Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
False-negative and false-positive errors in abdominal pain evaluation: failure to diagnose acute appendicitis and unnecessary surgery.
To test the hypothesis that physician errors (failure to diagnose appendicitis at initial evaluation) correlate with adverse outcome. The authors also postulated that physician errors would correlate with delays in surgery, delays in surgery would correlate with adverse outcomes, and physician errors would occur on patients with atypical presentations. ⋯ Errors in physician diagnostic decisions correlated with patient clinical findings, i.e., the missed diagnoses were on appendicitis patients with few clinical findings and unnecessary surgeries were on non-appendicitis patients with clinical findings similar to those of patients with appendicitis. Adverse events (perforation, abscess formation) correlated with physician false-negative decisions.
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Comparative Study
Potential errors in the diagnosis of pericardial effusion on trauma ultrasound for penetrating injuries.
To evaluate ultrasound error in patients presenting with penetrating injury with a potential for pericardial effusion. ⋯ A serious potential exists for misdiagnosing epicardial fat pads as pericardial effusion in critically ill trauma patients. Emergency physicians need to be aware of this and should consider one of two suggested alternative methods to improve the accuracy of diagnosis.
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Case Reports
Clinical errors in emergency medicine: experience at the emergency department of an Italian teaching hospital.
The level of commitment in the analysis of clinical errors made in the emergency department (ED) is currently focused on organization and processes rather than on individual action. Four major cases of clinical errors made in the ED of a teaching hospital were investigated. ⋯ The authors have initiated a systematic analysis of errors made during the diagnostic workup in their ED, and the rate of clinically significant errors is tracked. A file is being created with the purpose to use it for teaching and orientation of all new staff.