The Killer Aorta: Diagnosing Thoracic Aortic Dissection
January 16, 2017
Thoracic aortic dissection (TAD) is one of the most dramatic and life-threatening conditions encountered in all of medicine. Every year in the United States, there are an estimated 6,000 to 10,000 cases of TAD. Since it is an uncommon condition compared to the 5 million ED chest pain visits and more than 1 million acute…Read More
Very Abnormal Vital Signs & Death after Discharge: Remember That Patient You Sent Home Last Night?
December 12, 2016
The majority of malpractice suits in acute care and emergency medicine involve patients who were discharged home. These patients experienced an unexpected adverse outcome after they left the ED such as worsening of their illness or even death. For many of these patients, the “bad outcome” could not have been foreseen — the workup was…Read More
The Deceptive Pied Pipers: “Bedside Maneuvers” for Chest Pain
December 5, 2016
Malpractice claims related to the chief complaint of chest pain continue to plague clinicians. Foremost among these claims is the allegation of “missed MI,” which has now been expanded to include missed unstable angina as well as missed actual myocardial infarction. Although the evaluation of the adult with chest pain is fraught with many pitfalls,…Read More
The Chief Complaint of Pain: A Pain for You and Your Patient!
October 31, 2016
A chief complaint of pain is one of the most common encountered by practitioners in any specialty. The pain may be acute or chronic. It may be located in the abdomen, chest, head or any other body part. It may be spontaneous in onset or may be due to an injury. It can range from…Read More
Case: Failure to Diagnose Spinal Epidural Abscess
August 29, 2016
Failure to diagnose is the most common medical error in the practice of emergency, urgent care and primary care medicine. Spinal epidural abscess (SEA) is one of the most difficult conditions to diagnose, but there are common threads among failure to diagnose spinal epidural abscess cases. This case is presented to provide perspective and to increase our vigilance for catching this disabling and possibly even fatal diagnosis.
Necrotizing Fasciitis is Still Lurking Out There
August 8, 2016
The uncommon but lethal infection known as necrotizing fasciitis continues to be in the news. This is a devastating disease that can be difficult to diagnose in the early stages. The first presentation is often nothing more than arm or leg pain that looks very much like garden-variety musculoskeletal discomfort. By the time the diagnosis…Read More
3 Pediatric Heat-Related Illnesses
August 1, 2016
The temperatures are rising, and school sports are starting long practices in all kinds of weather. During intense exercise, people can lose up to 1.5 liters of fluid per hour. Summer is prime time for pediatric patients to sustain heat-related illnesses, and these patients may present to the emergency department in some distress. Defining the…Read More
Heart Disease in Women: Underdiagnosed and Undertreated
February 8, 2016
February is American Heart Month 2016 and an appropriate time to recognize the recent reduction in mortality rate from cardiovascular disease in women. The increased awareness of women and healthcare professionals has resulted in better care and is at least partially responsible for the lower death rate from heart disease seen over the past decade….Read More
Managing Patient Volume in ED
November 12, 2014
Are you prepared for surges in your ED patient volumes? As we head into the peak of flu season, many facilities are already feeling the effects of increased volumes, such as: Longer waiting times Staff exposed to more airborne illnesses resulting in increased sick time A shift in perceptions of care resulting in lower patient…Read More
