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People understand that natural disasters like floods, hurricanes, or tornadoes are going to happen every year. That's why EDs across the country routinely conduct practice drills so that they have plans in place to deal with mass-casualty events.
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Noting that opioid analgesics are among the drugs most often associated with adverse drug events, the Joint Commission has issued a Sentinel Alert, urging hospitals to step up their efforts to prevent complications and deaths from use of these powerful drugs.
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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.
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Many medical conditions aren't possible to diagnose without appropriate cardiorespiratory monitoring, vital sign reassessments, and diagnostic testing, and these are "disasters waiting to happen," warns Andrew Garlisi, MD, MPH, MBA, VAQSF, medical director for Geauga County Emergency Medical Services (EMS) and co-director of University Hospitals Geauga Medical Center's chest pain center in Chardon, OH.
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Lawsuits related to treatment delays in EDs aren't limited to patients in the lobby who are waiting to be seen, says Andrew Garlisi, MD, MPH, MBA, VAQSF, medical director for Geauga County EMS in Chardon, OH.
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Is your ED considering screening out non-critical patients by giving medical screening examinations (MSEs), as required by the Emergency Medical Treatment and Labor Act (EMTALA), then giving patients a choice of seeing a primary care doctor or paying a fee?
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EPs may try to put off intervening on admitted patients waiting for inpatient beds to become available to avoid confusion about what was already done for the patient and what the inpatient care plan is, says William C. Gerard, MD, MMM, FACEP, chairman and professional director of emergency services at Palmetto Health Richland in Columbia, SC.
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"This is a new electronic record, and it does not work very well." If an emergency physician (EP) didn't review the nursing notes because these couldn't be located within the ED's electronic medical record (EMR), this statement could very well be the EP's only defense in the event a medical malpractice suit occurs, says Michael Blaivas, MD, FACEP, FAIUM, professor of emergency medicine at Northside Hospital Forsyth in Atlanta, GA.
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In some states, only one party to a conversation has to consent for a recording to be legal, while in other states, both parties have to consent unless one of several exceptions to the law is present, such as anticipation that a crime is going to be committed or use by law enforcement, says William Sullivan, DO, JD, FACEP, an emergency physician at University of Illinois Medical Center in Chicago and a practicing attorney in Frankfort, IL.
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Admitted ED patients are "definitely in a gray zone," according to William C. Gerard, MD, MMM, FACEP, chairman and professional director of emergency services at Palmetto Health Richland in Columbia, SC. "Fortunately, they are admitted, and that takes your [Emergency Medical Treatment and Labor Act] risk away. But then you get into the malpractice risks," he says.
