Man dies of massive heart attack after being sent home from eD A seventy-three-y

Question

Man dies of massive heart attack after being sent home from eD

A seventy-three-year-old man and his wife walked into the ED at 3:00 a.m. He told the nurse at the desk that he was having chest. pain and tingling in his arm. The nurse phoned the physician on duty who was upstairs. The nurse spoke with the doctor, handed the phone to the patient who spoke with the physician for sev- eral minutes, then, handed the phone back to the nurse. The nurse spoke with the physician again, then hung up and told the man and his wife to go home and call his personal physician in the morning. She explained that his insurance did not cover treat- ment at their facility and that the pain and tingling was probably nothing—just old age. The couple left the hospital and walked the three blocks back to their home and up the four flights to their apartment. While taking his shirt off to get into bed, the man had a massive heart attack and died instantly.

For the following case study, create at least one policy or design a procedure to handle the following circumstances.
What is your plan to deal with the staff and the media when this happens at your facility? What preventive plans can be put into place to avoid this happening again? how would you handle this situation during the event?

Explanation / Answer

ED is a dynamic entity of an hospital or an institute, medical health care professional in ED have a challenge to deal with vast range of patients with different medical conditions and not necessarily with visible signs and symptoms, it is a challenging job to aknowledge these cases and bring in a rapid diagnosis with adequate proof like labs and procedures or radiology, many a times patient safety and medical errors the major resons for patient's fatality hence ED needs to have an strict guidlines or protocol for patient safety.

Policy or procedure for walkin emergancy cases in ED

1. Assess patient vitals and condition immediatley after recieving to ED, proper physical examnination time provided is very vital foe any diagnosis,

2. communicate with the patient or relative who has accompanied the patient, try to get a clear data on patient complaints to have a clear plan on his tratment (remember communication is vry important in case of data collection)

3. Assess if patient is in requirment with special needs, it is very important to know the complete past medical history of the patient or throgh EMS

4. Educate the patient about the procedures that needs to be done to have a clear diagnosis

5. Every patient has right to avail health and there are different ways to avail them, if patient has an insurance then need to educate about if the insurance will cover the prodecure or tratment of desease condition in the health care institute.

6. Refer patients to helath care providers where they can get it done in case if they are not able to porivde in their institute or hospital. there are government hospitals that provide the care

7. Patient in ED with nill insurance support can be provided atleast with the basic initial treatment before shifting the patient to a different hospital or health care provider.

8. There should be a an proper inter institutional co-ordination amongst the hospitals which will give a proper and quick treatment of the patient.

9. Nurse and Medical Officers are to be educated about guidlines and protocol of treatment of ED cases. intermittent CNE training that keeps updating knowledge of health care providors.

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Handling this case completely depends on the managment view point, The nurse definitly needs a proper training on protocols and guidlines on patient safety and management,

- Patient details needs to be recorded, and once its recorded a complete data needs to be completed about the patient

- Make sure medical doctor advices are followed, if no advices or unethical issues can raise incident report

Media needs to be handled at the earliest, i would consult the legal advisor of the mangament team and work out a plan of action on how to explain and come out with the truth of the incedence that has been taken place and explain the precautionary measures that are implimented which will not repeat the incedence.

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