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An ED's policy may state that reassessments should occur every 30 minutes, or that EKGs should be given within 10 minutes of the patient's arrival, but there will always be circumstances in which these timeframes aren't met.
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Jurors might be able to understand the fact that patients can't always be treated immediately in a busy ED, particularly if a plaintiff didn't have obviously life-threatening symptoms at the time.
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If a boy is brought to an emergency department after being injured in an all-terrain vehicle (ATV) accident while at a friend's house, do triage nurses wait to get in touch with the parents before treating him?
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Ryan R. Domengeaux, JD, vice president of risk management at Schumacher Group in Lafayette, LA, says, "Policies and procedures are not only driven by statutory requirements, they are also necessary to memorialize service expectations."
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If a lawsuit is filed alleging malpractice in your ED, the only thing worse for your defense than not having a policy covering an important subject might be having one but failing to adhere to it.
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Pediatric advanced airway management is a critical skill for the emergency medicine practitioner. Safe, effective, emergent intubation can be completed with the use of rapid sequence intubation (RSI). A multitude of alternatives are available with a variety of advantages and disadvantages based on the individual clinical scenario. This article provides a comprehensive review of the process and alternatives associated with pediatric RSI.
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Even if continuous cardiac monitoring is ordered, ED patients may be taken off the monitor for transport or to go to the restroom and kept off the monitor due to oversight, warns Andrew Garlisi, MD, MPH, MBA, VAQSF, medical director for Geauga County EMS in Chardon, OH.
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The ED nurse is the "first line of defense" against a malpractice lawsuit alleging missed or delayed diagnosis of sepsis, according to Paula Mayer, RN, LNC, a partner at Mayer Legal Nurse Consulting in Saskatchewan, Canada.
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Emergency medical services (EMS) crews are all on assignments, it's rush hour, the cardiologist hasn't called back, or the transfer center is waiting for approval before assigning a bed. These are all valid reasons for delays in transfer of a patient with an ST-elevation myocardial infarction (STEMI), says Kevin Brown, MD, MPH, FACEP, FAAEM, principal with Brown Consulting Services in Armonk, NY, and former director of the department of emergency medicine at Greenwich (CT) Hospital, but if any of these delays occur, times should be documented by the emergency physician (EP).
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Waiting time has always been the number one complaint against hospital emergency departments (EDs). In an attempt to address the waiting issue, hospitals recently began allowing patients with nonemergency conditions to "schedule" their ED visits through the Internet and then wait at home until their "projected treatment time" in the ED.
