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Emergency Department Management of Violent Patients

A violent patient is someone under medical care who is a threat of danger to themselves, other patients, or hospital staff. Like many of the problems we face in the emergency department, the management of a violent (or potentially violent) patient is not always straightforward. Each encounter will be influenced by the patient’s background, underlying health conditions, comorbid issues, psychiatric history, socioeconomic factors, and much more.

An ED-Friendly Screening Tool to Identify Potentially Violent Patients

Considering violence is a continuing concern in the emergency setting, there is high interest in new mechanisms that can identify potentially violent patients at the front end of their care encounters. This way, safeguards or preventive measures can be activated to keep providers and other patients safe. However, any such tool needs to be brief and easily integrated into the workflow of a busy ED.

Thyroid Emergencies

Thyroid emergencies, while rare, are life-threatening conditions that require prompt recognition, diagnosis, and treatment to optimize patient outcomes.

Ethics Plays Important Role in Response to Abortion Ruling

As healthcare professionals process the clinical, legal, and even personal implications of the recent Supreme Court decision to allow states to restrict abortion access or ban it entirely, ethicists play an important role.

ED Visit Is Teachable Moment on Stroke Care

Researchers provided an ED-based educational intervention to 100 Black patients at an urban facility, including video, brochure, and verbal counseling. After, participants were much more likely to demonstrate confidence in the ability to recognize stroke symptoms in themselves or others and were more likely to feel confident about calling 911 in the case of stroke warning signs.

Updated Abdominal Pain Guidelines Close Knowledge Gap

Without clear guidelines, patients could undergo unnecessary testing (or not receive tests they need), which could lead to misdiagnoses — or worse.

Admissibility of ED Recordings Depends on Multiple Factors

Even if the patient recorded the entire discharge instructions, relevant discussions might have happened throughout the visit. The defense can challenge the admissibility based on that argument, but the ruling could go either way.

Emergency Providers Uneasy About Recording Visits

Clinicians might need more information, such as specifics on who would record the discharge instructions, whether it would be recorded on the patient’s personal smartphone, and what safeguards could be required to ensure patient privacy. Combined with possible involvement of the hospital’s legal department, this might make providers more comfortable with the idea.

Many Charge Nurses Receive Little, if Any, Training

Charge nurses are responsible for patient flow, moving them from the waiting room to appropriate disposition. To be effective, these nurses must understand the clinical conditions of the patients in the waiting room. This informs good decision-making on which patients to bring in, in collaboration with the triage nurse, and which nurses to assign those patients.

Misconceptions About Homelessness Put Patients, EDs at Risk

Engage these patients in care plans the same as anyone else. Ensure the patient understands the treatment plan, and can carry it out if discharged.