Emergency Medicine - Adult and Pediatric
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Procedure-related Complication? Expect Supervising EP to Be Named
Lack of adequate supervision and procedure proficiency are the two most common allegations plaintiffs level in such cases.
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ED Protocols Might Add to Liability Exposure of Low-risk Chest Pain
Researchers set out to understand how EPs determine risk and decide to admit patients with low-risk chest pain. They surveyed dozens of emergency medicine residents and faculty about their perceived risk of various scenarios and an admission decision. Physicians used qualitative terms in ways that are different from how those terms are used in typical conversation. This can lead to miscommunication during shared decision-making processes. Investigators discovered that EPs considered any probability greater than 1% for acute coronary syndrome enough of a risk to warrant admission.
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In Missed Appendicitis Cases, Presentations Are Early, Atypical
The authors of a recent study discovered that a triage chief complaint that was less indicative of appendicitis correlated with a higher rate of missed appendicitis in one pediatric ED. The researchers concluded that their findings suggest the potential impact of anchoring bias by a triage chief complaint when trying to diagnose appendicitis. However, one analyst advises that the results should be interpreted with caution because the study authors did not look for the denominator of chief complaints.
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Analysis of Closed Malpractice Cases Reveals Lost Chances to Avoid Problems
A recent analysis of several dozen closed ED malpractice claims revealed failed opportunities to avert diagnostic errors and bad outcomes. Investigators analyzed 62 claims that closed between 2008 and 2015 at a large malpractice insurer, discovering some common final diagnoses in the cases in which errors were made.
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Subarachnoid Hemorrhage and Intracranial Hemorrhage
Time is of the essence in management of intracranial hemorrhage and subarachnoid hemorrhage. The longer it takes to make the diagnosis and initiate treatment, whether it is surgical intervention or simply aggressive primary stabilization, the greater the risk to the patient regarding both morbidity and mortality.
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Tickborne Illnesses
Blood-feeding ticks can transmit a wide variety of pathogens to people, which can result in significant infection and morbidity. During the past 10 years, the incidence of these diseases has increased rapidly, and the geographical regions where they occur has expanded. Recognizing symptoms that often are nonspecific and initiating appropriate treatment are critical to patient outcomes.
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Viral Influenza Infection and Complications: A Pediatric-focused Review
As influenza season approaches, it is important that clinicians prepare themselves with the current literature on clinical presentation, best and most rapid diagnostic testing, and treatment strategies in pediatric patients. The literature shows that antiviral agents are underutilized in children, a critical issue for this vulnerable population. The authors provide insight and evidence for diagnostic and therapeutic practice for the upcoming influenza season.
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Multiple Theories of Liability Regarding ED Violence
An expert shares insights on third-party violence and hospital liability.
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Hospitals Sued for False Imprisonment Due to Involuntary Holds
Recent lawsuits allege that patients who sought help at an ED for clinical reasons were held involuntarily because they were at homicidal/suicidal risk.
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No One Saw ED Nursing Notes? Jury May Not Like It
An ED patient was very specific during the nursing evaluation of his chest pain: It worsened during exertion. He also reported an extensive family history of cardiac problems. Both worrisome pieces of information were carefully documented in the ED nursing notes. However, they were mentioned nowhere in the EP’s documentation. This became a key issue during malpractice litigation.