Emergency
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Orofacial, Eye, and Ear Trauma
Facial trauma is uncommon in children. However, the unique features of these injuries, as well as the assessment and management considerations to minimize radiation exposure and ensure optimal cosmetic outcome, require an awareness of the diagnostic and therapeutic approach in pediatric patients. The authors provide an overview of orofacial, eye, and ear trauma in children.
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Pre-existing Health Determines Quality of Life, Physical Symptoms After ICU Discharge
The authors of this nested cohort study within a randomized, controlled trial of ICU survivors requiring > 48 hours of mechanical ventilation found that pre-existing comorbidity was the main determinant of long-term health-related quality of life.
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Massive Transfusion Protocols: Recommendations Regarding Initiation and Termination
This was a narrative review of societal recommendations for initiation of massive transfusion protocols based on objective scoring systems and clinical assessment and criteria for termination of protocols.
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Implementing Restrictive Transfusion Strategies to Improve Patient Outcomes
There is extensive evidence supporting a restrictive transfusion approach in critically ill patients and cardiac surgery patients. The data favor restrictive strategies in hip and knee surgery, except in geriatric patients for whom evidence favors a more liberal transfusion strategy. Evidence is sparse in sepsis, oncology, and acute coronary syndrome patients, warranting further study.
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Hemorrhage Control: Advances in Trauma Care
Massive hemorrhage is a devastating scenario. Early identification is essential to allow for prompt, potentially lifesaving interventions with the goal of rapid control of exsanguination.
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Four Thrombocytopenic Emergencies
Thrombocytopenia is encountered commonly in the emergency department. In most instances, the emergency physician will not be able to determine the definitive diagnosis, but it is important that the initial evaluation be started in a timely manner and that appropriate specialists be consulted from the emergency department.
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Overtesting for Medical Clearance Not Only Wasteful, It’s Also Dangerous
Still, many psychiatric facilities won’t accept patients transferred from an ED until extensive testing is complete.
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Study: Constant ED Interruptions Source of Med/Mal Exposure
EPs were interrupted 12.5 times every hour on average, according to a recent study. EPs rejected or delayed interruptions less than 2% of the time.
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Settlement Likely for Missed Diagnosis Case, Even if ED Chart Shows It’s ‘Reasonable’
Defensible cases are settled sometimes because the plaintiff is sympathetic or because the dollar value of damages is high.
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Did EP Override Safety Prompt for No Apparent Reason? It’s a Hurdle for Defense
Emergency physicians routinely override safety prompts in clinical decision support systems for very good reasons. However, a skilled plaintiff attorney can depict it as a rogue physician’s negligence.