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Few clinical situations place intensive care practitioners in a more uncomfortable position than does treating patients of the Jehovahs Witness faith. The faith-based refusal of autogenous or allogenic blood transfusions conflicts with the typical life-saving intent implicit in the critical care environment. However, it is our obligation to have a basic level of understanding of the set of beliefs that leads to the choice to refuse this specific set of life-saving therapies, while accepting other aspects of modern medical care.
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Adverse events and hospital deaths are common, and when these are combined, a large proportion of deaths are deemed preventable. Are there organizational approaches we can adopt in the ICU that will create a safer place?
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The primary objective of this study was to determine whether patients receiving mechanical ventilation who tolerate kinetic therapy have better pulmonary function than patients treated with standard turning. A secondary objective was to assess the cost-effectiveness of kinetic therapy.
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GEMINI Trial; CAMELOT Trial; INVEST Trial; The Dangers of Vitamin E; FDA Actions.
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Mortality among patients with advanced cirrhosis who required intubation and mechanical ventilation was related more to the derangement of liver function than to the severity of critical illness as assessed by APACHE II or SAPS.
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Influenza takes an enormous toll on humanity with respect to mortality, hospitalization, and medically attended illness. Despite the licensure of antiviral medications, immunization is the best control measure of influenza. Because patients eligible for influenza vaccine frequent EDs, health care providers working in this arena should offer the vaccine or appropriately recommend and refer patients following current guidelines to sites where the vaccine is obtainable.
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In recent years, the analysis of complex system errors, such as medical errors occurring in the ED, has changed from simply labeling and punishing individuals to understanding the underlying systems that contribute to medical error. In this issue of Emergency Medicine Specialty Reports, error in the ED and its contributing factors will be discussed, as well as steps to develop a culture of safety.
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This issue discusses some of the pitfalls that may arise in the care of the psychiatric patient. The lessons learned may assist EPs and nurses in reducing their malpractice risk, but more importantly, assist them in providing a safe disposition for these patients.
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This article focuses on specific populations presenting with abdominal pain to the ED and their specific or unique diagnoses. The pediatric, elderly, pregnant, and immunocompromised patients are special populations that pose a particular challenge to clinicians. These high-risk groups often present atypically, and serious conditions can be missed or misdiagnosed. This article discusses unusual diagnoses that often present with abdominal pain as one of the main symptoms.
