Emergency
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Re-evaluating Steroid Therapy in Septic Shock
Septic shock carries a significant risk of mortality despite increasing knowledge of its pathophysiology and clinical management. Studies dating back to the 1960s suggested steroid treatment may alter the course of septic shock and led to the concept of critical illness-related corticosteroid insufficiency. Two recent trials have provided more data regarding steroid therapy for septic shock. Comparing these seminal studies provides context for the decision about whether to treat septic shock with steroid therapy.
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Pediatric Abdominal Ultrasound: A Comprehensive Guide to Making the Diagnosis — Part I
Ultrasound is rapidly evolving as the ideal imaging modality for many common pediatric complaints. This two-part series reviews the select applications of ultrasound, reviewing the basic techniques, indications, and limitations for each exam.
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Significant Legal Exposure for Hospital if Patient Assaulted in ED
Seldom does a person go from a state of calm to physical violence without warning. Are staffers trained to recognize when an aggressive patient’s behaviors are escalating?
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‘Divide and Conquer’ Is Plaintiff’s Strategy With ED Co-defendants
When both ED nurses and EPs are named in a malpractice suit, a unified defense is the goal.
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Does Reassessment Before Discharge Reveal Abnormal Vitals? Documentation Is Key
Dozens of times each shift, EPs determine the appropriate disposition for patients. A well-documented, appropriate reassessment can reduce legal risks and should include proof that the EP spoke to and examined the patient, as well as repetition of pertinent portions of the physical exam.
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Can Rarely Used ‘Empty Chair’ Strategy Help ED Defense?
The “empty chair” strategy comes into play when there is a potential unnamed defendant with possible exposure. Using the empty chair defense, a named defendant would argue the liability of the unnamed defendant.
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‘Patient Dumping’ Still Happens 30 Years After EMTALA; EDs Face Significant Exposure
Have you ever heard the question, “What would you do if an ED patient behaved in an unruly manner?” If an investigator from CMS asked one of your ED’s security guards this question, would the response reveal non-compliance with federal law?
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Center Addresses Needs of Acutely Intoxicated Patients, Links Them to Treatment
Soon, EDs in Baltimore may feel some relief from the crushing volume of patients with substance use problems, thanks to the creation of a new type of facility designed for patients who are under the influence of drugs or alcohol and need a place where they can safely recover while receiving short-term medical care.
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Emergency Clinicians Steer Patients With Substance Use Problems Into Effective Treatment
To address an increasing volume of ED patients with substance use issues, leaders at the University of Maryland Medical Center in Baltimore decided to integrate peer recovery coaches into the emergency medicine team. The peer recovery coaches are people in long-term recovery from their own addictions who have received training on how to counsel other addicts toward positive change and facilitate their transition into appropriate treatment programs. The approach has been in effect for two years, and administrators say it is affecting patients and emergency staff positively.
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The Case for Educating At-risk Patients About Firearms Violence
Investigators from the Violence Prevention Research Program at the University of California, Davis have unveiled a new resource for clinicians to guide them in their discussions with patients about firearms violence. Called the “What You Can Do” initiative, developers are encouraging frontline clinicians to familiarize themselves with the risk factors for gun violence, provide counseling to appropriate patients on safe firearms practices, and to intervene when there is an imminent threat of harm.