Emergency Medicine - Adult and Pediatric
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End-Stage Renal Disease, Hyperkalemia, and Dialysis
Evaluation and management of patients with end-stage renal disease and patients on hemodialysis can be challenging because they are at risk for a multitude of complications.
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An Update on Physical Abuse of Children
Approximately one in five children evaluated in the emergency department is physically abused. Emergency physicians have a responsibility to consider abuse in the differential of every injured child. Although there is increasing awareness of the emergency physician’s role in diagnosing abuse, emergency physicians frequently fail to recognize the more subtle presentations of abuse. This article reviews the identification, evaluation, and management of a child with possible physical abuse.
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Attorneys Use EMTALA in False Claims Act Lawsuits — So Far, Unsuccessfully
The Department of Justice moved to dismiss several recent False Claims Act lawsuits based on alleged EMTALA violations. Future similar lawsuits are possible, but unlikely. Still, ED providers should watch the lawsuits closely, since FCA actions linked to EMTALA violations are theoretically possible.
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Physician Health and Malpractice Risk: A Look at Holmes v. Lyons
If a state board licensing investigation is initiated, it is wise to immediately consult an attorney who is familiar with applicable law. Cases like these are a challenging factor in the tension between physician wellness and the shift to a culture of openness about physician wellness and medicolegal risk. Physician involvement in shaping how the states manage these issues has the potential to positively affect the health of both physicians and their patients.
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Shocking Injuries: Knowing the Risks and Management for Electrical Injuries
Approximately 5,000 patients present to the emergency department each year for evaluation and treatment of electrical injuries. This article will discuss the different classifications of electrical exposures and describe the recommended initial evaluation, diagnostic workup, and treatment. In addition, the authors also discuss special situations, such as lightning exposures, pediatric exposures, and electrical exposures during pregnancy.
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An Evidence-Based Review of Gastrointestinal Bleeding Evaluation and Management in the Emergency Department
Gastrointestinal bleeding is a common presentation to the ED, and patients can present at any age with varying complexity and severity.
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Procedural Sedation and Analgesia in the Emergency Department
Procedural sedation and analgesia (PSA) is performed in the emergency department (ED) to alleviate anxiety, decrease pain, and provide amnesia to patients undergoing painful procedures or diagnostic imaging.This article will review guidelines for performing PSA in the ED, including suggested training, preprocedural assessment, and intraprocedural monitoring.
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Sleep Tight, and Don’t Let the Ectoparasites Bite: Part 2
Providers in the pediatric emergency department frequently encounter ectoparasitic infestations. Infestations require early recognition and knowledge of effective treatment strategies. Last month, the author reviewed scabies, chiggers, and lice. This month, the bedbugs and ticks will come biting!
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New EMTALA Data Show Decline in Settlements
EMTALA’s status as an unfunded mandate and efforts to repeal the Affordable Care Act threaten the financial viability of safety-net hospitals, researchers warn, which could lead to more EMTALA violations.