Articles: emergency-medicine.
-
Clearly, a multitude of potential consent problems can exist for the emergency physician. It is difficult at times to balance the concepts of patient autonomy with the desire to provide optimal medical care. ⋯ Documentation of consent and refusal of treatment are critical for quality of patient care and legal liability reasons. Principles of what is good, "appropriate" legal consent usually follow from good medical care and strict concern for the patient's health and rights.
-
The attitudes of emergency physicians toward using medical techniques in out-of-hospital medical cardiac arrest scenarios were assessed. The physicians' willingness to further limit the use of these techniques through prehospital Do Not Attempt Resuscitation (DNAR) protocols and their personal use of advance directives were also assessed. Questionnaires were distributed to the 1990 Council of the American College of Emergency Physicians, San Francisco, CA, to elicit demographic and clinical information. ⋯ Only one-third of respondents had any type of advance directive for themselves. Experienced emergency physicians recognize that there are limits to the application of medical techniques, but are less willing to stop pediatric resuscitations, than they are to stop adult resuscitations. Emergency physicians agree on the need for prehospital DNAR protocols, but few have completed their own advance directives.
-
Internal Medicine is an essential but diverse field. This is the first in a three-part set of objectives for an off-service rotation in general internal medicine. This series may be used to guide the resident during the rotation or to serve as part of a teaching program integrated with didactic training and emergency department experience.
-
This article analyzes past legal trends in emergency medicine with an effort to project those trends and current developments into future legal issues that will confront emergency physicians and emergency departments. Special emphasis is placed on insurance trends and professional liability insurance developments along with medical malpractice claims past, present, and future. Also discussed in this article is the health care industry environment and ways that it might affect future legal challenges for emergency medicine.
-
Emergency department encounters between physicians and patients are fraught with obstacles to communication. Rapport must be established rapidly in order to assure information exchange, patient compliance, and desired treatment outcomes. The direct impact of rapport on the quality of medical treatment is reviewed, and three common misconceptions regarding physician-patient interaction are challenged. Psychologists Bandler and Grinder have provided a model of rapport well suited to emergency medicine; their concepts of pacing, anchoring, and reframing are presented.