How is a concussion managed?
Conservative management of concussions is standard practice. Physical and cognitive rest is recommended for at least 24 hours pending cessation of symptoms. Gradual return to work, school, and physical activity is also endorsed. For a person with prolonged symptoms, reevaluation and treatment may be beneficial. (Evans, Concussion and mild traumatic brain injury, 2013) Admission to […]
What is post-concussion syndrome?
One common consequence of concussion is the post-concussion syndrome (PCS), which is a group of symptoms that includes headache, dizziness, decreased concentration, memory problems, irritability, fatigue, visual disturbances, sensitivity to noise, judgment problems, depression, and anxiety. PCS is usually associated with mild traumatic brain injury (TBI), such as a concussion, but may also occur after […]
How is a concussion diagnosed?
The initial diagnosis of concussion is based on evaluation of the symptoms a person reports, or someone else observes, after sustaining the injury. Concussion is commonly divided into three different types: Grade 1, Grade 2, and Grade 3. The chart below distinguishes the features of each: [su_table] Grade Behavior Signs Time 1 Confused but remains […]
What exactly is a concussion?
When a bump, jolt, or blow to the head causes a change in the way the brain works, it is called a concussion. A concussion is a type of traumatic brain injury (TBI) that causes the brain to move quickly back and forth inside the skull. They are sometimes considered “mild” because concussions are not […]
Verbal Abuse in Chemical Restraint
The following case scenario is an examples of the use of chemical restraint: Mr. Jones is a 65 year old man who is being evaluated in the emergency room after a fall with a possible fracture. He is experiencing symptoms of alcohol withdrawal and is yelling and cursing at the staff. The nurses believe that […]
Patient Safety: Policies (Part II)
Policies should be in place to help providers make decisions about impaired patients. The legal matters to consider in developing a policy are breach of confidentiality (Part I, last week), duty to warn, duty to report, and authority to detain (Part II, today). Duty to warn Taken from tort law, this refers to the failure of […]
Patient Safety: Policies (Part I)
Policies should be in place to help providers make decisions about impaired patients. The legal matters to consider in developing a policy are breach of confidentiality (Part I, today), duty to warn, duty to report, and authority to detain (Part II, next week). Breach of confidentiality The federal Health Insurance Portability and Accountability Act (HIPAA) […]
Patient Safety: Documentation
One of the most important actions for medical providers in the situation described last week is meticulous and frequent documentation of every interaction with the patient. All treatment, instructions, evaluations, physical observations, and advice not to leave must be clearly documented in the records. In the New York case, scrupulous documentation was extremely helpful to the defense. […]
Patient Safety: Intoxication Case Scenario
In July, our monthly topic was a typical scenario that a patient will go through when they call 911. This month, we are going to see what happens when a severely intoxicated patient comes into the hospital and what the responsibility of the healthcare providers is in terms of patient safety. We will investigate the legal […]
911 to ER: Discharge
Mrs. Smith receives an EKG, CT scan of the head, a chest x-ray and multiple lab tests that reveal she has had a myocardial infarction (MI), commonly known as a heart attack. A cardiologist is consulted with and it is determined that she has a “stable” MI and she will be admitted for observation and […]
