Emergency
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Atrial Fibrillation in Sepsis: Should We Worry?
New-onset atrial fibrillation (AF) is a common occurrence in the ICU. Over the past decade, there is increasing interest in its epidemiology, specifically in the population of critically ill patients with sepsis. Recent literature suggests that far from a transient complication of sepsis, new-onset AF is associated with worse short- and long-term outcomes. As such, exploring its potential causes and evaluating its overall management is warranted in hopes of discovering ways to prevent and treat AF with the goal of improving outcomes for patients with sepsis.
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Acute Ischemic Stroke Due to Large Vessel Occlusion
Acute stroke reperfusion therapies have led to significant reduction in the morbidity and mortality associated with ischemic strokes due to large vessel occlusion. This article will discuss the prevalence, mechanism, diagnosis, and treatment options of acute ischemic stroke due to large vessel occlusion.
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ED Providers’ Documentation Clashes Help Plaintiffs Prove Negligence
If ED providers’ documentation conflicts in any way, plaintiff attorneys will use this to bolster a malpractice case. Conflicting documentation makes it difficult for either side to determine what really happened.
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‘Gotcha’ Deposition Questions Can Devastate Even Well-prepared EPs
Deposition questions are designed to elicit damaging testimony from EPs. A “yes” response to a seemingly innocuous question about the standard of care can lead to a world of trouble for the defense team.
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Sparse Neurology Exam Complicates ED Defense of Missed Stroke
Sparse or inaccurate charting allows plaintiff attorneys to allege inadequate neurological examination in missed stroke cases against EPs. However, documentation that includes a thorough description of all the aspects of the exam, an explanation of why the EP didn’t think stroke was likely, and an indication that the EP consulted a neurologist can help the defense.
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Late Electronic Medical Record Entries Create Indefensible ED Malpractice Claims
Malpractice cases may become indefensible if the forensic IT expert can prove the ED chart was altered in some way. Data regarding physical examination or history can appear self-serving. The veracity of altered information will be questioned. Even if the EP’s motive was valid, it may appear otherwise.
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EPs Face Legal Exposure as ‘Captain of the Ship,’ Even for Triage Mistakes
An EP could be hundreds of feet away when a patient with a life-threatening condition is mistriaged. That doesn’t necessarily stop an affected patient from suing that EP for the resulting adverse outcome.
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Use Simple Strategies to Manage Frequent Interruptions, Minimize Potential for Errors
Research shows that emergency physicians may be interrupted 10-15 times per hour, leading to the potential for errors and patient harm. However, experts note that an array of relatively simple strategies can help clinicians better manage these interruptions to both minimize related mistakes and potentially ease the frustration that results from continuous interruptions.
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Hospital Leverages Pharmacists, Trained Technicians to Reduce Medication History Errors
To reduce the high number of medication errors observed in the medication lists of medically complex patients who are admitted to the hospital from the ED, Cedars-Sinai Medical Center in Los Angeles developed an intervention whereby pharmacists or trained pharmacy technicians review and prepare medication histories rather than rely on usual care for this task.
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ED-based Intervention Connects Frequent Users With Program to Address Underlying Needs
Grady Memorial Hospital in Atlanta established a Chronic Care Clinic (CCC) to take over the care of high-needs patients who frequent the ED. Navigators intervene with these patients when they present to the ED and connect them to the CCC, which offers an array of services to meet several social and medical needs. The goal of the program is to eventually transition these patients to primary care so their underlying needs can be addressed.