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Most emergency physicians will be sued during their career. Lawsuits can lead to interpersonal difficulties, loss of job satisfaction, and emotional distress. An understanding of the malpractice process and ways to reduce risk can help emergency physicians deal with this ever present threat.
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If you aren't going to give tPA and would like to avoid a lawsuit, you'll want to be very clear in your documentation as to why the patient didn't meet treatment criteria. "And if you do give it, you should be very clear why the patient did meet the criteria," says John Burton, MD, chair of the Department of Emergency Medicine at Carilion Clinic in Roanoke, VA.
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Although some ED physicians remain opposed to the idea of using tPA, the consideration of the use of thrombolytics such as tPA for stroke patients who are eligible candidates has become the public expectation
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Penetrating trauma to the torso can present a complex diagnostic and therapeutic challenge. Injuries can occur to the precordium, the thoraco-abdominal region, abdomen, flank, back, and pelvis. Injuries often occur simultaneously in several body cavities. Each of these body regions may require a different approach for both diagnosis and treatment. Penetrating injury from the nipple line to the inguinal ligaments anteriorly and from the tip of the scapula to the inferior gluteal folds should prompt suspicion of intra-abdominal injury.
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This issue is the second in a two-part series covering vaginal bleeding in pregnancy. Part I discussed spontaneous abortion and ectopic pregnancy. Part II will discuss other causes of vaginal bleeding that typically present later in pregnancy.
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Remember the days before sensitive serum pregnancy tests and 24-hour ultrasound availability? Remember performing a culdocentesis to determine if the patient was stable for discharge? I do, and I don't miss them.
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The world of the ED manager changed significantly in July, when the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) for Health Information Technology released the final rule for the definition of the term "meaningful use."
