emergency room essay

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This essay outline paper seeks to analyze the considerable higher rates of utilization of the emergency room in the Canadian health sector compared to other industrialized nations. The analysis will be carried out systematic to identify and point out the current issues affecting the health sector in Canada. These issues are the ones that will be finally discussed in the final research paper upon approval of the essay outline.

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One of the most common diseases in the world today is diabetes. The statistics show that in the year 2000, it was prevalent in approximately 180 million people, and the figure is rapidly increasing and reaching epidemic proportions (1). This increase is constantly being associated with higher mortality rates. However, early diabetes and pre-diabetes screening may assist in the reduction of complications arising from diabetes. Point of Care Testing (POCT) is one way of bringing diagnostic tests and associated therapeutic actions to the patients, and thus aid in controlling the spread of diabetes (2).

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Medication Error in the Emergency Room Essay

The emergency department (ED), sometimes termed the emergency room (ER), emergency ward (EW), accident & emergency (A&E) department or casualty department is a hospital or primary care department that provides initial treatment to patients with a broadspectrum of illnesses and injuries, some of which may be life threatening and requiring immediate attention. Emergency departments developed during the 20th century in response to an increased need for rapid assessment and management of critical illnesses. In some countries, emergency departments have become important entry points for those without other means of access to medical care.

Upon arrival in the ED, people typically undergo a brief triage, or sorting, interview to help determine the nature and severity of their illness. Individuals with serious illnesses are then seen by a physician more rapidly than those with less severe symptoms or injuries. After initial assessment and treatment, patients are either admitted to the hospital, stabilized and transferred to another hospital for various reasons, or discharged.

The staff in emergency departments not only includes doctors, but physician assistants (PAs) and nurses with specialized training in emergency medicine and in house emergency medical technicians, respiratory therapists, radiology technicians, Healthcare Assistants (HCAs), volunteers, and other support staff who all work as a team to treat emergency patients and provide support to anxious family members. The emergency departments of most hospitals operate around the clock, although staffing levels are usually much lower at night. Since a diagnosis must be made by an attending physician, the patient is initially assigned a chief complaint rather than a diagnosis. This is usually a symptom: headache, nausea, loss of consciousness. The chief complaint remains a primary fact until the attending physician makes a diagnosis.

Patients arrive at emergency departments in two main ways: by ambulance or independently. The ambulance crew notifies the hospital beforehand if they are transporting a severely ill patient, and if the patients condition warrants, a physician may direct the ambulance crew to begin treatment while still en route. These patients are rushed to the emergency department’s resuscitation area, where they are met by a team with the expertise to deal with the patients’ conditions. For example, patients with major trauma are seen by a trauma team consisting of emergency physicians and nurses, a surgeon, and an anestheologist.

Patients arriving independently or by ambulance are typically triaged by a nurse with training in emergency medicine. Patients are seen in order of medical urgency, not in order of arrival. Patients are triaged to the resuscitation area, majors area, or minors area. Emergency/Accident and Emergency departments usually have one entrance with a lobby and a waiting room for patients with lessurgent conditions, and another entrance reserved for ambulances.

Medication errors can and do occur in all clinical settings. However, the complexity and fast-paced nature of care provided in the emergency department (ED) enhance the probability of errors occurring. Studies reporting medication errors in the ED setting have typically been limited to only one ED.

Data collected through USP’s two national voluntary medication error-reporting programs -MEDMARX and the Medication Errors Reporting (MER) Program—represent one of the largest reviews of ED errors reported from multiple facilities. (MER is presented in cooperation with the Institute for Safe Medication Practices.) An analysis of medication error records from both MER (1991-June 2003) and MEDMARX (calendar year 2002) uncovered 3,516 records of errors in the ED.

EDs were ranked as the fifth leading location of medication error in calendar year 2002. More than 300 unique facilities collectively reported more than 3,440 medication errors. The majority (94.8%) of errors did not result in patient harm. However, 5.2% did result in various levels of harm, with two fatalities reported.

