Articles Tagged With:
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Metabolic Acidosis in the ICU
Sodium bicarbonate therapy for severe metabolic acidemia did not affect a primary composite outcome of all-cause mortality at 28 days and at least one organ failure at day 7. However, in an a priori-defined stratum of patients with acute kidney injury, sodium bicarbonate therapy decreased 28-day mortality and the primary outcome.
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Severe Sepsis and Septic Shock Early Management Bundle
When the Severe Sepsis and Septic Shock Early Management Bundle was used to identify patients with severe sepsis or patients in septic shock, delays in lactate measurements for patients with abnormal lactate levels were associated with delayed initiation of antibiotic therapy and increased mortality.
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Should We Use Early Physical Therapy for Respiratory Muscles?
Mechanically ventilated patients undergoing inspiratory muscle training demonstrated significant increases in both maximum inspiratory and expiratory muscle pressures; the training was associated with reduced weaning duration of 2.3 days.
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A Novel Prediction Tool for Hypoxemia During ICU Intubation
The authors of this retrospective analysis of data from two prospective randomized trials of tracheal intubation created a new risk score calculator to identify patients who may develop severe hypoxemia during this procedure.
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Can Plaintiff Prove Documented ED Evaluation Never Happened?
Inadvertent checking of items is one of the legal risks of electronic medical records. One common scenario: Someone checks a box stating that the patient’s current medications were reviewed. It turns out the patient was taking a medication that was contraindicated to something that was administered in the ED. This can lead to a "he said/she said" situation.
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Report: Liability Fears of Discharging Low-risk Pulmonary Embolism Patients Unfounded
Various investigators have spent the last several years trying to demonstrate the safety and effectiveness of outpatient care in a community setting.
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Anaphylaxis-related Lawsuits Allege Exposures to Known Triggers
To reduce the likelihood of anaphylaxis-related litigation, researchers recommend additional anaphylaxis education, provision of epinephrine auto injectors or other alternatives to reduce dosing errors, and stronger safeguards to prevent administration of known allergens.
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Procedure-related Complication? Expect Supervising EP to Be Named
Lack of adequate supervision and procedure proficiency are the two most common allegations plaintiffs level in such cases.
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ED Protocols Might Add to Liability Exposure of Low-risk Chest Pain
Researchers set out to understand how EPs determine risk and decide to admit patients with low-risk chest pain. They surveyed dozens of emergency medicine residents and faculty about their perceived risk of various scenarios and an admission decision. Physicians used qualitative terms in ways that are different from how those terms are used in typical conversation. This can lead to miscommunication during shared decision-making processes. Investigators discovered that EPs considered any probability greater than 1% for acute coronary syndrome enough of a risk to warrant admission.
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In Missed Appendicitis Cases, Presentations Are Early, Atypical
The authors of a recent study discovered that a triage chief complaint that was less indicative of appendicitis correlated with a higher rate of missed appendicitis in one pediatric ED. The researchers concluded that their findings suggest the potential impact of anchoring bias by a triage chief complaint when trying to diagnose appendicitis. However, one analyst advises that the results should be interpreted with caution because the study authors did not look for the denominator of chief complaints.