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Toxicology

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  • If Patient Videotapes ED Care, It Could Be Used as Evidence

    While unauthorized videotapes made by a patient in your ED may seem highly inappropriate, those recordings can often be introduced as evidence in medical malpractice lawsuits, according to William Sullivan, DO, JD, FACEP, an emergency physician at University of Illinois Medical Center in Chicago and a practicing attorney in Frankfort, IL.
  • Don't Disregard Any Input on ED Patient

    Some emergency physicians (EPs) have admitted that they don't take time to read the nursing notes, according to J. Tucker Montgomery, MD, JD, a health care attorney in Knoxville, TN. "Complaints recorded there that go unaddressed, or a particular abnormal vital sign, can come back to bite an EP," he says.
  • Lessen "Boarder" Risks With These Three Practices

    When an ED patient is being held while waiting for an inpatient bed, Rolf Lowe, JD, an attorney with Rogers Mantese & Associates in Royal Oak, MI, says "there is no bright line cut off for liability. Substandard care in the ED that has an effect on the patient's outcome can result in liability for the EP and the ED staff."
  • Community-acquired Pneumonia in Pediatric Populations

    Classically, pneumonia is defined as an infection of the lung parenchyma. However, worldwide, a variety of definitions exist, including fever, hypoxia, a constellation of other clinical symptoms, and radiologic findings. In pediatric and adolescent populations, early diagnosis will assist emergency department (ED) physicians with correctly managing and subsequently avoiding potential morbidity and mortality of this common infectious disease.
  • Pediatric Foreign Body Ingestions

    Foreign body ingestion is a common problem, especially in children younger than 3 years of age. Fortunately, most cases have uneventful outcomes, but the potential for a devastating complication exists. Button batteries are particularly dangerous, and timely and appropriate management is critical. This article comprehensively reviews pediatric foreign body ingestions.
  • Physical Abuse of Children: Identification, Evaluation, and Management in the ED Setting

    Approximately one in five of children evaluated in the emergency department (ED) are physically abused. Emergency physicians (EPs) have a responsibility to consider abuse in the differential of every injured child.
  • The Approach to Penetrating Abdominal Trauma

    Penetrating abdominal trauma (PAT) has the potential to be a devastating injury and ranks in the top 15 causes of death for all ages. This article will define the problem of PAT and review the initial management, including the ability to identify, resuscitate, and initiate treatment in patients with unstable PAT prior to their transfer to the operating room (OR).
  • Reassess Boarders, or Risk Bad Outcomes and Lawsuits

    Even though the admission handoff has occurred, the "boarded" ED patient is often still managed by the admitting emergency physician (EP) or another ED attending physician many hours after the shift has ended, warns Uwe G. Goehlert, MD, MPH, an ED attending physician at Northwestern Medical Center in St. Albans, VT, and principal of Goehlert & Associates in South Burlington, VT.
  • If Parent Refuses Treatment, Act in Child's Best Interest

    If a parent objects to a medical evaluation or treatment of a child with a potentially life-threatening emergency, due to religious beliefs or any other reason, says Kevin M. Klauer, DO, EJD, FACEP, chief medical officer of Emergency Medicine Physicians in Canton, OH, the emergency physician (EP) can get a court order to get the child treated.
  • Battle of the Experts: Be Truthful and Direct

    When experts on either side of a lawsuit alleging ED malpractice make misleading or false statements, this reflects badly on the whole legal system, according to Ken Zafren, MD, FAAEM, FACEP, FAWM, EMS medical director for the state of Alaska and clinical associate professor in the Division of Emergency Medicine at Stanford (CA) University Medical Center.