Improper dose/quantity and prescribing errors (27%/22%) were the most common types of error committed (see Table 1). Performance deficit was cited as the leading cause of error (see Table 2). There were nearly 400 unique products reported, with heparin at 7.6% the most common drug reported in a medication error. Heparin was followed by ceftriaxone (3.0%), insulin (2.9%), meperidine (2.4%), and levofloxacin (2.4%). Patients appeared to receive medications for which they had previously reported allergies.

Medication errors and emergency room statistics reveal that emergency room departments have a greater rate of medication errors than any other facet of health care services. Patients in need of emergency room care are often those with the greatest need for urgent and proper care. The United States Pharmacopeia (USP) released the results of a major study regarding medication errors and emergency room cases in 2003. Since 1998, over 360,000 medication errors occurring in emergency rooms have been reported to the USP database. In 2001 alone, more than 2,000 cases of medication errors and emergency room cases were reported to the agency.

Timing is of the essence in emergency room situations and medications often need to be administered quickly and correctly. This haste, paradoxically, is one of the major causes of medication errors and emergency room departments need to have an efficient protocol in order to avoid these mistakes. The USP found that 23 percent of medication errors in emergency rooms were intercepted before they reached the patient, compared to 39 percent in other areas of hospital service. The combination of great pressures, a high speed and stressful environment, interruptions, and other complications makes medication errors in emergency rooms all the more likely. This fact, however, does not mitigate a patient’s right to receive prompt and appropriate medical care.

In terms of medication errors and emergency room situations, there are many different times at which an error can take place. There are three major types of errors that the USP have identified in the emergency room setting. Prescribing errors involve a physician’s failure to prescribe the correct medication. Omission errors involve a health care professional’s failure to administer a prescribed medication. Improper dosage errors occur when a patient receives the incorrect dose of a medication.

Medication errors can also occur when the wrong medication is administered altogether. Another consideration regarding medication errors and emergency rooms is a patient’s medical history, including current medications and known allergies. If overlooked, these can cause or contribute to medication errors and subsequent injuries. Communication breakdown among medical staff can also result in missed doses or duplicate doses of a medication.

There are steps that consumers can take to reduce the likelihood of medication errors in emergency room situations. Keeping a list of allergies and current medications can help avoid medication errors. Ultimately, it is the responsibility of medical professionals to administer the proper dose of a medication at the appropriate time. When medication errors occur in emergency rooms, they increase a patient’s risk for suffering injury and even death as a result of this medical negligence.

If you or a loved one has been injured as a result of medication errors in a health care setting, you may be eligible to seek compensation for your losses through a medical malpractice lawsuit. For more information on medication errors and emergency room cases, you may wish to contact a well qualified and knowledgeable attorney.

Based on these findings, the following conclusions can be drawn:

• Nearly 6% of the errors resulted in some form of harm.
• Distractions were the leading contributing factor to errors.
• Omission errors were associated with patient deaths.
• Errors involving improper dose/quantity (wrong dose) were associated more often with harmful outcomes than any other type of error.
• Emily S. Patterson, Richard I. Cook, David D. Woods, Marta L. Render, “Examining the Complexity Behind a Medication Error: Generic Patterns in Communication”. Web.
• David G. Schulke, “IOM Medication Error Identification and Prevention Study”. Web.
• John P. Santell, “USP Patient Safety CAPSLink”. Web.
• Michael R. Cohen, “ISMP Medication Error Report Analysis”. Web.
• David P. Phillips., Jason R. Jarvinen, and Rosalie R. Phillips, “A Spike in Fatal Medication Errors at the Beginning of Each Month”. Web.
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IvyPanda. (2021, August 14). Medication Error in the Emergency Room. https://ivypanda.com/essays/medication-error-in-the-emergency-room/

"Medication Error in the Emergency Room." IvyPanda , 14 Aug. 2021, ivypanda.com/essays/medication-error-in-the-emergency-room/.

