Articles: emergency-medicine.
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Physicians and the public often assume that herbal preparations are harmless. Aconite is a Chinese herb used as an analgesic by homeopaths; its chief effects are on the cardiovascular and central nervous systems. The first two reported cases of aconite poisoning in Australia are described.
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Administrative knowledge and skills are essential for the emergency physician. This is the 12th article in a continuing series of "off-service" goals and objectives. ⋯ The article includes materials describing the Administrative Content, Goals and Objectives, Key Contact System, and Contents of the EM Administrative briefcase. This information should assist faculty charged with the development or revision of the Administrative literature review and experiential block rotation in an emergency medicine residency.
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In summary, Wrenn and Brody's [14] study raises important questions about the appropriate role of emergency physicians in discussing DNR decisions in the emergency setting. Their approach to DNR orders expands, appropriately we believe, the traditional role of emergency physicians. ⋯ In addition, emergency physicians have a heightened obligation to promptly address DNR status when appropriate decisions about resuscitation have been reached previously, as in the following cases: (1) when a clearly valid portable prehospital DNR order is in effect; (2) when the patient's primary physician clearly indicates to the emergency physician that the patient is DNR; (3) when an incompetent patient has an advance directive that explicitly precludes CPR and unquestionably applies to the current situation; (4) when a clearly competent, informed patient requests that a DNR order be entered. Finally, we advise emergency physicians against using the principle of futility as sole justification for DNR orders except in situations in which cardiopulmonary arrest is expected, and outcome data suggest that survival is virtually unprecedented.
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Emerg. Med. Clin. North Am. · Feb 1992
ReviewLegal issues in emergency radiology. Practical strategies to reduce risk.
Various joint commission and individual state standards affect emergency radiology practice and have legal implications. The ACEP has entered the burgeoning field of practice guidelines; fortunately, their practice guideline preparation system is arguably the most thorough in medicine at this time. This is of great importance to emergency physicians, because practice guidelines are not without their own potential legal, educational, and compliance problems. ⋯ The use of CQI strategies may prove helpful in improving practice patterns. Communication between emergency physician and radiologists is critical. Good communication requires the development of good rapport and should pay dividends in improved patient care.