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The recent federal approval of nonprescription sales of the emergency contraceptive Plan B (Barr Laboratories; Woodcliffe Lake, NJ) to women and men ages 18 and older may have quieted what was a brewing controversy in emergency medicine. However, the ethical issues that gave rise to the debate still are very much in play, ED experts say.
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Three hospital EDs in Binghamton, NY, overcame late June floodwaters that caused one of them to close by sharing staff and other resources to enable the remaining two to function with increased caseloads until operations returned to normal.
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These disasters showed how severely clinical operations can be affected in health care organizations that lose their electrical power, and they have led the Joint Commission on the Accreditation of Healthcare Organizations to issue a Sentinel Event Alert.
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Patient satisfaction improvement projects can be a significant challenge for an ED manager, says Marcia Abernathy, RN, director of emergency services at Saint Francis Medical Center in Cape Girardeau, MO.
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In the case of fulminant meningococcal disease, laboratory tests are not available fast enough to be helpful, and may be within normal ranges early in a precipitous course. Provide rapid fluid support and antibiotics immediately and obtain blood cultures with the initial IV placement if possible, but do not delay antibiotics for the sake of good cultures.
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Penetrating neck trauma continues to be a challenging subset of trauma care. This area is loaded with potential high-risk injuries and controversies about the optimal management.
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A recently published study using a large national administrative database found that only two-thirds of patients hospitalized with exacerbations of chronic obstructive pulmonary disease (COPD) received care that was consistent with current guidelines of the American College of Physicians and the American College of Chest Physicians.
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