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September 22, 2016

Temple University ER doctor's 'losing a child' NYT essay attracts many readers

Naomi Rosenberg, a Temple University Hospital doctor, talks to students at the Lewis Katz School of Medicine

A heart-wrenching essay about what it's like to tell a mother that her child is dead, which was the most read on the New York Times' website for about 24 hours, came from the mind of Naomi Rosenberg's who learned the advice in a North Philadelphia hospital.

Rosenberg is an emergency room doctor at Temple University Hospital and an assistant professor of emergency medicine. Her piece, "How to Tell a Mother Her Child is Dead" was published in the newspaper on Sept. 3.

“One of the things we see a lot is people who lose a family member, so I wrote about my experience participating in that process,” she told Temple University . “And as much as anything, the essay is about violence and violence prevention.”

Rosenberg enrolled in a nonfiction writing workshop after she finished uher residency at Temple Hospital.

The full essay can be read on the New York Times' website, but here's an excerpt:

If the mother has another son with her and he has punched the wall or broken the chair, do not be worried. The one that punched the wall or broke the chair will be better than the one who looks down and refuses to cry. The one who punched the wall or broke the chair will be much easier than the sister who looks up and closes her eyes as they fill. Security is already outside the room and when they hear the first loud noise they will know to come in. No, you will not have to tell them. They know about the family room in the emergency department in summer in North Philadelphia. It is all right. They will be kind. If the chair cannot be sat in again that is all right. We have money for new chairs every summer. If he does not break your chair you stay in your chair. If he does you find a new place to sit. You are here for the mother and you have more to do.

The university also launched a "Narrative Medicine" program that focuses on "the human side" of the industry that's headed by Pulitzer-Prize winning writer Michael Vitez, who has medical students write stories like Rosenberg's.

Amazing and powerful piece of writing by a Temple ER doc. An incredible debut by Dr. Naomi Rosenberg! https://t.co/FuluYtc3gc — michael vitez (@michaelvitez) September 4, 2016

"... building this program will be a great opportunity, especially at a place like Temple, which is in the heart of North Philadelphia and serves one of the poorest communities in America," Vitez writes on his website . "I want to share my storytelling skills, my appreciation for stories, with the students, and help them develop theirs. I want to encourage the students to write and reflect, to process their experiences and express their feelings."

Beautiful, powerful, imaginable writing @nytimes How to Tell a Mother Her Child Is Dead https://t.co/WSyIS1C1yb — Yvonne Ivey, MLIS (@ypivey) September 20, 2016

Beautifully written piece about the most painful part of a doctor's job https://t.co/WOSX9HBtKA — Keerea Mazz (@kmazz007) September 17, 2016

NSFW because it will rip your heart out. How to Tell a Mother Her Child Is Dead https://t.co/NQCJOS0tyt — Ty Graham (@tygraham) September 19, 2016

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Man sets himself on fire outside Trump courthouse

• Updated: Apr. 19, 2024, 3:42 p.m. |
• Published: Apr. 19, 2024, 1:42 p.m.

New York Police officers inspect a backpack left at the scene where a man lit himself on fire in a park outside Manhattan criminal court, Friday, April 19, 2024, in New York. Emergency crews rushed away a person on a stretcher after fire was extinguished outside the Manhattan courthouse where jury selection was taking place in former President Donald Trump's hush money criminal case. (AP Photo/Mary Altaffer) AP

• Kevin Manahan | NJ Advance Media for NJ.com

As MSNBC reporter Yasmin Vossoughian was announcing on live TV that the jury for Donald Trump’s hush-money trial had been seated, with all six alternates, she announced in horror that a man had set himself on fire across the street from where she was reporting outside the Manhattan courthouse on Friday.

With tensions running high because of the first criminal trial for an ex-president, Vossoughian reported in horror as spectators rushed to assist the man and extinguish the fire, which Vossoughian said was about 50 feet from her. The incident occurred at approximately 1:40 p.m. inside an area set aside for demonstrators.

