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ED physicians responding to "code blue" alerts on inpatient units is a common practice but one that exposes them to considerable legal risks.
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Most of us dread the chief complaint of weakness. This nonspecific symptom engenders a differential that ranges from malingering to fatal, from psychiatric to cancer. The finding of demonstrable muscle weakness helps, but then leads to a confusing set of relatively rare diagnoses.
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A new generation of physicians is reinvigorating the field of cardiac arrest research. I am grateful that two of the experts in this area have written this issue of EM Reports. After reading this, I anticipate you will place these principles into practice.
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On Sept. 29, 2005, the lives of the ED staff at St. Mary Medical Center in Langhorne, PA, were affected dramatically when a man arrested for DUI pulled a gun and shot an ED technician and two police officers one fatally.
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The public safety room at St. Mary Medical Center, Langhorne, PA, has several special features to help ensure the safety of staff and patients in the ED, according to Harry Myers, director of safety, security, and parking. Here is his description of those features:
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"If a hospital permits physicians to selectively take call while the hospital's coverage for that particular service is not adequate, the hospital would be in violation of its EMTALA obligation by encouraging disparate treatment."
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If an emergency physician is arrested for assaulting a patient or for inappropriate sexual conduct, there is potential liability exposure for both the hospital where the ED is located and the emergency medicine (EM) group, says Thomas H. Taylor, a health care attorney at LaCrosse, WI-based Johns Flaherty.
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Any persistent thoughts of or conversations about wanting to die or committing suicide should be taken seriously, advises the American College of Emergency Physicians (ACEP).
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The world of emergency medicine was thrown into a state of turmoil on Feb. 10, 2008, when the Centers for Medicare & Medicaid Services (CMS), issued the following guidance: "If a hospital uses other written protocols or standing orders for drugs or biologicals that have been reviewed and approved by the medical staff, initiation of such protocols or standing orders requires an order from a practitioner responsible for the patient's care."
