Emergency
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Unique Approach Helps Address Volume, Higher-Acuity Patient Challenges
A multifaceted triage process is credited with helping a California-based ED slash turnaround times and the left-without-treatment rate without requiring additional spending or resources. The approach integrates elements of the provider-in-triage and split-flow models while also using waterfall-style shifts for certain physician/nurse teams.
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Sports-Related Concussion
Concussion is now known to be a significant public health issue, with high rates of emergency department visits and hospitalizations. Much of the current concern surrounding concussions revolves around recognition, early diagnosis, treatment modalities, return-to-play, and prevention of recurrent concussions.
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The Capacity Conundrum in Emergency Medicine
A patient’s capacity to give informed consent or to leave the emergency department against medical advice is a topic of great relevance to emergency clinicians. This article discusses the difference between competence and capacity and highlights the four essential elements involved in the assessment of a patient’s capacity.
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Decision-Making Capacity in the ICU
A multicenter, one-day prevalence, prospective, observational, double-blind study in 19 ICUs revealed that the decisionmaking capacity of ICU patients was widely overestimated by all clinicians as compared with a capacity score measured by the Mini-Mental Status Examination and the Aid to Capacity Evaluation.
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Acute Kidney Injury With Combination Antibiotics in the Critically Ill
In this retrospective study, a short course (24 to < 72 hours) of combination antibiotic therapy with piperacillin-tazobactam and vancomycin was not associated with an increased risk of acute kidney injury among critically ill patients when compared with other β-lactam and vancomycin combinations.
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NOACs vs. Warfarin: What Are the Data in Patients With Traumatic Brain Injury and Intracranial Hemorrhage?
A three-year analysis of a prospectively maintained database with traumatic brain injury patients revealed that novel oral anticoagulant use is associated with increased risk of intracranial hemorrhage progression, neurosurgical intervention, and mortality.
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Early Neuromuscular Blockade in Moderate-to-Severe Acute Respiratory Distress Syndrome
When the early use of a continuous infusion of cisatracurium was compared to contemporary supportive care for moderate-to-severe ARDS, including a light sedation target, high positive-end expiratory pressure, and conservative fluid strategy, there was no difference in 90-day mortality. Patients in the early neuromuscular blockade group more frequently experienced a severe cardiovascular event and ICU-acquired weakness by day 28.
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Approach to Pediatric Abdominal Pain in the ED: Part II
Abdominal pain is challenging in pediatrics. This two-part series deals with must-not-miss diagnosis and common etiologies of abdominal pain. In this second part, the authors focus on toddlers and older children. -
‘Very Scary’ Legal Ramifications for Hospitals if ED Clinician Diverts Drugs
If ED nurses or physicians are diverting drugs, a state board investigation, malpractice lawsuit, or both are possible. The hospital also could be legally exposed.
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ED Patient 'Drunk, Disheveled, Foul-Smelling,' According to Medical Record
Healthcare workers should avoid angry charting. Judgmental or insulting statements about patients and coworkers can come back to haunt a physician or nurse in litigation.