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The ED nurse is the "first line of defense" against a malpractice lawsuit alleging missed or delayed diagnosis of sepsis, according to Paula Mayer, RN, LNC, a partner at Mayer Legal Nurse Consulting in Saskatchewan, Canada.
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Emergency medical services (EMS) crews are all on assignments, it's rush hour, the cardiologist hasn't called back, or the transfer center is waiting for approval before assigning a bed. These are all valid reasons for delays in transfer of a patient with an ST-elevation myocardial infarction (STEMI), says Kevin Brown, MD, MPH, FACEP, FAAEM, principal with Brown Consulting Services in Armonk, NY, and former director of the department of emergency medicine at Greenwich (CT) Hospital, but if any of these delays occur, times should be documented by the emergency physician (EP).
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Waiting time has always been the number one complaint against hospital emergency departments (EDs). In an attempt to address the waiting issue, hospitals recently began allowing patients with nonemergency conditions to "schedule" their ED visits through the Internet and then wait at home until their "projected treatment time" in the ED.
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If an emergency department (ED) patient with impending sepsis is discharged, returns hours later in septic shock, and dies or develops organ failure, "you're likely to get sued," warns Bruce Wapen, MD, an emergency physician with Mills-Peninsula Emergency Medical Associates in Burlingame, CA.
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Head trauma is a common presenting problem among emergency department (ED) patients. It has been estimated that 1-2 million Americans sustain traumatic brain injury (TBI) annually.
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Hospitals that receive federal funds are required by law to offer language assistance to patients with limited English proficiency (LEP).
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Every day patients flock to EDs with sore throats, headaches, and other non-emergent problems that are more in line with what you would expect a primary care provider (PCP) to handle.
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Mental health experts believe that as with many acute medical conditions such as stroke and heart attack, early diagnosis and treatment can make a critical difference for patients with schizophrenia, potentially limiting the severity and progression of the disease.
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Emergency departments in the United States are frequently confronted with trauma patients with varying degrees of injury.
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The ED is a common setting for the initial evaluation of emotional and behavioral disorders, including suicidal behavior or attempts. In the United States, approximately 2 million adolescents attempt suicide each year. As the number of visits by adolescents to the ED rises and the availability of outpatient mental health services diminishes, the ED physician must be not only able to stabilize the patient medically, but also should be comfortable with differentiating organic from psychiatric disease, performing a targeted psychosocial interview, initiating treatment, and arranging for disposition.
