Emergency Medicine Topics
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Ethical Use of Restraint Hinges on Decision-Making Capacity
The situation becomes ethically complex if the patient’s capacity is unclear, ambiguous, or fluctuating. It is much harder to know if, when, and how to avoid inflicting harm while balancing the patient’s legal and ethical right to make their own decisions.
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Medical Orgs Ask White House to Intervene on Boarding Problem
More than 30 groups say making admitted patients wait for a room or transfer has become a national crisis.
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Not Just an ED Problem: How to Solve the Boarding Problem Caused by Staff Shortages
It takes thought, planning, and some amount of money.
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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.