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It may be in the best interest of your ED patient with chest pain, seizures, or transient ischemic attack (TIA) to be admitted, but this may not occur due to factors beyond your control.
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Pediatric head trauma is one of the most common presenting complaints to the emergency department (ED).
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A female patient told ED nurses that her only complaint was back pain, with no shortness of breath, chest pain, discomfort, nausea, or vomiting.
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"More and more" preteen and adolescent patients are coming to the Emergency Department Trauma Center at Children's Hospital of Wisconsin in Milwaukee with a variety of psychosocial needs, and many have underlying medical conditions as well, says Carrie L. Baumann, RN, BSN, patient care supervisor.
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An 85-year-old man who reports vomiting and diarrhea after an injury, and also happens to be on beta blockers, might have a blood pressure of 120/70 and heart rate of 82 and "look absolutely normal, even though in reality he is hypotensive and tachycardic, and he is in shock," says Justin Milici, RN, MSN, CEN, CPEN, CFRN, CCRN, TNS, education specialist for the ED at Methodist Dallas Medical Center.
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A mother rushes into your ED and states that her child is having an asthma attack, but the child seems to be breathing normally.
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After a child was diagnosed with acute appendicitis at St. John's Mercy Medical Center in St. Louis, MO, the ED physician ordered antibiotics and dosed the patient according to the weight that was in her chart.
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Errors involving insulin were commonly reported to Pennsylvania's Patient Safety Authority in 2010, with 52% of 2695 events leading to a patient possibly having received the wrong dose or no dose, and 49 resulting in harm to the patient.
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William Sullivan, DO, JD, FACEP, director of emergency services at St. Margaret's Hospital in Spring Valley, IL, and a practicing attorney, helped an ED physician defend a case involving a patient who died after being boarded in the ED for more than 5 hours. The ED physician stated that the admitting physician accepted responsibility for the patient. The admitting physician denied responsibility since the patient was not admitted to the floor.
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Two of the American College of Emergency Physicians (ACEP)'s policies address the issue of who is responsible for inpatients being held in EDs. The October 2007 policy, "Responsibility for Admitted Patients" recognizes that the patient benefits when there is a clear delineation of who is responsible for the patient's care.
