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  • Should you give PEP after an unknown stick?

    In the May issue of HEH, we reported on an effort to reduce sharps injuries by using disposal containers with a better design. A reader subsequently posed a question: Would you administer post-exposure prophylaxis to an employee who receives a sharps injury from an unknown source, such as a sharp protruding from a container?
  • What Makes Successful Suit Against ED Mid-level?

    The number of lawsuits involving mid-level providers (MLPs) in the ED "seems to have skyrocketed in the last few years," according to Michael Blaivas, MD, FACEP, FAIUM, professor of emergency medicine at Northside Hospital Forsyth in Cumming, GA. "There are multiple scenarios that result in successful suits, and there is a common theme among them."
  • ED Nurses Face Increased Risk of Malpractice Suits

    Have you ever made an honest mistake that a family member caught before you did, or given the wrong dose of a medication? "These scenarios, unfortunately, can make the news, and they make us look careless," says Michelle Myers Glower, RN, MSN, LNC, a health care consultant based in Grand Rapids, MI. "But how we handle them can make or break us."
  • You Say Admit, Consultant Says Discharge? Do This

    What if the emergency physician (EP) strongly believes a patient needs to be admitted, but a consultant gives a recommendation over the phone to discharge the patient?
  • Does HIV Testing in EDs Carry More Legal Risks Than Other Tests?

    A patient treated and discharged for pneumonia several times at an ED is later diagnosed with acquired immunodeficiency syndrome (AIDS). Could the ED be successfully sued for failing to test for human immunodeficiency virus?
  • Uptick in Lawsuits Involving Mid-level Providers in EDs

    As the number of mid-level providers (MLPs) staffing EDs increases, the number of lawsuits involving them is also increasing, reports Jennifer L'Hommedieu Stankus, MD, JD, a medical-legal consultant, former medical malpractice defense attorney, and a senior emergency medicine resident at the University of New Mexico Health Sciences Center in Albuquerque.
  • Be Direct, But Diplomatic, If Assessment Differs From EP's

    If nursing assessment conflicts with an emergency physician's (EP), the ED nurse should speak privately with the EP about this, advises Mariann Cosby, MPA, MSN, RN, LNCC, principal of MFC Consulting in Sacramento, CA. Document subjective and objective patient data, what was communicated to the EP and other providers, their response, and then the nurses' actions, she recommends.
  • Clinical Conflicts: Should You Go Up Chain of Command?

    Imagine finding a note in your ED patient's chart from a consultant, which recommends care that you believe is totally inappropriate. Should you quietly seethe, or report it to a higher-up?
  • Treatment Delay? ED Patient May Sue For "Loss of Chance"

    Lawsuits for "loss of chance" involving ED care are increasing, reports Jennifer L'Hommedieu Stankus, MD, JD, a medical-legal consultant, former medical malpractice defense attorney, and a senior emergency medicine resident at the University of New Mexico Health Sciences Center in Albuquerque. "This is a tricky legal concept that is gaining in popularity, particularly for things such as failure to offer [tissue plasminogen activator] to patients with acute ischemic stroke," she says.
  • ED Legal Letter - Full August 2011 Issue in PDF