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Quality measures from the Centers for Medicare & Medicaid Services (CMS) and other groups are putting EPs "in a huge bind," according to Sandra Schneider, MD, professor of emergency medicine at University of Rochester (NY) Medical Center.
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If there is absolutely no credible reason to think that a patient's symptoms are due to a heart attack, says John Burton, MD, chair of the Department of Emergency Medicine at Carilion Clinic in Roanoke, VA, you shouldn't be ordering tests such as cardiac enzymes.
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In this article, we present a series of actual clinical scenarios that could have turned out differently if the wrong management decision had been made.
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This is the first of a two-part series on liability risks involving ordering of diagnostic tests in the ED. This month, we'll cover the legal ramifications of deciding not to order a test, the legal risks of unexpectedly abnormal results, how ED protocols can help an EP's defense, and a new quality measure that increases liability risks for EPs.
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If you don't believe a diagnostic test is truly necessary but you order it anyway, you must be prepared for results to come back unexpectedly abnormal, even if these "incedentalomas" have nothing to do with what brought the patient to the ED, warns Bruce Janiak, MD, professor of emergency medicine at Medical College of Georgia in Augusta.
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Imagine a plaintiff's lawyer poring over stacks of documents provided by the defense as a result of a lawsuit alleging ED malpractice, and finding the statement, "This nurse will eventually kill a patient."
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New emphasis on optimal medical therapy in atherosclerotic cardiovascular (CV) disease has focused attention on the short-term variability of blood pressure (BP) measurements and the difficulty this poses for the diagnosis and treatment of hypertension.
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This paper presents data from the Nurses' Health Study. This is a large study that was begun in 1976 which surveyed nurses with initial ages between 30 and 55 and collected data on lifestyle and other risk factors and correlated these data with the development of cardiac disease.
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