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Prompt, accurate assessment of the severity of injury and early initiation of appropriate critical care — including adequate oxygenation, ventilation and correction of hypotension — is of crucial importance in preventing deaths in children with severe trauma. This article reviews the critical aspects of airway assessment and management in the pediatric trauma patient.
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The first part of this series discussed abdominal pain in pediatric patients. This second and final part will cover abdominal pain in elderly, immunocompromised, and pregnant patients. Those 65 years of age and older constitute the fastest-growing segment of the population, and currently comprise about 12% of the U.S. population. This means that abdominal pain in the elderly will be a commonplace occurrence in EDs.
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The evaluation of a febrile child is an extremely common scenario in most emergency departments. Emergency physicians must decide which children require a work-up, the nature of that work-up, and the need for antibiotics with or without hospitalization. This process often is in the context of evaluating many febrile children, with only subtle clues as to which child truly may be ill. Unfortunately, it is common for inadvertent errors in judgment to end up in the courtroom as a subject of malpractice lawsuits. This months issue focuses on some of the risks and controversies in the evaluation of the febrile child.
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The newly announced national patient safety goals, which are expected to receive special emphasis at accreditation surveys, require EDs and other departments of the hospital to accurately and completely reconcile medications across the continuum of care.
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As of Jan. 1, hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations must meet a new standard that has a higher requirement for care given to admitted patients in the ED, and CEOs will depend on ED managers to lead the effort in complying with this standard.
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The annual impact of influenza on the United States is staggering: 10% to 20% of the population will get the flu. Some 36,000 people will die, and 114,000 will be hospitalized.
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If youre having difficulty staffing your call panel, there are two options: You can institute a new approach internally, or contract with a company such as Emergency and Acute Care Medical Corp. (EA) in Rancho Santa Fe, CA, a management services organization with an independently contracted medical group providing call panel and stipend solutions and programs.
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A large number of emergency medicine observers agree that the inability to fully staff ED call panels has reached a critical point.
Why has the problem become so serious?
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There was a long history of frustration over lab specimen turnaround time but not anymore. Thanks to a successful Six Sigma initiative, turnaround time for the EDs criteria draws (draws based on specific patient criteria that indicate lab work will be needed) has dropped from about 46 minutes to 16 minutes.
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A series of 27 lawsuits aimed at organizations controlling about 250 nonprofit hospitals in 15 states and the Chicago-based American Hospital Association (AHA) have shone the spotlight on the Emergency Medical Treatment and Labor Act (EMTALA) and its requirements concerning the treatment and admission of uninsured and underinsured patients.
