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This is the third part in the ED Legal Letter series on abdominal pain. The first two parts detailed common presentations of adult abdominal pain. Part four will discuss pediatric abdominal pain. This part discusses ectopic pregnancy and trauma in pregnancy.
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Emergency practitioners must understand patients rights regarding informed consent. Rapid diagnosis and treatment can be lifesaving, and any delay in obtaining consent may have devastating consequences to the patient. Emergency physicians have an obligation to make decisive and rapid treatment decisions. In addition, they must know when patients can refuse treatment and when consent is not needed. Finally, patients can and do refuse treatments that may be lifesaving. The emergency physician must ensure that the patient is competent to make these decisions. A mistake will bring the wrath of disgruntled family members who undoubtedly will bring suit for negligence. This issue of
ED Legal Letter illustrates the issues that emergency physicians encounter regarding informed consent and the exceptions that may apply.
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This is the second and final part in a series on chemical warfare agents. Part I focused on choking agents, vesicants, and halogenated oximes. This article will cover nerve agents, blood agents, and protective gear.
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Whether a bite or sting results in an anaphylactic reaction, impressive local effects, or a life-threatening systemic reaction, the emergency physician must be able to institute appropriate and effective treatment. Emergency physicians also must be able to recognize clinical envenomation patterns, since some critically ill patients may not be able to convey the details of the attack. Since all areas of the country are represented in the envenomation statistics, all emergency physicians should be familiar with identification and stabilization of envenomated patients and know what resources are available locally for further management of these often complicated patients.
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The potential of chemical warfare agents should be of overwhelming concern to civilian emergency physicians and prehospital providers. As General Pershing warned after World War I, the effect is so deadly to the unprepared that we can never afford to neglect the question.
