Risk Management in Emergency Medicine, An Issue of Emergency Medicine Clinics of North America

1st Edition, Volume 38-2 - May 5, 2020
Editors: Lauren M. Nentwich, Jonathan S. Olshaker
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 8 9 4 9 - 3
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 8 9 5 0 - 9

This issue of Emergency Medicine Clinics, guest edited by Drs. Lauren Nentwich and Jonathan Olshaker, focuses on Risk Management in Emergency Medicine. This is one of four issues… Read more

Risk Management in Emergency Medicine, An Issue of Emergency Medicine Clinics of North America

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This issue of Emergency Medicine Clinics, guest edited by Drs. Lauren Nentwich and Jonathan Olshaker, focuses on Risk Management in Emergency Medicine. This is one of four issues each year selected by the series consulting editor, Dr. Amal Mattu. Articles in this issue include, but are not limited to: Surviving a Medical Malpractice Lawsuit, Communication and Documentation, Physician Well-Being, Emergency Department Operations I: EMS and Patient Arrival, Emergency Department Operations II: Patient Flow, Confidentiality & Capacity, Supervision of Resident Physicians & Advanced Practice Providers, Evaluation of the Psychiatric Patient, Physical and chemical restraints, High-Risk Pediatric Emergencies, The High-Risk Airway, High-Risk Chief Complaints I: Chest pain, High-Risk Chief Complaints II: Abdomen Pain and Extremity Injuries, High-Risk Chief Complaints III: Neurologic Emergencies, and Mitigating Clinical Risk through Simulation.

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Managing Emergency Department Risk Through Communication and Documentation
Key points
Introduction
Types of communication
Types of documentation
Malpractice risk
Regulatory and compliance risk
Financial risk
Legal risk
Summary
Confidentiality and Capacity
Key points
Confidentiality
Capacity
Summary
Physician Well-Being
Key points
Introduction
Background
Epidemiology
Stress, burnout psychology, and physiology
Causes of burnout
Signs and symptoms
Measurements of burnout
Consequences of burnout
Prevention and interventions
Limitations and future directions of burnout research
Summary
Emergency Department Operations I: Emergency Medical Services and Patient Arrival
Key points
Introduction
Medical Control
Summary
Emergency Department Operations II: Patient Flow
Key points
Introduction
Model of patient flow in the emergency department
Role of metrics
Input and front-end strategies
Split-flow model
Provider in triage model
Throughput
Optimizing staffing
Reducing subcycle time intervals
Utilizing results pending areas
Flow coordinators
Discharge and alternative output strategies
Boarders
Alternatives to inpatient admission
Summary
Supervision of Resident Physicians
Key points
Introduction
The push for increased resident supervision
Evidence base for resident supervision
Policies and procedures for supervision of residents
Implication of resident supervision on billing
Concerns regarding lack of resident autonomy
Entrustment in the supervisory relationship
Balancing resident autonomy with adequate supervision
Summary
Supervision of Advanced Practice Providers
Key points
Introduction
Training requirements for advanced practice providers
Laws and guidelines governing supervision of advanced practice provider
Factors affecting supervision of advance practice providers
Scope of practice of advanced practice providers
Credentialing and privileges for advanced practice professionals
Billing issues for advanced practice providers
Medicolegal considerations for advanced practice providers
Summary
Practice Makes Perfect: Simulation in Emergency Medicine Risk Management
Key points
Introduction
History
Reducing risk using simulation
Guide to article
Simulation process overview
Role of procedural simulation training in emergency medicine risk management
Individual simulation in risk management
Team-based simulation
In situ simulation
Simulation-based risk mitigation in community emergency medicine
Existing academic community partnerships
Key elements of community-based simulations in emergency medicine risk management
Future directions in simulation: augmented reality/virtual reality/serious games
Summary
High-risk Pediatric Emergencies
Key points
Meningitis
Pneumonia
Appendicitis
Testicular torsion
Fractures and orthopedic injuries
Child abuse
Summary
Disclosure
The High-Risk Airway
Key points
Introduction
General physiologic considerations
Metabolic acidosis
Anatomic considerations
The bougie
Intubation medications
Awake intubation
Bougie-assisted surgical cricothyrotomy
Specific airway scenarios
Postintubation analgesia and sedation
Discussion
Supplementary data
Emergency Department Evaluation of the Adult Psychiatric Patient
Key points
Introduction
Emergency department identification and triage
Emergency department medical evaluation
High-risk diagnoses
Risk assessment
Psychiatric patient emergency department boarding
Physical and Chemical Restraints (an Update)
Key points
Introduction
Epidemiology
Pathophysiology
Recognizing and preparing for the violent patient
De-escalation
Physical restraints
Chemical restraints
Preventive measures
Summary
High-Risk Chief Complaints I: Chest Pain—The Big Three (an Update)
Key points
Introduction
Acute coronary syndrome
Thoracic aortic dissection
Pulmonary embolism
Tension pneumothorax
Esophageal rupture
Cardiac tamponade
Summary
High-Risk Chief Complaints III: Abdomen and Extremities
Key points
Introduction
Appendicitis
Abdominal aortic aneurysm
Mesenteric ischemia
Small bowel obstruction
Retained foreign body in acute wounds
Hand and finger lacerations
Compartment syndrome
High-Risk Chief Complaints III: Neurologic Emergencies
Key points
Introduction
Summary
Surviving a Medical Malpractice Lawsuit
Key points
Introduction
The basics
The process
Summary

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Lauren M. Nentwich