Emergency Medicine Topics
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The Legal Standard of Care if ED Is Understaffed
Frustrated emergency physicians want to be sure the lack of nursing staff is duly noted in the mistaken belief such a note will change the legal standard of care to which they are held. However, that documentation is ammunition for plaintiff lawyers to use against the provider, and leaves the standard of care unchanged.
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EMTALA Concerns if Patient Harm Is Linked to Staffing Shortage
It is important for administrators to understand an individual emergency physician or facility can be held liable under EMTALA, even if no one is hurt.
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Informed Consent Requirements May Hinder Innovation in Stroke Treatments
IRBs and regulatory bodies should consider the changing scope of acute stroke care, and collaborate with investigators to design studies that can ethically answer important questions and allow innovation and progress in the field.
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‘Informed Assent’ for CPR Is Reasonable Approach for Some Hospitalized Patients
This concept was developed to satisfy the right of physicians to initiate DNR orders in futile situations and their duty to communicate to patients and lawful surrogates. Through informed assent, physicians state they will write a DNR order because it would be futile and harmful to the patient to attempt CPR in their current serious illness.
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Reviewing Pediatric Arrhythmias
Although pediatric arrhythmias are uncommon, it is essential to recognize which ones require diagnostic evaluation and therapy and which ones do not. Frequently, there are normal variations on pediatric ECGs that do not require a significant evaluation, but recognizing critical arrhythmias in pediatric patients is a must-know for providers.
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Repeat Visits Are Second Chances to Avoid Misdiagnosis
Conditions that start with subtle signs and evolve over time are traps for the practitioner who is too rushed to let the situation unfold.
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Tracking Undertriage Can Help Prevent Medical Errors
Investigators found several issues were important to track using quality improvement methods, including discrepancy in exam or history between the triage and assessment nurses, along with discrepancy between the chief complaint and the physical exam. Also, they found failure to synthesize historic or objective information.
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Legal Implications if Adolescents Seek Confidential Care
Generally, emergency clinicians are required to obtain parental consent for care provided to minors. However, there can be exceptions if the minor is seeking treatment for sexually transmitted infections, mental health, substance use disorders, sexual assault, or pregnancy. Several federal and state laws apply. Healthcare professionals are advised to be aware of the laws where they practice.
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Many Emergency Medicine Residents Struggle with Communication
Researchers studied how to objectively assess patient/physician interactions in the ED. They used an observational tool to assess emergency medicine residents’ non-technical skills in patient interactions. This tool allows educators to consistently measure several important interpersonal domains to pinpoint the reasons why interactions are poor.
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Dozens of Facilities Predicted to Show Interest in Rural Emergency Hospital Model
Key targets are hospitals that operated three years with negative total margins, facilities that recorded an average acute and swing daily census of less than three, and centers running with net patient revenue of less than $20 million.