Browse Emergency Articles by Topic

Plaintiffs Prevailing in Incidental Findings Claims

Experts recommend EDs should address how to prevent an important incidental finding from falling through the cracks in the communications between the ED and radiology. One approach is to ensure that all imaging reports, consultations, and other pertinent information are emailed to the patient’s primary care physician. This could serve as an opportunity to catch something that might otherwise be missed, thereby reducing the risk of harm to the patient and the risk of litigation.

Determining the Reliability of a Triage Tool in Med/Mal Litigation

Many ED malpractice claims allege a patient was mistriaged. But what if the plaintiff attorney takes things a step further and claims that the tool used to triage patients was unreliable?

Ocular Trauma

This review will help the practitioner to be more comfortable evaluating and treating a patient with a traumatic eye complaint and understanding when to involve ophthalmology and with what urgency.

Adverse Reactions to Cannabis and Cannabinoids

Understanding the potential reactions that can occur from cannabis and synthetic cannabinoids can help emergency physicians recognize these effects in patients who may present to the emergency department.

Psychological Evaluation Unit Provides Specialized Expertise, Calmer Atmosphere for Behavioral Health Patients

Elliot Hospital in Manchester, NH, has unveiled a new $1.5 million psychiatric evaluation unit within the confines of its ED to boost resources and access to care for patients in psychological distress. The center is designed to offer an atmosphere more conducive to emotional healing. Administrators note that the added resources also should help ease crowding and boarding at the level II trauma facility.

A Growing Number of ED-based Physical Therapy Programs Taking Root

While a few ED-based physical therapy programs have existed for decades, the practice is gaining new converts as emergency clinicians increasingly turn to physical therapy for expertise with conditions ranging from vertigo and orthopedic issues to wounds, vestibular issues, and gait training. Long-standing programs have shown that leveraging physical therapy in emergency medicine can be a financially viable approach with the proper administrative support and guidance.

Coordination Center Uses Real-time Data to Speed Collaborative Decision-making

To handle increasing volumes better, Yale New Haven Hospital has opted to centralize operational decision-making in a new Capacity Coordination Center. Here, a nurse navigator representing the health system’s two busy adult EDs works with representatives from EMS, admitting, bed management, and other key operations to manage incoming and outgoing traffic optimally and to anticipate clinical services that may be needed further upstream.

Syncope

Relying on the most current literature, this article discusses the causes of syncope and syncope mimics, provides the best practice evaluation strategies, and will refamiliarize emergency physicians with current state-of-the-art practices regarding syncope risk stratification guidelines.

What Is Really BRUEing?

In May 2016, the American Academy of Pediatrics (AAP) published clinical practice guidelines titled Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants, suggesting a new terminology, an evaluation based on the risk of recurrent events or serious underlying causes, and key action statements (management recommendations) for patients meeting the brief resolved unexplained events (BRUE) definition for lower-risk patients. The authors review and discuss the definitions and key management strategies recommended in these new guidelines.

Metabolic Acidosis in the ICU

Sodium bicarbonate therapy for severe metabolic acidemia did not affect a primary composite outcome of all-cause mortality at 28 days and at least one organ failure at day 7. However, in an a priori-defined stratum of patients with acute kidney injury, sodium bicarbonate therapy decreased 28-day mortality and the primary outcome.