Introduction: US child firearm fatality rates have risen since 2013. Child Access Prevention (CAP) laws aimed at reducing minors' access to firearms have existed since the 1980s. However, specific requirements for safe storage of firearms, standards of negligence, and penalties for offenders vary significantly by state, yielding a heterogeneous body of CAP legislation.
View Article and Find Full Text PDFParkinson's disease (PD) is a debilitating condition that affects 1.8% of people 65 years of age and older. Patients with PD often require hospitalization and are frequently admitted through the emergency department (ED).
View Article and Find Full Text PDFJ Am Coll Emerg Physicians Open
June 2024
[This corrects the article DOI: 10.1002/emp2.13143.
View Article and Find Full Text PDFThere is a growing need for clear and definitive guidelines to prevent firearm violence in communities across the United States. Recommendations explore the utility and feasibility of universal screenings and recommend utilizing universal screening due to a lack of a clear risk to it. Providers should also work to create risk reduction plans with patients as well.
View Article and Find Full Text PDFJ Am Coll Emerg Physicians Open
April 2024
Patients in custody due to arrest or incarceration are a vulnerable population that present a unique ethical and logistical challenge for emergency physicians (EPs). People incarcerated in the United States have a constitutional right to health care. When caring for these patients, EPs must balance their ethical obligations to the patient with security and safety concerns.
View Article and Find Full Text PDFThis article provides a brief review of moral and legal duties to respect confidentiality in emergency medicine. The article considers current challenges to confidentiality in emergency departments and proposes strategies to address them. It is offered as an update of the two-part review of confidentiality in emergency medicine in 2005 by Moskop et al published in 2005 in .
View Article and Find Full Text PDFIndividual rights can be limited in the context of psychiatric emergencies. The emergency physician should be familiar with state laws pertaining to involuntary holds. Physicians are equipped to perform a medical screening examination, address mental health concerns, and lead efforts to de-escalate agitation.
View Article and Find Full Text PDFBackground: The opioid epidemic is a serious social, economic and public health problem. This study was designed to evaluate the effectiveness of individual institutional opioid prescriber training on prescriber adherence to the Centers for Disease Control and Prevention (CDC's) guidelines for responsible opioid prescribing practices to treat acute pain.
Methods: Opioid prescribing data were collected from an academic medical centre and its associated outpatient clinics.
J Am Coll Emerg Physicians Open
April 2023
Striking the balance between professional duties, obligations, and responsibility with protecting one's wellness as a physician and as an individual have been brought into sharper focus during COVID-19. The objective of this paper is to describe ethical principles in the balance between emergency physician wellness and professional responsibility to patients and the public. We propose a schematic that helps us as emergency physicians visualize continuously striving to be both well and professional.
View Article and Find Full Text PDFBackground: Haloperidol can be used off-label for agitation and/or delirium in older individuals. The recommended initial intramuscular or intravenous dose is 0.5 to 1 mg.
View Article and Find Full Text PDFJ Am Coll Emerg Physicians Open
December 2021
Undocumented immigrants with end-stage renal disease in the United States are uniquely disadvantaged in their ability to access dialysis. This article examines the unique circumstances of the medical condition and healthcare system, including the relevant legal and regulatory influences that largely relegate undocumented immigrants to relying on emergency-only dialysis through a hospital's Emergency Medical Treatment and Labor Act obligations. We explore the ethical implications of this current state, emphasizing the adverse effects on patients and staff alike.
View Article and Find Full Text PDFJ Am Coll Emerg Physicians Open
June 2021
Patients who are undocumented immigrants (UIs) frequently present to emergency departments in the United States, especially in communities with large immigrant populations. Emergency physicians confront important ethical issues when providing care for these patients. This article examines those ethical issues and recommends best practices in emergency care for UIs.
View Article and Find Full Text PDFClin Pract Cases Emerg Med
November 2018
Fungal rhino-orbital cerebritis is a devastating opportunistic invasive disease. Survival requires urgent diagnosis. Thus, all patients at risk who present with rhinosinusitis-type symptoms and have co-morbid conditions that decrease their immunocompetence should trigger the clinician's consideration of this disease.
View Article and Find Full Text PDFObjectives: In medical education and training, increasing numbers of institutions and learners are participating in global health experiences. Within the context of competency-based education and assessment methodologies, a standardized assessment tool may prove valuable to all of the aforementioned stakeholders. Milestones are now used as the standard for trainee assessment in graduate medical education.
View Article and Find Full Text PDFEthical dilemmas can create moral distress in even the most experienced emergency physicians (EPs). Following reasonable and justified approaches can help alleviate such distress. The purpose of this article is to guide EPs providing Emergency Medical Services (EMS) direction to navigate through common ethical issues confronted in the prehospital delivery of care, including protecting privacy and confidentiality, decision-making capacity and refusal of treatment, withholding of treatment, and termination of resuscitation (TOR).
View Article and Find Full Text PDFInformed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk.
View Article and Find Full Text PDFThe United States has the highest rate of incarceration in the world. Many correctional facilities have outsourced the medical care for this population that often presents with complex health issues. This study evaluates the reasons that inmates present to an emergency department (ED) and compares them to the general population ED visits.
View Article and Find Full Text PDFIntroduction: Electroencephalography (EEG) is indicated for diagnosing nonconvulsive status epilepticus (NCSE) in a patient who has altered level of consciousness after a motor seizure. A study in a neonatal population found 94% sensitivity and 78% specificity for detection of seizure using a single-lead device. This study aims to show that a reduced montage EEG would detect 90% of seizures detected on standard EEG.
View Article and Find Full Text PDF