January 24, 2019
Here’s the true story of a really unfortunate side effect from a very common medication. Remember that anyone can learn from their own mistakes, but a wise person learns from others’ mistakes. A man was working onboard a cruise ship as a waiter when he
November 20, 2018
Here’s something that should come as a shock to no one: bouncebacks are dangerous. Patients are distressed or ill enough to feel that whatever was done for them the first time, wasn’t enough. Beyond just managing patient expectations, you have to ask yourself: “What could
April 12, 2018
The Case A 30 year old woman gave birth to a baby after nearly 20 hours in labor. Three days later she started having fever, chills, and abdominal pain. At this point, there really isn’t any need to provide additional information as the ‘diagnosis until
December 14, 2017
I get a lot of questions from residents and new attendings about the liability ER physicians take on when co-signing charts for APPs (advanced practice providers, aka nurse practitioners/physician assistants). To start, a small disclaimer: local practices vary and there are certain guidelines that many
November 14, 2017
A 50-year-old insulin-dependent diabetic was found unresponsive by family. He was taken to the ED and suffered a seizure upon arrival. His blood glucose level was 14. D50 was administered, his sugar level stabilized, and he was discharged home. He returned to the ER less
July 16, 2017
This is a real [reported] story of a lawsuit involving an ED physician in Ohio. — The summary: Michael Cleveland was grocery shopping when he had an apparent heart attack. He was taken to a hospital where, after resuscitative efforts, the ED doctor pronounced him dead.
July 7, 2017
We work in a high-risk field. The very nature of emergency medicine and the types of patients it attracts is litigious. A 2011 study published in the New England Journal of Medicine found that EM had a higher than average risk of malpractice. It states:
July 2, 2017
We’ve all experienced this: your overnight shift is winding down, you’re trying to wrap up dispositions on all of your patients, and you’re tired. You either discharge some people a little prematurely (those fluids will finish, they’ll feel better, and they’ll be able to leave.
June 19, 2017
The next chart up is a healthy 12-week pregnant woman with vomiting. Labs have already been ordered and are normal. You decide to forego the IV and give her a Zofran dissolvable tablet – saving her time, needle stick, and the pain of having to
