Emergency Medicine - Adult and Pediatric
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Will EPs Be Dismissed — or Get ‘Stuck’ in the Claim? These Are Determining Factors
Understandably, emergency physicians (EPs) who believe that allegations of malpractice are unfounded don’t want to suffer through litigation one minute longer than necessary. However, getting “out” of a claim, regardless of the merits of the case against the EP, is often no easy task.
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Peer Review: How Protected Are You?
While it has definite advantages, peer review presents unique and significant challenges, particularly for the individual provider.
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Missing Documentation on Evolving High-risk Conditions? It Will Complicate Defense of Medical/Malpractice Suit
Lack of documentation on patients with high-risk-conditions often results in the settlement of otherwise defensible claims against emergency physicians (EPs), according to Douglas Segan, MD, JD, FACEP, a medical-legal consultant based in Woodmere, NY.
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Warning: ED Peer Review Materials Aren’t Always Protected from Discovery
Many emergency physicians (EPs) assume that all aspects of the peer review or quality improvement processes involving emergency department (ED) care are automatically protected from discovery during malpractice litigation. This is not necessarily the case.
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Here Are Plaintiff Attorneys’ Toughest Deposition Questions for Emergency Physicians
Did an emergency physician (EP) come off poorly during a deposition, volunteer some damaging information, or inadvertently complicate the defense of a co-defendant? If so, “it will significantly change the perspective of the defense attorney, the hospital, or the insurance company on whether the case should settle and for how much, in a way that’s going to be adverse to the EP,” warns John Burton, MD, chair of the Department of Emergency Medicine at Carilion Clinic in Roanoke, VA.
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Recognizing Human Trafficking Victims in the Emergency Department
You may have seen a case of human trafficking and not recognized it. Emergency physicians can play a role in identifying victims and mobilizing resources for them.
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Less-than-honest Responses? Too-loose Lips? These Actions Complicate EP’s Malpractice Defense
A recent malpractice case involved a patient who was discharged from an emergency department (ED) with a diagnosis of benign positional vertigo. “She was having a stroke, and was returned to the hospital a few hours later with an occluded basilar artery,” says Gary Mims, JD, a partner at Sickels, Frei and Mims in Fairfax, VA.
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Nursing Notes Can Become Unexpected Problem for EP During Med/Mal Litigation
A triage nurse’s note stating that a patient had fever and hip pain in his prosthetic hip became a key area of focus during a recent malpractice trial. At deposition and at trial, the emergency physician (EP) claimed to have examined the hip, and found that the patient did not have increased pain with range of motion.
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Overview and Instructions
Read each of the following sections. CME Questions are presented inline with links to begin the CME Post-Test. -
Pulmonary Embolism
For emergency physicians, acute pulmonary embolism (PE) provides a particularly complex diagnostic challenge. It has been estimated that 650,000 to 900,000 individuals annually suffer a fatal or nonfatal acute pulmonary embolism.1 While the classic textbook clinical presentation is well known, it is insufficiently accurate and precise in the timely diagnosis of an acute PE. In addition, many patients presenting with seemingly typical exacerbations of their underlying cardiopulmonary disease or other chronic illness may be masking symptoms of an undiagnosed acute pulmonary embolism.2 The high acuity coupled with the unreliable clinical presentation led to the development of several clinical tools, laboratory diagnostics, and radiographical studies to increase the clinician’s diagnostic power. This article we will review the Geneva Score and Wells Criteria, as well as the Kline and PERC rules. In addition, it will discuss special patient populations and diagnostic modalities for treating pulmonary emboli.