Emergency Medicine - Adult and Pediatric
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Did ED Patient Threaten Violence? EP Might Have Legal Duty to Warn
EPs might have a legal “duty to warn” individuals if a patient threatens violence against them, depending on their state statute. EPs are shielded from allegations of breach of confidentiality if they warn someone of a threat. Importantly, EPs can be held liable if their failure to warn leads to a violent act.
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Psych Patients Elope or Are Discharged? Either Way, It’s a Wrongful Death Lawsuit
If psychiatric patients are discharged or elope from the ED and harm themselves or others, a wrongful death lawsuit is possible. To reduce risks, EPs can document that there was no evidence of homicidal or suicidal ideation at the time of the ED visit, contact a psychiatrist to support the decision to discharge, keep the patient secure until the evaluation is complete, and take reasonable precautions when patients are transported to another facility.
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Liability for EP if Admitted Patient’s Condition Deteriorated
EPs are not absolved of legal responsibility for admitted patients who remain in the ED while waiting for an inpatient bed to become available. Juries rely on documentation to determine what information was communicated to the admitting physician. Providing treatment to admitted patients can lead to the EP being held to a higher standard of care. Undocumented interactions are problematic for the defense.
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ED-based EHR Errors Caused More Significant Harm to Patients Compared to Other Settings
Seeking to obtain more information on health IT-related problems, researchers analyzed EHR-related cases occurring between 2011 and 2015. They found 420 cases in which the EHR was a contributing factor. Of this group, 50 cases occurred in the ED.
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The Opioid Minefield
The opioid epidemic has become not only a public health crisis, but also a political one. Legislative activity at the state and federal levels of government has reached a fever pitch, the ramifications of which certainly will affect the practice of emergency medicine.
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Airway Management in Trauma
The process of airway management has evolved considerably to include rapid sequence intubation (RSI), the use of various procedures, and sophisticated devices designed to assist in the placement of an endotracheal tube. This article summarizes the basic concepts of airway management, the technique of RSI, and post-intubation management in trauma patients.
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Advanced Imaging in Acute Ischemic Stroke
Any clinician who may have a role in the initial triage and management of these patients would be well-served to have an understanding of the currently available imaging modalities and techniques, and the applications of each in the evaluation of acute ischemic stroke.
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Targeted Management of Headaches for Emergency Physicians
Headaches are one of the most prevalent and disabling categories of disorders worldwide. Emergency healthcare providers are in a unique position to provide management of acute attacks, exclude emergent causes, educate patients, initiate some forms of preventive treatment, refer patients for appropriate outpatient workup and management of chronic headaches, and clarify and provide feedback regarding diagnostic criteria.
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Approach to Pediatric Eye Discharge and Periorbital Swelling
Eye problems, particularly conjunctivitis and periorbital swelling, are very common. The majority are managed easily, but more serious disease processes must be considered. Early recognition and prompt treatment of more serious etiologies, such as gonococcal conjunctivitis and herpes simplex virus, can prevent vision loss.
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Take Steam Out of Plaintiff’s Missed Fracture Claim
About 2% of minor trauma patients presenting to a Belgian ED leave with a missed diagnosis, according to a recent study. Of 56 minor trauma patients with missed diagnoses, the most frequently missed diagnoses were ankle, wrist, and foot fractures.