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The concussion laws passed by 39 states establish an expectation for emergency physicians (EPs) involved in the case of a student athlete who has potentially suffered a concussion to have a very low threshold for making the diagnosis of concussion and removing the child from any potential for further injury, says Roger J. Lewis, MD, PhD, a professor in the Department of Emergency Medicine at Harbor UCLA Medical Center in Torrance.
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Below is a list of some things that EPs should consider to be red flags for abuse, according to Daniel M. Lindberg, MD, an attending physician in the Department of Emergency Medicine at Brigham and Womens Hospital and assistant professor of medicine at Harvard Medical School, both in Boston:
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Michael Gerardi, MD, FAAP, FACEP, director of pediatric emergency medicine at Goryeb Childrens Hospital in Morristown, NJ, reports that he is aware of several recent lawsuits naming an emergency physician (EP) for failure to diagnose child abuse.
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The cuff-leak test (CLT) was performed prospectively in this study using the volume technique whereby the difference between inspired and expired tidal volume before and after cuff deflation is used to detect the presence of laryngeal edema and the likelihood of developing post-extubation stridor.
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Family members of patients recovering from critical illness may experience psychological problems, including anxiety, depression, and post-traumatic stress disorder (PTSD). Jones and colleagues reasoned that provision of an ICU diary, written in everyday language by ICU staff, would be beneficial to family members by providing an explanation of daily events and opportunity for expression of feelings and contribution to the plan of care.
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The authors note a paucity of literature on early (0-48 hours of ventilation and ICU admission) sedation practices and their impact on outcomes; thus they performed this multicenter prospective cohort study with the hypothesis that early sedation is associated with delirium, time to extubation, and hospital and 180-day mortality.
