Emerg Med Clin North Am
· 2025 Feb · PMID 39515941
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More than 75% of emergency physicians will be named in a malpractice suit over the course of their careers. When a case is brought to trial, it is the chart that will be the primary source of information, not the faded m...More than 75% of emergency physicians will be named in a malpractice suit over the course of their careers. When a case is brought to trial, it is the chart that will be the primary source of information, not the faded memories of an encounter that happened years in the past. Being mindful of all 3 audiences that the chart is generated for and developing techniques to adequately address all 3 should be the focus of the clinician when documenting a patient encounter.
Emerg Med Clin North Am
· 2025 Feb · PMID 39515940
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For emergency medicine physicians, being named in a malpractice suit is not an if, it is a when. By the age of 55 years, 68% of emergency physicians have been sued. In the following article, we review the most common fac...For emergency medicine physicians, being named in a malpractice suit is not an if, it is a when. By the age of 55 years, 68% of emergency physicians have been sued. In the following article, we review the most common factors shared by closed claims in adult and pediatric patients from emergency departments and acute care settings. Our hope is that by identifying shared characteristics, we may improve patient care and reduce litigation risk.
Emerg Med Clin North Am
· 2025 Feb · PMID 39515939
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Good decision-making, solid notes that show care and a reasonable thought process, and skillful interpersonal dealings with patients and loved ones are keys to avoiding claims and lawsuits related to care in the emergenc...Good decision-making, solid notes that show care and a reasonable thought process, and skillful interpersonal dealings with patients and loved ones are keys to avoiding claims and lawsuits related to care in the emergency department (ED). This means taking measures to control the brisk assembly line of work in the ED so that important steps such as assessment, testing, treatment, and communication promptly occur without any dilution in quality. It is crucial that the physician in the ED displays excellent bedside manner, including dealing with an increasing challenging patient population and the family and friends who often accompany them.
Emerg Med Clin North Am
· 2025 Feb · PMID 39515938
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While clinical practice guidelines (CPGs) were developed to help improve patient care, they have increasingly been used as evidence in medical malpractice lawsuits. They are used by both sides in malpractice litigation a...While clinical practice guidelines (CPGs) were developed to help improve patient care, they have increasingly been used as evidence in medical malpractice lawsuits. They are used by both sides in malpractice litigation as a surrogate for the standard of care. Providing care compliant with a CPG can be protective for physicians, but it does not completely absolve them of liability. Providing noncompliant care does carry an increased risk of litigation, but there are several defenses that have been successfully used to defend physicians. Effective communication and comprehensive documentation help mitigate the risk incurred by not following a CPG.
Emerg Med Clin North Am
· 2025 Feb · PMID 39515937
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As emergency medicine physicians, we engage in informed consent, have conversations with patients leaving against medical advice, and screen them daily. Better understanding these concepts and processes can improve patie...As emergency medicine physicians, we engage in informed consent, have conversations with patients leaving against medical advice, and screen them daily. Better understanding these concepts and processes can improve patient care.
Emerg Med Clin North Am
· 2025 Feb · PMID 39515936
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Current trends demonstrate that the proportion and complexity of emergency care provided by advanced practice providers (APPs) is increasing, which underscores the importance of emergency physician supervision and suppor...Current trends demonstrate that the proportion and complexity of emergency care provided by advanced practice providers (APPs) is increasing, which underscores the importance of emergency physician supervision and support. Laws governing supervision vary between physician assistants and nurse practitioners, with the latter legally able to practice independently in some states. Regardless of the supervision model, emergency medicine professional organizations advocate for physician-led teams. Communication lapses and contradictory documentation with errors and omission are potential sources of medical error and risk. Ensuring appropriate oversight with consideration of the APPs experience and documenting appropriately may minimize legal risk.
Emerg Med Clin North Am
· 2025 Feb · PMID 39515935
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Medical malpractice is an inevitable truth of being a practicing provider. Despite awareness of malpractice risk, education on understanding the legal landscape and protecting oneself from being named in a malpractice cl...Medical malpractice is an inevitable truth of being a practicing provider. Despite awareness of malpractice risk, education on understanding the legal landscape and protecting oneself from being named in a malpractice claim is sorely underrepresented in medical school and residency curricula. This review summarizes what is known about the legal risks to the resident in training and the attending physician supervisor. It also explores the legal landscape for physicians practicing and supervising telehealth encounters.