It is unknown whether the man was protesting the trial. He was taken to a hospital, where he was in critical condition in the burn unit, police said at a news conference later in the day.

It was the climax of an intense day inside the courtroom that resulted in two jurors breaking down in tears and three being excused after expressing anxiety about being on the case.

“We have our full panel,” Judge Juan Merchan declared after the last of the six alternates were added. They will serve alongside the panel of 12 jurors, and the completed jury sets the stage for opening statements to begin Monday.

Within minutes of Merchan’s declaration, the fire was lit. With flames leaping toward the sky, police raced in to put out the fire with extinguishers. Emergency personnel were summoned and arrived quickly. EMT personnel took the man away on a stretcher. Vossoughian reported that the man could move his limbs.

“There was no threat to anyone else in the area,” Vossoughian reported. “He was standing alone. People were yelling he was on fire.”

Laura Coates from CNN , also reporting from outside the courthouse, watched the incident unfold:

“We have a man who has set himself on fire, a man has been emblazoned himself outside of the courthouse just now,” she shouted during a live report. “Our cameras are turning right now. A man has now lit himself on fire outside of the courthouse in Manhattan.

“We are watching a man who is fully emblazoned in the front of the courthouse today. We are watching multiple fires breaking out around his body and person. We have seen an arm that has been visible that has been engulfed in total flames. There is chaos that is happening. ... I’m looking across the corner, across the courtyard. There is a man racing towards him, there’s coats coming off to try to put out the fire.

“We have members of security details. NYPD is rushing to the scene. They are trying to come now ... officers are on the scene with fire extinguishers right now. They are trying to put this man out. They’re climbing over barricades to try to separate the public and put out the flames on this man. He has lit himself out in fire in front of the courthouse right now.”

According to The Associated Press:

Emergency crews rushed away a person on a stretcher after fire was extinguished outside the Manhattan courthouse where jury selection was taking place Friday in Donald Trump’s hush money criminal case.

No other details were immediately available from police.

It’s unknown whether Merchan, who is presiding over the case, Trump or the jurors were aware of the incident, which occurred amid heavy security. The jurors had been dismissed for the day.

“There’s some irony in the fact that in this heavily fortified courthouse behind us that someone was able to so easily self harm,” MSNBC legal analyst Lisa Rubin said from outside the courthouse. “With all of this spectacle and all this security around them — and to what extent the jurors are aware of this, we can’t say we don’t know, but obviously we want to. And after we come back from the break. If the proceedings are called, we’ll come back out here and we’ll share that as soon as we can.”

In the afternoon session, prosecutors will argue for the judge to admit prior acts by Trump that they believe are relative to the case. The hearing is designed to inform defendants of the scope of questions they could face from prosecutors on cross-examination if they choose to take the witness stand in their own defense.

Manhattan District Attorney Alvin Bragg’s office disclosed in a court filing that it would ask Trump about more than a dozen items, including a $464 million civil judgment against him and his company for fraud, $88 million verdicts and liability findings for sexual abuse and defamation in lawsuits brought by writer E. Jean Carroll, and a number of other adverse court rulings. Merchan will rule on what’s allowable.

One of the prospective jurors who broke down in tears told the court: “I feel so nervous and anxious right now. I’m so sorry. I wouldn’t want someone who feels like this to judge my case, either. I don’t want to waste the court’s time.”

The trial centers on a $130,000 payment that Michael Cohen , Trump’s former lawyer and personal fixer, made to porn actor Stormy Daniels to prevent her claims of a sexual encounter with Trump from becoming public in the final days of the 2016 race.

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4 Men Showing Signs of Beating Charged With Terrorism After Moscow Attack

The four accused of carrying out an assault at a concert hall near Moscow are migrant laborers from Tajikistan. They face a maximum sentence of life in prison.

