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While blood transfusions are often essential in the care of trauma patients, several prominent health care organizations recognize that too often providers are ordering blood transfusions when they are not medically necessary. This drives up costs and exposes patients to unnecessary risks, according to experts. And it also essentially wastes precious blood supplies.
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A new study, led by researchers at the University of Michigan (UM) in Ann Arbor, MI, suggests that clinicians might not be spending enough time discussing some of the most complex patients when they are handing-off these cases during shift changes. And there is a simple reason why, according to Michael Cohen, PhD, professor of complex systems, information, and public policy at UM.
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In the immediate aftermath of Hurricane Sandy, many hard-hit hospitals along the northeast coast were putting in calls to colleagues in New Orleans for advice on how best to pick up the pieces and, perhaps more importantly, bolster their defenses for future disasters. While hospitals along the Gulf Coast are much more accustomed to preparing for hurricanes than facilities in the Northeast, Hurricane Katrina knocked even the best-prepared facilities on their heels when it devastated the region in August of 2005.
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Michael Gerardi, MD, FAAP, FACEP, director of pediatric emergency medicine at Goryeb Childrens Hospital in Morristown, NJ, reports that he is aware of several recent lawsuits naming an emergency physician (EP) for failure to diagnose child abuse.
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Below is a list of some things that EPs should consider to be red flags for abuse, according to Daniel M. Lindberg, MD, an attending physician in the Department of Emergency Medicine at Brigham and Womens Hospital and assistant professor of medicine at Harvard Medical School, both in Boston:
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The concussion laws passed by 39 states establish an expectation for emergency physicians (EPs) involved in the case of a student athlete who has potentially suffered a concussion to have a very low threshold for making the diagnosis of concussion and removing the child from any potential for further injury, says Roger J. Lewis, MD, PhD, a professor in the Department of Emergency Medicine at Harbor UCLA Medical Center in Torrance.
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If the plaintiff had to prove beyond a reasonable doubt that an emergency physician (EP) made a wrong decision, there are so many gray zones in medicine that there would never be a plaintiff judgment again, says Kevin Klauer, DO, EJD, chief medical officer for Emergency Medicine Physicians in Canton, OH, and a member of the board of directors at Physicians Specialty Ltd. Risk Retention Group.
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Kansas court rules that a patient had not come to the emergency department by virtue of a clinic physician calling and asking the hospital to accept the patient. Furthermore, the court determined that EMTALAs duty to accept a patient in transfer is only actuated when the hospital is called by another hospital, not by a clinic or physicians office.
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Concussion laws often require evaluation to be done by a particular class of health care provider one trained in the evaluation and management of a concussion, says William M. McDonnell, MD, JD, an associate professor of pediatrics in the Division of Pediatric Emergency Medicine at University of Utah in Salt Lake City.
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While the Centers for Disease Control (CDC) in Atlanta has been calling on EDs to routinely test patients for HIV since 2006, the practice is hardly widespread.
