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Many ED physicians do not get blood alcohol levels on intoxicated patients because levels do not correlate well with the patient's mental status or competence, while others say this practice is legally risky. So should blood alcohol levels be obtained?
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Imagine being held legally responsible for everything that goes wrong during your shift—whether you were involved or not. Under the "captain of the ship" legal doctrine, could this be a legal reality? Not likely, according to experts in emergency medicine litigation.
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If a patient is physically violent, your ED's process may involve the use of restraints and contacting security. But the appropriate action to take may be less clear if a patient seems flirtatious, exposes him or herself intentionally, or makes sexually provocative remarks.
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In what context would a court determine that a patient was not on equal footing with a provider or institution and, therefore, in a position of weakness regarding his/her ability to effectively bargain?
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It is the duty of a physician or other health care provider dealing with a case in the ED to give the patient or, in certain circumstances (where the patient's competence is in question), the patient's family, attendants or caregivers, all necessary and proper instructions as to the care and attention to be given to the patient and the cautions to be observed following discharge from the ED.
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This issue of Emergency Medicine Reports deals with infection control as it relates to the emergency department (ED). Several states now require infection control training for continued licensure, and it is hoped that this article may be useful to some in meeting that requirement.
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All of us have personal experience with the topic of this issue of EMR--diarrhea. We all have had diarrhea, likely several times, and all have seen more cases than we can count.
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On nearly every shift, the emergency physician confronts a patient with atrial fibrillation (AF), either new onset or chronic. AF is often seen in patients with congestive heart failure or prior myocardial infarction.
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When used in conjunction with clinical and radiographic data, brain natriuretic peptide levels may provide a non-invasive alternative for distinguishing between ARDS and cardiogenic pulmonary edema in patients with severe hypoxemic respiratory failure.
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Although it is understood that good nutrition is essential for normal immune function, wound healing and maintenance of muscle mass and function, and is likely beneficial for overall recovery from the highly catabolic state of acute critical illness, it is less clear when and how best to deliver adequate nutritional support in practice.
