric patients is relatively low. In one retrospective review, primary cardiac arrhythmias were identified in 13.9 per 100,000 pediatric ED visits.1 The incidence of these dysrhythmias peaked during infancy and then again in adolescence.1 Cardiac dysrhythmias in children may be due to primary conduction abnormalities or may occur in the setting of structural heart disease, metabolic derangements from toxic ingestions, or infections. Supraventricular tachycardias (SVT) represent the most common pediatric dysrhythmias in adolescents (an estimated 63% of all documented tachycardias).1 After a brief review of initial emergency management of dysrhythmia, the authors will emphasize important pediatric ECG parameters and how they differ from adults.
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Process improvements typically take center stage whenever hospital administrators decide that patient throughput and patient satisfaction are not where they need to be.
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Christiana Hospital in Newark, DE, averages between 315 and 320 patients per day. It's a huge ED, taking up a lot of space, explains Amy Whalen, RN, BSN, SANE-A, the assistant nurse manager in the ED.
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There is nothing like working on the front lines in a busy emergency department to learn about the impact of traumatic injuries. Consider, for example, the experiences of Brent Parry, NREMTP. Serving as a paramedic for LifeFlight, and as a tech for the ED at Geisinger Wyoming Valley (GWV) Medical Center in Wilkes-Barre, PA, Parry is often among the first to see patients who have been seriously injured.
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An elderly man presented to an emergency department (ED) with new-onset chest pain. In reviewing the patient's electronic medical record (EMR), the emergency physician (EP) noted a history of "PE," but the patient denied ever having a pulmonary embolus.
