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Delays for treatment for heart attack patients will continue to be a high-risk area for EDs legally, predicts Robert L. Norton, MD, a professor in the Department of Emergency Medicine at Oregon Health & Science University in Portland.
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A 12-year-old boy with an unremarkable familial and medical history presents with global aphasia and right hemiplegia 14 days after a streptococcal pharyngeal infection. A neurological examination performed three hours after symptom onset reveals a conjugate gaze deviation to the left, right hemiplegia, hemihypesthesia, and extensor plantar sign. The NIHSS score is 22. Laboratory examinations are normal. A cerebral CT shows a hyperdense left MCA and early signs of infarction in that area.
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Did an emergency physician write an order for a magnetic resonance imaging (MRI) scan, but one cannot be obtained because the machine is being serviced? If so, the chart should reflect that the ordering physician was advised of the delay.
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Emergency physicians (EPs) named in lawsuits likely won't be eager to answer detailed questions about their legal problems years down the road, but there are situations in which they'll need to do so.
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If an ED nurse is contacted by the state board of nursing about a medication error that harmed a patient, his or her first instinct might be to state, "I told them this would happen because we didn't have enough staff!"
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The view that every emergency physician (EP) is going to get sued sooner or later is "a bit of an oversimplification," according to Stephen A. Frew, JD, vice president of risk consulting at Johnson Insurance Services and a Rockford, IL-based attorney.
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ED nurses shouldn't wait to be the subject of an investigation to become familiar with the hospital's risk management department, says Karen Jarboe, RN, CEN, CCRN, a legal nurse consultant specializing in emergency medicine and a senior clinical nurse with the adult ED at University of Maryland Medical Center in Baltimore.
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If an emergency physician (EP) learns he or she is being investigated by the medical board, this should be taken seriously but not personally, advises Michael Blaivas, MD, professor of emergency medicine in the Department of Emergency Medicine at Northside Hospital Forsyth in Cumming, GA.
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A U.S. District Court in Texas allows a physician's retaliation claim against the hospital that allegedly terminated his privileges for reporting violations of the Emergency Medical Treatment and Labor Act (EMTALA).
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Children with diabetes, especially type 1, remain at risk for developing diabetic ketoacidosis (DKA). This may seem confounding in a modern society with such advanced medical care, but the fact remains that children who are type 1 diabetics have an incidence of DKA of 8 per 100 patient years.
