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Burns may range from a minor injury from a brief contact with hot water to a life-threatening, devastating injury. Burns may be obvious or subtle depending on the mechanism and type of force producing the injury. The early recognition and aggressive management of even the smallest burn makes a significant impact on the outcome of each individual patient, especially in terms of function.
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Jason Rinehart presented to the emergency department (ED) of Akron General Medical Center with nausea, vomiting, and back pain.1 No definitive diagnosis was made, and the patient was discharged with medications to control his symptoms. He died hours after discharge, and an autopsy revealed an aortic dissection as the cause of death.
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Some EDs have adopted the practice of documenting overcrowding, either
by flagging patient charts or electronically recording the
information with software, to pinpoint exactly how busy—and
possibly, how understaffed—the department was on a given time
and day. But is this going to help or hurt the ED physician in the
event of a malpractice lawsuit?
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Dr. Janiak has served as an emergency medicine medico-legal consultant for over 30 years, and has reviewed hundreds of malpractice cases. In the process, he has recognized common patterns and mistakes that emergency physicians make that set them up to be sued. This article takes a tongue-in-cheek approach to pointing out potential mistakes and ways that lawsuits might be avoided.
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Being served with papers indicating a patient has sued you is a
shocking and upsetting moment. However, this doesn't necessarily mean
the case is valid—or even that it will go forward at all.
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Telemedicine has long been recognized for improving access to care as well as access to specialist expertise, particularly in rural facilities. Now, in an unpublished study just completed in Rochester, NY, the lead author says it also can offer a possible solution to overcrowding when it comes to pediatric ED patients, many of whom, he asserts, easily could be treated by a primary care physician.
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Imagine a new disease strikes your community that significantly increases mortality rates, particularly in critically ill patients. This same disease causes patients to suffer more pain, greater heart damage from a myocardial infarction, and, if they are elderly, increases the chance they will be discharged to a nursing home. Such a disease clearly would grab the public's attention, and even in these difficult times, money would be diverted to find a cure. This problem exists today in many of our communities: crowding.
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Recently, we published a series of articles on the international traveler in the ED, emphasizing the risk factors and geography. This article provides a more standard review of some of the diseases seen in travelers to tropical areas and also some, like West Nile, that have migrated into temperate climates. This article will complete our series.
