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Everyone working in Emergency Medicine is aware that many non-accidentally-caused childhood injuries (NAI) are missed and misdiagnosed in Emergency Departments despite our best efforts to improve the screening of, and responses to, injured children. We also know that the most vulnerable children, infants, are most at risk of non-accidental trauma while at the same time they are the group most at risk of slipping through our injury-detection processes. Inflicted trauma continues to cause unacceptably high rates of mortality and morbidity in young children. Sadly, ‘missed child abuse’ remains almost the same diagnostic challenge it was 20 years ago.
This presentation will critique NAI screening tools and processes, review methods commonly used to detect injury (including EMR-based triggers and alert systems), and highlight gaps in our approaches that continue to place young children at risk of systemic failures around NAI detection and response. Consideration will also be given to the possibility that workflow and workforce pressures escalate risk. An appreciation of new and increasing risks might enable the greatest risks to be mitigated.
In this presentation I will be looking at the issues surrounding the indication for DVT prophylaxis in adult patients requiring lower limb immobilisation after trauma. Specifically, I will be looking to answer questions such as:
What is the evidence of an increased risk of DVT in adult patients requiring lower limb immobilisation after trauma and in reality how high is that risk?
How might we further refine the risk for an individual and are there tools to assist us in this evaluation of risk?
What treatments can be taken to reduce that risk and how effective might they be?
What are the harms of those treatments ( ie: in taking thromboprophylaxis (TP))? And finally:
What are the current barriers to taking such action and what can we do about it?
Even when we think we have acted appropriately, receiving a complaint can be very distressing.
In this talk I will look at the complaints process, what sort of issues lead to complaints, why patients of their families complain, and how to deal with the confronting challenge of receiving complaints.
I will debunk some myths about what can happen after a complaint is received by a regulatory authority and provide advice on how to address the issues in the complaint to help achieve the best outcome.
I have Patients with a history of eating disorders are frequent attenders to Emergency Departments.
The challenges occurring for physicians are to:
identify and treat the immediate medical and psychological threats to life.
manage patients with respect for their autonomy whilst acknowledging their decision making is impacted by low BMI and associated mental health disorders
understanding your duty of care when the patients are declining admission/treatment that we believe to be in their best interest.
These are covered in this presentation in addition to looking forward to your questions and interaction in the session.
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