Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2020
ReviewEmergency Department Evaluation of the Adult Psychiatric Patient.
Many patients with acute behavioral or mental health emergencies use the emergency department for their care. Psychiatric patients have a higher incidence of chronic medical conditions and are at greater risk for injury than the general population. ⋯ This article addresses high-risk areas of the treatment and management of emergency department patients presenting with behavioral emergencies. This article identifies methods successful in determining whether the patient's behavioral emergency is the result of an organic disease process, as well as recognizing other potential acute medical emergencies in this high-risk population.
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Emerg. Med. Clin. North Am. · May 2020
ReviewHigh-Risk Chief Complaints I: Chest Pain-The Big Three (an Update).
Nontraumatic chest pain is a frequent concern of emergency department patients, with causes that range from benign to immediately life threatening. Identifying those patients who require immediate/urgent intervention remains challenging and is a high-risk area for emergency medicine physicians where incorrect or delayed diagnosis may lead to significant morbidity and mortality. This article focuses on the 3 most prevalent diagnoses associated with adverse outcomes in patients presenting with nontraumatic chest pain, acute coronary syndrome, thoracic aortic dissection, and pulmonary embolism. Important aspects of clinical evaluation, diagnostic testing, treatment, and disposition and other less common causes of lethal chest pain are also discussed.
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Being named in a medical malpractice case is one of the most stressful events in a physician's career. This article reviews the legal system and the medical malpractice process. It details the steps a physician experiences during a medical malpractice case, from being served to the deposition and then to trial and appeals if the physician loses. This article also reviews necessary steps to take in order to proactively participate in one's own defense.
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More than half of pediatric malpractice cases arise from emergency departments, primarily due to missed or delayed diagnoses. All providers who take care of children in emergency departments should be aware of this risk and the most common diagnoses associated with medicolegal liability. ⋯ It highlights challenges and pitfalls that may increase risk of liability. It concludes with a discussion on recognition and management of abuse in children, including when to report and decisions on disposition.