Emergency Medicine - Adult and Pediatric
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Vague Symptoms Trigger Sepsis Care Delays and Lawsuits
More than one-third of ED patients with septic shock reported only vague symptoms at presentation, according to the authors of a recent study of septic shock patients discharged from a large urban ED. These patients had delayed antibiotic administration and were at a higher risk of mortality compared to patients with explicit infection symptoms. Another recent analysis revealed that a faster completion of a three-hour bundle of sepsis care and quick administration of antibiotics — but not rapid completion of an initial bolus of IV fluids — were associated with lower risk-adjusted, in-hospital mortality rates.
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High Policy Limits Make EP a ‘Deep Pocket’ for Plaintiff
One insider recommends emergency physicians spend money ensuring their assets are protected from third parties rather than on "higher premiums for larger limits."
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Was ED Unprepared for Critically Ill Child? Guidelines Could Help Prove It
The risk of a poor outcome for a critically ill child is high when a system is not ready to meet the emergency needs of that child. New guidelines from the National Pediatric Readiness Project can be used to prove that an ED fell short in this regard.
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30 ED-Related Cases Resolved Without Litigation
All cases were approached using a process of investigation, disclosure, and apology.
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ED Provider Apologies: Dangerous or Legally Protective?
Conventional wisdom holds that any EP who admits fault (or even displays empathy) probably will end up in court hearing their own words used against them. Still, a growing number of states are passing apology laws to protect against this possibility.
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Can Communication and Resolution Programs Prevent ED Malpractice Lawsuits?
If an ED patient is seriously hurt by a medical error, a costly, years-long malpractice lawsuit probably is inevitable, at least according to standard thinking. Yet there is growing awareness of an alternative to this all-too-familiar story.
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Stroke: The Subtle, Atypical, and Enigmatic
This article will explore the subtle and enigmatic presentations of stroke. These patients often will present with nonspecific symptoms, such as vision problems, headache, a subtle language deficit, dizziness, or amnesia.
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Evaluation and Treatment of Adrenal Insufficiency in the Emergency Department
This article addresses the pathophysiology, discusses various clinical presentations, and reviews current evidence-based practices for managing adrenal insufficiency and crisis in the emergency department.
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Update on Urinary Tract Infections in Children: What’s New in 2019?
Urinary tract infections (UTIs) are a potential cause of fever in the pediatric patient. Early testing and a timely diagnosis are critical to avert complications and potential scarring of the kidneys. Complication rates in children younger than 90 days of age include bacteremia, meningitis, and urosepsis. The authors present a concise review of the current status of the diagnosis and management of pediatric UTIs.
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Was It a Missed STEMI or Just Too Early to Identify?
A STEMI pattern may develop minutes, hours, or days after a patient’s initial presentation. When this occurs, the case appears to be a “missed STEMI,” even though the STEMI pattern was not present on the initial ECG.