System Failures and Medical Malpractice – Imagine: A critical care manager accepting a supposedly experienced nurse’s description of her experience and knowledge base gained out an out of state hospital. A critical care manager that supports nurses thinking that they do not need close observation while being precepted. A hospital that has, on staff, surgeons […]
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Inferior Myocardial Infarction Complications When reviewing a case involving chest pain and a resultant diagnosis of Acute Myocardial Infarction an attorney should pay particular attention to the type/area of myocardial infarction the patient sustained. An acute Inferior Myocardial Infarction has certain characteristics that set it apart from other infarcts. While the Inferior Myocardial Infarction itself, […]
Importance of ST-Segment Monitoring Post- Acute Myocardial Infarction When reviewing a chest pain case that has resulted in a diagnosis of Acute Myocardial Infarction it is important to ascertain if the patients ST-segment was monitored post intervention. The following are the indications for ST-Segment monitoring post-Acute Myocardial Infarction: Evaluating post-MI ischemia Evaluating reocclusion after angioplasty […]
Around the year 2008 an agency nurse intubated a patient that was obtunded, had decreased respirations, and decreased oxygen saturation and was ultimately barred from the hospital….What If…that nurse had not performed the intubation and the patient had coded and died. The setting is a level one teaching hospital ICU that has a residency/fellowship program. […]
1. Joint Commission Core Measures for Acute Myocardial Infarction PTCA (percutaneous transluminal coronary angioplasty) with 90 minutes. Fibrinolytic Therapy Received within 30 Minutes of Hospital Arrival. Aspirin given on arrival to facility and prescribed at discharge. ACE inhibitor (Lisinopril, Vasotec, and Captopril are examples) prescribed if EF (ejection fraction) <40%. Beta blocker (Metoprolol and Coreg […]
The discussion in this blog post will continue the discussion of Anatomy of a Chest Pain Case: What Attorneys Must Know to Navigate the Medicine, addressing the different types of Myocardial Infarction, diagnostic testing, and treatment. Please refer to the previous blog post regarding this topic for an introduction to the topic. When a patient […]
I recently reviewed a case where the patient arrested during transport from the Operating Room and due to lack of documentation it was not initially clear whether the patient had been monitored during the transport. I was asked to review the case to determine, essentially, if the standard of care had been breached during transport. […]
The estimated annual incidence of acute myocardial infarction in the United States is 600,000 new cases and 320,000 recurrent attacks. The diagnosis of Acute Myocardial Infarction is made on the basis of a high clinical suspicion based on the history and physical examination findings in addition to changes in cardiac biomarkers and EKG changes. Treatment […]
The nursing assessment is an important tool not only for the nurse performing the assessment but as I tool to determine progress or lack of progress of a patient. As a Legal Nurse Consultant reviewing the nursing record of a patient you also need to determine the accuracy of the assessments. One might suggest that […]
Legally where does the responsibility of the nurse begin and end? If an order that a physician writes causes harm to the patient and the nurse that followed through with the order had the knowledge and experience to know that the order could/would cause harm to the patient, does that nurse not bear some responsibility […]