Emergency
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Advanced Cardiac Life Support Updates
The American Heart Association Advanced Cardiac Life Support guidelines are recognized as the authoritative reference for acute cardiopulmonary resuscitation. Emergency medicine providers should be thoroughly familiar with these guidelines.
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Urine Output: The New Vital Sign?
An analysis of a large ICU database showed that hourly monitoring of urine output was associated with improved detection of acute kidney injury (AKI) and lower 30-day mortality in patients with AKI.
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More ICU Care Does Not Equal Better Survival for Elderly Patients
Using a systematic strategy for promoting ICU admission for elderly patients resulted in a higher ICU admission rate but the strategy produced no effect on six-month mortality.
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Implementing Noninvasive Ventilation: If You Build It, They Will Come
Hospitals that have been highly effective in implementing noninvasive ventilation as front-line therapy for acute exacerbation of chronic obstructive pulmonary disease recognized that a combination of allied health autonomy, interdisciplinary teamwork, and devoting sufficient resources are essential features for success.
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Crystalloid Resuscitation in Sepsis and Septic Shock: The Earlier, the Better
Although the most recent Surviving Sepsis Campaign guidelines authorized completion of 30 mL/kg of IV crystalloid within three hours of the recognition of sepsis and septic shock, there remains controversy regarding the benefits and harms of early, aggressive crystalloids, especially in specific patient populations.
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Soft Tissue Disorders of the Neck in Children
Pediatric patients frequently present to the emergency department with issues affecting the soft tissues of the neck. This article will focus on the assessment, evaluation, differential, and treatment of both superficial and deep neck soft tissue disorders that clinicians should consider in the emergency setting.
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Did ED Patient Threaten Violence? EP Might Have Legal Duty to Warn
EPs might have a legal “duty to warn” individuals if a patient threatens violence against them, depending on their state statute. EPs are shielded from allegations of breach of confidentiality if they warn someone of a threat. Importantly, EPs can be held liable if their failure to warn leads to a violent act.
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Psych Patients Elope or Are Discharged? Either Way, It’s a Wrongful Death Lawsuit
If psychiatric patients are discharged or elope from the ED and harm themselves or others, a wrongful death lawsuit is possible. To reduce risks, EPs can document that there was no evidence of homicidal or suicidal ideation at the time of the ED visit, contact a psychiatrist to support the decision to discharge, keep the patient secure until the evaluation is complete, and take reasonable precautions when patients are transported to another facility.
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Liability for EP if Admitted Patient’s Condition Deteriorated
EPs are not absolved of legal responsibility for admitted patients who remain in the ED while waiting for an inpatient bed to become available. Juries rely on documentation to determine what information was communicated to the admitting physician. Providing treatment to admitted patients can lead to the EP being held to a higher standard of care. Undocumented interactions are problematic for the defense.
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ED-based EHR Errors Caused More Significant Harm to Patients Compared to Other Settings
Seeking to obtain more information on health IT-related problems, researchers analyzed EHR-related cases occurring between 2011 and 2015. They found 420 cases in which the EHR was a contributing factor. Of this group, 50 cases occurred in the ED.