John Cafaro MD
A 2 year old boy is brought to the Emergency Department after a drowning event. Bystanders noted the child was underwater for 1 minute but was quickly pulled from the bottom of the pool, he coughed and vomited. On arrival, he is aware and alert and behaving appropriately per parents. His GCS is 15. On examination, he has a heart rate of 110, respiratory rate of 30 breaths/minute SaO2 of 98% on room air. His lungs are clear. What is the next step in management?
A 30 year-old female presents altered and minimally responsive. She was found next to an empty bottle of Valproic Acid. Her blood pressure is 130/80, heart rate is 90, afebrile and without tachypnea or hypoxia. You stabilize her. Depakote level is 550. What is the treatment of the choice?
Answer: A, L-carnitine
- A dispute between two parties.
- Burden of proof is based on a "preponderance of evidence".
- Punishment is monetary without threat for incarceration.
- Government or state brings action against an individual/ entity accused of wrongdoing.
- Burdern of proof is "beyond a reasonable doubt".
- Punishment is incarceration or fines.
Negligence - There are 4 elements.
One of the best risk management strategies is clear discharge instructions.
- Estimated that half of lawsuits in EM are related in someway to discharge planning.
Instructions should be time specific and action specific and include what to return to the ER for.