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Although cervical spine injuries are uncommon in children, a missed or delayed diagnosis may have devastating consequences for the patient. A thorough understanding of normal pediatric anatomy, injury patterns, and children who are at increased risk for injury is critical for the physician caring for the acutely injured child.
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Holding admitted patients waiting for an available bed not only hinders your ability to provide quality care, frustrates staff, and hurts your bottom line, but it also is the single biggest factor resulting in overcrowded EDs, according to a just-released report from the Washington, DC-based General Accounting Office.
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Is your ED in compliance with federal regulations for care of non-English-speaking patients and their families? You are required to provide language assistance to patients in your ED, and penalties for failure to comply are severe, including exclusion from participation in Medicare and Medicaid and possible criminal charges.
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A sharp decrease in hours on diversion. Decreased length of stay. Greater staff satisfaction. These three items are on every ED managers wish list, but they are real-life examples of changes made as a result of one EDs participation in the GE Medical Systems Six Sigma process.
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A sickle cell patient is in excruciating pain. A man who comes to your ED frequently always complains of different illnesses to obtain narcotic analgesics. These two patients have completely different needs, but youll need strategies to improve care for both. To improve management of chronic pain patients, follow these steps proven to work.
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When performing a transfer, is it necessary to have an interpreter along for the transfer of a non-English-speaking patient, assuming that an interpreter was available for performing the medical screening examination?
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Only half of ED staff would report a near-miss drug error if the patient was not harmed, according to this study from the Naval Hospital Jacksonville (FL).
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Every month, up to 20 hours of overtime are saved in the ED at Paradise Valley Hospital in National City, CA, by videotaping staff meetings and
inservices.
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Whether a bite or sting results in an anaphylactic reaction, impressive
local effects, or a life-threatening systemic reaction, the emergency
physician must be able to institute appropriate and effective
treatment. Emergency physicians also must be able to recognize clinical
envenomation patterns, since some critically ill patients may not be
able to convey the details of the attack. Since all areas of the
country are represented in the envenomation statistics, all emergency
physicians should be familiar with identification and stabilization of
envenomated patients and know what resources are available locally for
further management of these often complicated patients.
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Medication errors have been publicized as among the most dangerous risks to emergency department and hospitalized patients. Newspaper and magazine articles have leaped on the issue. While physicians and hospitals would like to believe this is just news propaganda to increase sales, they are wrong. Studies have shown that patients are dying from preventable adverse drug events (ADEs). Although hospitals, physicians, nurses, risk managers, and pharmacists have made attempts to reduce risks and prevent ADEs, there is much more that must be done. This months ED Legal Letter describes different types of ADEs and develops risk management strategies to reduce the chance of medication error. Adopting the guidelines provided in this issue will create a safer environment for our patients.