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By Neil MacFarquhar

• March 24, 2024

The four men suspected of carrying out a bloody attack on a concert hall near Moscow, killing at least 137 people, were arraigned in a district court late Sunday and charged with committing a terrorist act.

The four, who were from Tajikistan but worked as migrant laborers in Russia, were remanded in custody until May 22, according to state and independent media outlets reporting from the proceedings, at Basmanny District Court. They face a maximum sentence of life in prison.

The press service of the court only announced that the first two defendants, Dalerjon B. Mirzoyev and Saidakrami M. Rachalbalizoda, pleaded guilty to the charges. It did not specify any plea from the other two, Mediazona, an independent news outlet, reported.

The men looked severely battered and injured as each of them was brought into the courtroom separately. Videos of them being tortured and beaten while under interrogation circulated widely on Russian social media.

Muhammadsobir Z. Fayzov, a 19-year-old barber and the youngest of the men charged, was rolled into the courtroom from a hospital emergency room on a tall, orange wheelchair, attended by a doctor, the reports said. He sat propped up in the wheelchair inside the glass cage for defendants, wearing a catheter and an open hospital gown with his chest partially exposed. Often speaking in Tajik through a translator, he answered questions about his biography quietly and stammered, according to Mediazona.

Mr. Rachabalizoda, 30, had a large bandage hanging off the right side of his head where interrogators had sliced off a part of his ear and forced it into his mouth, the reports said, with the cutting captured in a video that spread online.

The judge allowed the press to witness only parts of the hearings, citing concerns that sensitive details about the investigation might be revealed or the lives of court workers put at risk. It is not an unusual ruling in Russia.

Russia’s Federal Security Services announced on Saturday that 11 people had been detained, including the four charged men, who were arrested after the car they were fleeing in was intercepted by the authorities 230 miles southwest of Moscow.

In the attack, on Friday night, four gunmen opened fire inside the hall just as a rock concert by the group Piknik was due to start. They also set off explosive devices that ignited the building and eventually caused its roof to collapse. Aside from the dead, there were 182 injured, and more than 100 remain hospitalized, according to the regional health ministry.

President Vladimir V. Putin used the fact that the highway where the men were detained leads to Ukraine to suggest that the attack was somehow linked to Ukraine’s war effort. But the United States has said repeatedly that the attack was the work of an extremist jihadi organization, the Islamic State, which claimed responsibility.

The first charged, Mr. Mirzoyev, who had a black eye and cuts and bruises all over his face, leaned for support against the glass wall of the court cage as the charge against him was read. Mr. Mirzoyev, 32, has four children and had a temporary residence permit in the southern Siberian city of Novosibirsk, but it had expired, the reports said.

Mr. Rachabalizoda, married with a child, said he was legally registered in Russia but did not remember where.

The fourth man charged, Shamsidin Fariduni, 25, married with an 8-month-old baby, worked in a factory producing parquet in the Russian city of Podolsk, just southwest of Moscow. He had also worked as a handyman in Krasnogorsk, the Moscow suburb where the attack took place at Crocus City Hall, at a concert venue within a sprawling shopping complex just outside the Moscow city limits.

The Islamic State has been able to recruit hundreds of adherents among migrant laborers from Central Asia in Russia who are often angry about the discrimination they frequently face.

Alina Lobzina , Paul Sonne and Milana Mazaeva contributed reporting.

Neil MacFarquhar has been a Times reporter since 1995, writing about a range of topics from war to politics to the arts, both internationally and in the United States. More about Neil MacFarquhar

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Resuming U.S. Military Aid: Much-needed munitions like artillery shells could start arriving relatively quickly , but experts say it could take weeks before U.S. assistance has a direct impact on the war . What would $60 billion buy ?

A Race to Hold the Line: The days of lightning battlefield breakthroughs  may be over. With Russia preparing to make a big push, the Ukrainians can do little but dig in.

Life in Ukrainian Villages: Russian assaults have all but destroyed the factories and plants that were the economic lifeblood  of the towns and cities in Ukraine’s east.

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