Emergency Medicine Topics
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Does a Clinical Decision Aid Constitute the Legal Standard of Care?
Each emergency physician should undertake the appropriate medical approach to evaluating a patient, regardless of any recommended course of action. The medical record should support using the recommended path or justify another course of action.
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Malpractice Lawsuits Allege ED Missed Intracranial Aneurysms
Failure to image patients is a relatively frequent cause of litigation, but it should be seen in context. It is not so much incorrect interpretations of imaging studies; rather, failure to consider the possibility of an aneurysm, resulting in an inadequate workup, is a more common allegation.
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Give Actionable Incidental Findings Proper Attention
New recommendations help health systems implement processes that will preserve patient safety. These tips aim to make it easy for providers to do right by their patients when clinicians identify actionable incidental findings.
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Does One Negative Troponin Measurement Rule Out Acute Coronary Syndrome?
Using a common clinical chest pain algorithm plus a point-of-care troponin measurement for low-risk patients, researchers reported significantly lower healthcare costs. Also, this approach did not seem to result in more major adverse cardiovascular events.
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Legal Exposure for EDs if On-Call Consultant Refuses to See Patient
There are multiple tactics to secure a consult, even if a specialist is busy. However, if a bad outcome occurs because there was no consult, clinicians should not play the blame game.
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Emergency Department Evaluation of Vertigo and Dizziness
Vertigo can be a complicated complaint for emergency medicine physicians to manage. The differential for this is broad, ranging from benign processes, such as BPPV, to more devastating causes, such as posterior strokes.
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Wrongful Prolongation of Life Suits Persist, Even When a Patient’s Status Was DNR
Regardless of training or good intentions to preserve life, at the end of the day, this is the patient's choice.
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Ethicists’ Role if Clinicians Disregard Documented End-of-Life Wishes
Early involvement of the ethics team can be helpful. After an initial assessment, the healthcare team should arrange a family meeting with surrogates, clinicians, the ethics team, social workers, and other appropriate individuals (e.g., clergy). This should happen as soon as possible, no later than the following day. The ethics team should facilitate an honest and compassionate discussion about the plan to best honor the patient’s end-of-life decisions.
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Ethicists Can Resolve Conflicts Over Nutrition Therapy at End of Life
When deciding whether to administer, withhold, or withdraw end-of-life nutrition and hydration therapy, ethicists can help clinicians, patients, and families reach an equitable agreement.
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New Ethical Guidance on End-of-Life Nutrition Therapy
The guidance is intended to help clinicians understand what medically assisted nutrition and hydration can and cannot accomplish for different groups of patients.