Emergency Medicine - Adult and Pediatric
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A Look at How ED Defendants Change Practice Habits After Litigation
One could argue that the threat of malpractice liability improves the quality of care delivered to patients. Data were lacking regarding the connection between litigation and subsequent improved quality of care in the ED. To learn more about this, researchers analyzed data from a national EP group practicing at 61 EDs in 11 states between 2010 and 2015. Learn more about those findings.
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Ignored Red Flags in ED Missed Sepsis Claims
Several recent malpractice cases alleging missed sepsis involved triage in some way. Often, the triage nurse does not recognize early signs of sepsis or identifies early signs of sepsis, but the patient remains in the waiting room because the ED is full. When reviewing ED charts in missed sepsis claims, one expert looks for documentation on who the nurse spoke with, whether the ED nurses notified the charge nurse to discuss which patients could be moved to a lesser care setting, and whether the ED nurse asked the nursing supervisor to assist with the process.
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No Professional Interpreter? ED Exposed to Med/Mal, Statutory Risks
Despite state and federal laws requiring professional interpreters be offered to patients with language barriers, many EDs still rely on family members, friends, or untrained staff. The ED chart should show that an interpreter informed the patient of risks of invasive procedures, the ED provider reviewed discharge instructions with the interpreter, and the patient was informed of risks of ad hoc interpreters.
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Pushback Against EMTALA Misinterpretation Emerges
Misinterpretation of the Emergency Medical Treatment and Labor Act (EMTALA) is the focus of a recently published policy statement from the American College of Emergency Physicians.
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Not All Round Rashes Are Ringworm: A Differential Diagnosis of Annular and Nummular Lesions
Although rashes are not usually an emergency, it is common for emergency physicians to see patients come in with a rash. Sometimes the rash is new onset, and sometimes it has been present for a while and refractory to treatment.
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Pediatric Medication Safety
Our smallest patients are the most vulnerable to medication errors. An awareness of potential vulnerabilities when prescribing in this population is essential. The authors discuss when medication errors are particularly likely, common types of errors, and strategies to minimize the potential for errors.
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Many EPs Rely on Observation to Mitigate Legal Risks
Many EPs routinely place patients in observation if those patients do not meet inpatient admission criteria but EPs believe the patients are at risk. This is true even if the perceived risk is just 1%, according to a recent study.
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Did ED Fail to Give Appropriate Discharge Instructions?
Contributory negligence, in those jurisdictions that recognize it, can be difficult to demonstrate. This is because the patient’s negligence must occur at or about the same time as the physician’s alleged negligence. The difficulty of arguing that the patient is at fault for failing to tell the EP an important piece of history is another obstacle.
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Suicide Risk in ED: Thorough Assessment Derails Litigation
A key component of evaluation of a psychiatric patient, especially in the ED, is an assessment of danger to self and others.
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Legal Protections of AMA Form Only Go So Far if ED Patient Refuses Admission
The use of a properly executed AMA/informed refusal form can create protection from future liability by clearly demonstrating that the patient understands the EP’s medical decision-making, creating the affirmative defense of “assumption of risk,” and establishing a record of evidence of the patient’s refusal of care.