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EPs may try to put off intervening on admitted patients waiting for inpatient beds to become available to avoid confusion about what was already done for the patient and what the inpatient care plan is, says William C. Gerard, MD, MMM, FACEP, chairman and professional director of emergency services at Palmetto Health Richland in Columbia, SC.
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"This is a new electronic record, and it does not work very well." If an emergency physician (EP) didn't review the nursing notes because these couldn't be located within the ED's electronic medical record (EMR), this statement could very well be the EP's only defense in the event a medical malpractice suit occurs, says Michael Blaivas, MD, FACEP, FAIUM, professor of emergency medicine at Northside Hospital Forsyth in Atlanta, GA.
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In some states, only one party to a conversation has to consent for a recording to be legal, while in other states, both parties have to consent unless one of several exceptions to the law is present, such as anticipation that a crime is going to be committed or use by law enforcement, says William Sullivan, DO, JD, FACEP, an emergency physician at University of Illinois Medical Center in Chicago and a practicing attorney in Frankfort, IL.
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Admitted ED patients are "definitely in a gray zone," according to William C. Gerard, MD, MMM, FACEP, chairman and professional director of emergency services at Palmetto Health Richland in Columbia, SC. "Fortunately, they are admitted, and that takes your [Emergency Medical Treatment and Labor Act] risk away. But then you get into the malpractice risks," he says.
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While unauthorized videotapes made by a patient in your ED may seem highly inappropriate, those recordings can often be introduced as evidence in medical malpractice lawsuits, according to William Sullivan, DO, JD, FACEP, an emergency physician at University of Illinois Medical Center in Chicago and a practicing attorney in Frankfort, IL.
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Some emergency physicians (EPs) have admitted that they don't take time to read the nursing notes, according to J. Tucker Montgomery, MD, JD, a health care attorney in Knoxville, TN. "Complaints recorded there that go unaddressed, or a particular abnormal vital sign, can come back to bite an EP," he says.
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When an ED patient is being held while waiting for an inpatient bed, Rolf Lowe, JD, an attorney with Rogers Mantese & Associates in Royal Oak, MI, says "there is no bright line cut off for liability. Substandard care in the ED that has an effect on the patient's outcome can result in liability for the EP and the ED staff."
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Case 1. Lily is a 23-year-old female nursing student who presented after losing consciousness. Lily was watching an EM nurse clean a wound for eventual suturing.
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Classically, pneumonia is defined as an infection of the lung parenchyma. However, worldwide, a variety of definitions exist, including fever, hypoxia, a constellation of other clinical symptoms, and radiologic findings. In pediatric and adolescent populations, early diagnosis will assist emergency department (ED) physicians with correctly managing and subsequently avoiding potential morbidity and mortality of this common infectious disease.
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Foreign body ingestion is a common problem, especially in children younger than 3 years of age. Fortunately, most cases have uneventful outcomes, but the potential for a devastating complication exists. Button batteries are particularly dangerous, and timely and appropriate management is critical. This article comprehensively reviews pediatric foreign body ingestions.
