Browse Emergency Articles by Topic

Spontaneous Breathing Trials and Occam’s Razor

Different ventilator modes used for a spontaneous breathing trial affected a patient’s work of breathing (WOB) variously and differed regarding WOB measured after extubation. The clinical relevance of these differences is uncertain.

Intensive Care Enteral Nutrition in 2017

Enteral nutrition, defined as any method of feeding that uses the gastrointestinal (GI) tract (including oral feeding), usually refers to the delivery of nourishment to the GI tract through a tube. Nutrition is of utmost importance for patients suffering from a critical illness, and EN is a mainstay of nutrition in the ICU. Malnutrition and nutritional risk are common in patients admitted to the ICU. The presence of critical illness causes the body to enter a catabolic state, putting patients at risk of development or worsening of malnutrition. The Society of Critical Care Medicine and the American Society for Parenteral and Enteral Nutrition have published and revised joint guidelines to offer evidence-based recommendations for how best to feed critically ill patients.

Pediatric Airway Management

Pediatric patients frequently present with respiratory complaints. Fortunately, most children respond well to simple medical interventions. Understanding a child's anatomic and physiologic differences is critical to effectively preventing respiratory failure and stabilizing a child when it occurs.

EP Defendants Need Forensic IT Experts to Explain EMRs

A recent malpractice lawsuit against an EP alleged that a patient coded and spent two weeks in an ICU because he received a medication to which he was allergic. Since the electronic medical record (EMR) clearly documented the patient’s allergy to the medication, at first glance, it looked as though the EP had made a colossal mistake. However, this was not the case.

Missed Compartment Syndrome in the ED Often Leads to Litigation

Compartment syndrome is one of the few true orthopedic emergencies seen in the ED, and the consequences can be dire.

Do State Damage Caps Apply to EMTALA?

A recent case is a good example of how a delay in implementing an order can expose EDs to EMTALA and medical malpractice claims.

Expanded tPA Criteria Means Many More Potential Plaintiffs

Did a stroke patient experience a bad outcome in the ED? If tissue plasminogen activator (tPA) wasn’t administered in the ED, without a good reason documented in the chart, a malpractice lawsuit is likely.

Informed Consent: Beyond Signing a Form

The informed discussion is critical to the informed consent process and meeting the applicable standard of care for obtaining informed consent. Thus, the content of that discussion is more important than a signature on a form, which frequently doesn’t include enough details about the information shared with the patient. The concept of shared decision-making adds complexity to the idea of informed consent.

Evaluation of Bradycardia in the Emergency Department

In this article, the normal anatomy and pathophysiology of bradydysrhythmias in adults will be reviewed, followed by the latest recommendations in evaluation and management.

Bundled Approach to Handoff Communication Delivers Significant Safety Dividends

Users note that the I-PASS handoff bundle offers structure for communications as well as guidance on implementation, feedback, and sustainability.