Emergency Medicine - Adult and Pediatric
RSSArticles
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Does This Older Patient Have a Spinal Fracture? Evaluation and Management of Spinal Fractures in Older Adults
Older adults present unique challenges for the clinician. Missing a spinal fracture can have devastating consequences for this more fragile population. The authors review the clinical presentation, injury patterns, and unique considerations for imaging and management of spinal fractures in older adults.
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Cervical Spinal Injury
Although spinal injuries are uncommon, they should be considered when children have sustained head or neck trauma or multiple severe injuries. Children with severe or multisystem trauma are more likely to suffer a spinal injury. Thus, emergency department providers should have a lower threshold to immobilize and image such patients to prevent morbidity and mortality. This article reviews the most common pediatric spinal fractures and injuries and optimal management practices.
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Undetected Medical Conditions in ‘Psych’ Patients Are Legal Landmine
Once EPs conclude that a patient’s behavior is psychiatric, they may miss underlying medical conditions that are the real cause of the symptoms. This is less likely if a patient is behaving bizarrely, presents with a psychiatric history, and is taking psychiatric medications. Experts recommend obtaining a good history before deciding a patient is psychiatric.
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Good Documentation of ED Consult Makes It Clear EP Met Standard of Care
To avoid needless legal entanglements, experts say EPs should know when they’re in over their heads and remain firm about what they need from a consultant. Invariably, specialists testify that while the EP asked for their opinion, the EP never asked or insisted that the specialist come in — and that had the severity of the situation been explained, the specialist certainly would have come to the ED.
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Legal Exposure for ED and Hospital if Patients Refuse Discharge
Some patients may choose to remain in the ED against medical advice for several social reasons, including the fact the patient has no home, or views a hospital room as safer, more comfortable, or less lonely than going home.
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Survey: More Than Half of EPs Sued for Malpractice at Least Once
Fifty-one percent of EPs have been sued during their career, according to a recent report on medical liability claims frequency, the third highest percentage of all the specialties examined by the study’s authors.
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Many ED Visits Documented on Cellphones
Whether such recordings are admissible in court depends on many different factors.
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Sickle Cell Emergencies
This article provides an overview of the most frequently encountered complications associated with sickle cell disease seen in the emergency department. It will discuss recent guidelines and novel approaches to the treatment of entities such as acute chest syndrome, vaso-occlusive crisis, and stroke, as well as new treatments on the horizon.
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Chest Pain in Young Adults
Chest pain is one of the most common reasons that patients present to the emergency department. The underlying disease processes can range from benign to life-threatening. The purpose of this article is to discuss the diagnosis, treatment, and management of the common causes of chest pain that can present in a young adult.
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Infectious Meningitis: A Focused Review
The effectiveness of the current vaccine schedule has led to a significant decline in the incidence of bacterial meningitis. Delays in recognition and antibiotic administration result in increased morbidity and mortality; therefore, clinicians must maintain a high degree of vigilance for the subtle findings of meningitis, particularly in infants. Current standards for selective imaging, diagnostic testing, and empiric antibiotics are discussed.