Emerg Med Clin North Am
· 2025 Feb · PMID 39515934
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The majority of physicians will face at least one medical malpractice claim over the course of their careers. The stress caused by medical malpractice claims can lead to litigation stress or malpractice stress syndrome....The majority of physicians will face at least one medical malpractice claim over the course of their careers. The stress caused by medical malpractice claims can lead to litigation stress or malpractice stress syndrome. Physicians experiencing a claim may have strained family relationships, worsening anxiety and depression, and burnout, and have higher rates of medical errors. In such cases, physicians should seek support of their legal counsel and from a licensed professional therapist. Above all, physicians should remember that malpractice claims are an occupational hazard and not a sign that they are a bad physician.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326997
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One cannot successfully employ point-of-care ultrasound (POCUS) without a process to provide support and guidance. POCUS administration is a multifaceted topic that demands the utmost attention from those responsible for...One cannot successfully employ point-of-care ultrasound (POCUS) without a process to provide support and guidance. POCUS administration is a multifaceted topic that demands the utmost attention from those responsible for program implementation and long-term execution. This article delves into POCUS administration and is meant to serve as a guide for the practitioner seeking to start, maintain, or augment their POCUS program.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326996
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The management of patients in shock or arrest is a critical aspect of emergency medicine and critical care. Rapid and accurate assessment is paramount in determining the underlying causes and initiating timely interventi...The management of patients in shock or arrest is a critical aspect of emergency medicine and critical care. Rapid and accurate assessment is paramount in determining the underlying causes and initiating timely interventions. This article provides a summary of essential ultrasound protocols for the critically ill patient including the extended focused assessment with sonography for trauma (EFAST), rapid ultrasound for shock and hypotension (RUSH), and sonography in hypotension and cardiac arrest in the emergency department (SHoC-ED).
Emerg Med Clin North Am
· 2024 Nov · PMID 39326995
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Ultrasound guidance is fundamental to procedural safety and success. For many emergency department (ED) procedures, the use of ultrasound improves first-pass success rate, time-to-completion, and complication rate when c...Ultrasound guidance is fundamental to procedural safety and success. For many emergency department (ED) procedures, the use of ultrasound improves first-pass success rate, time-to-completion, and complication rate when compared with traditional landmark-based techniques. Once learned, the general principles of ultrasound guidance may be adapted across a broad range of bedside procedures.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326994
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Ultrasound-guided nerve blocks serve as a valuable component of multimodal pain management for acutely injured patients in the emergency department and offer a potentially more efficient alternative to time-consuming pro...Ultrasound-guided nerve blocks serve as a valuable component of multimodal pain management for acutely injured patients in the emergency department and offer a potentially more efficient alternative to time-consuming procedural sedation.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326993
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Point-of-care ultrasound may be used to assist in the diagnosis of ocular complaints in the emergency department. With the use of a linear probe, the emergency physician can view anterior and posterior chamber structures...Point-of-care ultrasound may be used to assist in the diagnosis of ocular complaints in the emergency department. With the use of a linear probe, the emergency physician can view anterior and posterior chamber structures of the patient's eye and evaluate for signs of pathology.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326992
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Point-of-care ultrasound may be used to assist in the diagnosis of skin, soft tissue, and musculoskeletal concerns in the emergency department. Frequently, linear or curvilinear probes are used to perform these studies a...Point-of-care ultrasound may be used to assist in the diagnosis of skin, soft tissue, and musculoskeletal concerns in the emergency department. Frequently, linear or curvilinear probes are used to perform these studies and ultrasound may be used to assist in common emergency department procedures related to these conditions.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326991
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Point-of-care ultrasound is a useful tool in the evaluation of women with pelvic complaints in the emergency department. Transabdominal and transvaginal approaches may be employed to assess a variety of obstetric or gyne...Point-of-care ultrasound is a useful tool in the evaluation of women with pelvic complaints in the emergency department. Transabdominal and transvaginal approaches may be employed to assess a variety of obstetric or gynecologic pathologies.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326990
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Renal and genitourinary (GU) complaints are common reasons for presentation to the emergency department (ED). This article reviews the approach to renal, bladder, and testicular point-of-care ultrasound (POCUS) with spec...Renal and genitourinary (GU) complaints are common reasons for presentation to the emergency department (ED). This article reviews the approach to renal, bladder, and testicular point-of-care ultrasound (POCUS) with specific discussions of commonly encountered ED pathology. It presents algorithms highlighting the clinical integration of renal and GU POCUS into the evaluation and management of these patients.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326989
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Vascular point-of-care ultrasound is a useful tool for emergency department (ED) clinicians to evaluate lower extremity pain and swelling. It can quickly and safely detect deep vein thrombosis, a serious condition that c...Vascular point-of-care ultrasound is a useful tool for emergency department (ED) clinicians to evaluate lower extremity pain and swelling. It can quickly and safely detect deep vein thrombosis, a serious condition that can lead to pulmonary embolism and post-thrombotic syndrome as well as diagnose pseudoaneurysm, hematoma, and acute arterial occlusion, a vascular emergency that requires urgent surgical intervention. Point-of-Care Ultrasound can be a useful tool for the evaluation of ED patients with vascular emergencies.