The mouse slips, and the emergency room doctor clicks on the wrong number, ordering a medication dosage that’s far too large. Elsewhere, in another ER’s electronic health record, a patient’s name isn’t clearly displayed, so the nurse misses it and enters symptoms in the wrong person’s file

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Ask David Ross to describe an average day on the job. He says it doesn’t exist. Ross is a violence intervention specialist at the University of Maryland Medical Center. Though he isn’t a doctor, he’s been working at the hospital as part of its Violence Prevention Program for close to 10 years. His team works with patients who are victims of violent injuries

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When you are very sick or hurt, you know to go to the emergency room. Chances are good that our complex, aggressive medical interventions will make you better. But those odds change dramatically once you have an end-stage chronic medical condition or terminal illness. In that case, you are gambling, and the odds are heavily against you

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Community consultation is the only way to study issues in emergency medicine. “If you require consent for all clinical studies you end up getting into a Catch-22 where you can never systematically learn about anything in an emergency setting,” said Nancy Kass, deputy director of the Johns Hopkins Berman Institute of Bioethics. “A person having a heart attack cannot give consent.”

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