ED Management – December 1, 2003

December 1, 2003

• Want to drastically cut LWBS numbers? Try ice packs and adding a fast track

  Somewhere deep in an ED managers mind, maybe when youre feeling cynical at 3 a.m., the patients who left without being seen (LWBS) might seem like a blessing. After all, your ED is too busy, and they probably didnt need emergency care in the first place.

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• Fast track keeps everyone moving through your ED

  The fast track in the ED at Onslow Memorial Hospital in Jacksonville, NC, is designed to keep everyone in the ED moving, not just those seen in the minor emergency care unit (MECU), says Pat Stark, RN, BSN, nurse manager for the ED.

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• Are more lumbar punctures needed after CT scan?

  Far too many emergency physicians are complacent about the use of lumbar punctures following a negative computed tomography (CT) scan to rule out subarachnoid hemorrhage in a patient with high-risk headache (worst ever or thunderclap headache), some experts say.

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• Tool ensures follow-up for traumatized children

  A child comes in for an injury in a traffic accident in which others were hurt and killed. The ED clinicians take care of the physical injuries, and the patient is discharged. Still, the staff members feel uneasy about the impact of the accident on the childs mental health.

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• Simple questions used in screening kids for PTSD

  The Screening Tool for Early Predictors of PTSD (STEPP) is the first method available for emergency physicians to quickly and effectively assess the risk of post-traumatic stress disorder (PTSD), says Nancy Kassam-Adams, MD, associate director for behavior research at TraumaLink, a pediatric trauma research center based at Childrens Hospital in Philadelphia.

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• EMTALA Q&A

  Question: What does the final EMTALA rule say about taking time to consult with the patients personal physician?

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• CDC: Heart problems not linked to smallpox vaccine

  The nations efforts to vaccinate ED staff and other frontline health care providers against smallpox hit a serious bump when some people developed serious heart problems after the vaccination, but the concerns were unwarranted, states the Centers for Disease Control and Prevention (CDC) in Atlanta.

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• SARS plan offers tools, but could be hard to use

  ED managers are no longer on their own when it comes to figuring out how to respond to prepare and respond to a resurgence of severe acute respiratory syndrome (SARS) but theyre not home free just yet.

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• SARS audio program updates guidelines

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