Emergency
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Management of Catheter-related Bloodstream Infections
Catheter-related bloodstream infections (CRBSIs) remain one of the more common nosocomial infections today, with an estimated 250,000 CRBSIs occurring in the United States annually, of which approximately 80,000 are associated with an ICU stay. The science behind current practices has reduced the CRBSI rate by 50% between 2008 and 2014. However, the rate of infection is far from zero, and rates remain significantly different between states, suggesting that there is room for improvement.
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Infectious Meningitis: A Focused Review
The effectiveness of the current vaccine schedule has led to a significant decline in the incidence of bacterial meningitis. Delays in recognition and antibiotic administration result in increased morbidity and mortality; therefore, clinicians must maintain a high degree of vigilance for the subtle findings of meningitis, particularly in infants. Current standards for selective imaging, diagnostic testing, and empiric antibiotics are discussed.
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Disappointing Stroke Outcome? Patient ‘Likely to Blame EP’
A look at several common issues concerning ED malpractice claims involving stroke patients.
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Hospitals Face Liability if Impaired EP Becomes Malpractice Defendant
Experts discuss some ways plaintiff’s attorneys keep the hospital in the litigation against the EP and offer tips for reducing risks.
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Tissue Plasminogen Activator Decision Remains Legal Landmine for EDs
Most lawsuits involving tissue plasminogen activator (tPA) allege the EP failed to give the drug, or that the drug wasn’t given quickly enough. In reality, a minority of stroke patients receive tPA. Almost all are outside the treatment window or don’t meet the criteria for another reason.
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Lack of Discussion With Supervising EP Key Focus of PA Lawsuits
"An emergency physician who has agreed to supervise a PA may be sued, even when she never saw the patient, never reviewed the record, and does not remember the patient," one expert warns.
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Case Law Expanding ED’s Legal Exposure if Discharged Psychiatric Patient Commits Violence
Healthcare providers’ liability exposure for potentially violent ED patients could be expanding nationally.
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Court Applies EMTALA to Hospital’s Urgent/Walk-in Care Center
A Rhode Island federal court determined that under the Centers for Medicare and Medicaid Services Emergency Medical Treatment and Labor Act regulations, a walk-in urgent care center was a “dedicated emergency department” because it held itself out “as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment.”
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Mammalian Bites
Bites, whether dog, cat, or human, are a common reason for emergency department visits.This article reviews the complexities of different types of bites ED providers may encounter and issues regarding closure and antibiotic prophylaxis, in addition to vaccination concerns.
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Injectable Opioid Shortages Causing Adverse Consequences for Some Physicians, Patients
It’s ironic that even while the country is confronting a dangerous opioid epidemic, providers report that they are having trouble getting their hands on the powerful pain killers — a situation that is dangerous as well. The shortage, which primarily involves injectable opioid painkillers, is reportedly caused by drug manufacturing difficulties as well as the government’s efforts to address addiction by clamping down on drug production. However, the problem is resulting in adverse consequences for clinicians and patients.