PUBLISHED May 4, 2017

This white paper is a followup to our three-part Acquired Brain Injury series and explores Cost of Future Care considerations for developing successful long-term care for patients who have suffered a catastrophic brain injury. (Read Part OnePart Two and Part Three.)

BY LINDA SIMMONS, RN BScN

Consultant & Future Cost of Care Expert, Connect Medical Legal Experts

Acquired Brain Injury (ABI) can result from traumatic brain injury (i.e. motor vehicle accidents, falls, assaults, sports, falling objects etc.) and non-traumatic brain injury (i.e. stroke, brain tumours, infection, poisoning, hypoxia, ischemia, or substance abuse). The brain is the body’s control centre and as a result, injury to the brain can result in complication to almost every organ system. 

This article summarizes the potential complications of an ABI, the Cost of Future Care creation process, and goals. Additionally, it provides the reader with an outline of the possible recommendations for goods and services he client will possibly need. 

PUBLISHED April 13, 2017

This white paper is the third of three parts on the complex functions of brain, what happens when an injury is acquired and how to care for and manage a life-changing brain injury. (Read Part One and Part Two.)

BY LINDA SIMMONS, RN BScN

Consultant and Cost of Future Care Expert, Connect Medical Legal Experts

The prehospital care of a patient with a brain injury has a profound impact on the subsequent course of events and outcomes. Prehospital management refers to the initial resuscitation and interventions that stabilize the patient at the scene of the accident and on route to the hospital. Prehospital management requires timely and effective brain resuscitation, as the brain only has minimal reserves to meet ongoing metabolic needs. If resuscitation is insufficient because of reduced cerebral blood flow (CBF) and decreased oxygen delivery, ischemia and hypoxia develop and can lead to secondary brain injury.

Many of the patients who have a Traumatic Brain Injury (TBI) also suffer other life threatening injuries. Advanced Trauma Life Support (ATLS) is a set of standards that has been developed to prepare health care professionals in the effective management of trauma victims. Trained personal are taught to quickly triage and stabilize the patient. Primary and secondary survey is used when assessing the trauma victim. A brief description of primary and secondary survey is presented, and a more in depth discussion of TBI management follows.

PUBLISHED April 6, 2017

This white paper is the second of three parts on the complex functions of brain, what happens when an injury is acquired and how to care for and manage a life-changing brain injury

BY LINDA SIMMONS, RN BScN

Consultant and Cost of Future Care Expert, Connect Medical Legal Experts

TBI refers to any injury to the scalp, skull (cranium or facial bones) or the brain. Injury to the brain can be focal or diffuse. Focal injuries result in contusions, lacerations, or hemorrhages. The hemorrhages that can occur are epidural hematoma, subdural hematoma, intracerebral hematoma, and subarachnoid hemorrhage. The diffuse injury can cause a mild to severe concussion or diffuse axonal injury.

PUBLISHED MARCH 30, 2017

This white paper is the first of three parts on the complex functions of brain, what happens when an injury is acquired and how to care for and manage a life-changing brain injury. (Read Part Two and Part Three.)

BY LINDA SIMMONS, RN BScN

Consultant and Cost of Future Care Expert, Connect Medical Legal Experts

This document will increase the health care professionals understanding of Acquired Brain Injury (ABI). ABI is defined as damage to the brain that is acquired after birth. It can affect cognitive, physical, emotional, social, or independent functioning. ABI is an umbrella term used to describe all brain injuries. ABI can result from traumatic brain injury (i.e. accidents, falls, assaults, etc.) and non-traumatic brain injury (i.e. stroke, brain tumours, infection, poisoning, hypoxia, ischemia or substance abuse).

The motor vehicle related accident clients that we at Connect Experts see with ABI have often resulted from a Traumatic Brain Injury and thus ABI’s that have resulted from a TBI will be the focus of this document.

When your case involves future costs of care, you need an expert to accurately assess your clients’ needs who understands the full spectrum and interplay of medical diagnoses, treatments, medications and client goals. Connect Experts has the perfect expert for this role - Nurse Cost of Future Care consultants.

Mrs. Jefferson* was just like so many other residents living in so many other long-term care homes in Ontario. In her mid eighties and suffering from dementia, she had moved into Happy Hollow* from her home. Over time, her condition had deteriorated to the point where she was no longer walking, communicating or helping with any of her activities of daily living.

In modern litigation, though trials are few and far between, the prospect of eventual trial continues to be the infrastructure around which cases are built. The steps in preparing an expert for trial ensure parties identify the issues in dispute and distill complex matters to the essence. While the specific nature of allowable communication between counsel and experts may differ by jurisdiction, universally the courts will be looking to the expert to be an impartial advisor. The expert's evidence will assist the court in understanding complex technical matters in the decision making process.

The first of 4 of a series of articles prepared for CARE Magazine on the 5 most common allegations associated with nursing negligence lawsuits

When medical errors cause lasting injury, the patient can sue both the doctor and the nurse. This can result in a medical malpractice lawsuit. Nurses who have been through this experience describe it as extremely difficult; as difficult as other catastrophic life events such as death, divorce and job loss. The experience of being sued affected their work life, personal life, health and wellbeing. Emotions such as shock, shame, anger, depression and fear were common. Many nurses felt so isolated by their peers that they left their jobs. You don't want this to happen to you.

Pre-Hospital Care; Recognizing the Injury, Accessing Care

Brain Injury management starts with Emergency Service Providers (Nurses, Doctors, Paramedics, EMT's, First Aid Volunteers). The goal of care is to recognize, treat and transport the brain injured patient by the most appropriate method (ground, lights and sirens, air ambulance). EMS provider responsibilities include;

When a medical malpractice lawsuit occurs, the hospital and all members of the health care team may be named as defendants. This might include the nurses, physicians, nurse practitioners, midwives, ambulance attendants, laboratory technicians, respiratory therapists, nursing and medical students and contracted hospital employees who provided care. Both the plaintiff and defense lawyers may then be required to retain experts from each of the defendant disciplines to provide expert opinion. Although there is no obligation for health care professionals to take on this role, you may be considering it. Many regulatory bodies endorse the professional responsibility to do so. This article will help you learn more about the role and responsibilities of the expert witness.

You've got chills -- they're multiplying. It's 3 a.m. and you've been tossing and turning for hours. An extra blanket could put the shivers to rest, 
but where's the nurse? And the chorus of snores from the next bed is competing with the attention-seeking rumble from your hungry stomach. Aren't hospitals supposed to be places of rest and recovery? Fear and uncertainty can amp up your stress levels and ruin your stay, but don't let them run the show. Our hospital insiders give you the behind-the-scenes scoop on how you can feel more comfortable and in control.

Two years ago, at a conference in Atlanta, a woman from Jamaica excitedly approached me when she learned that my company provided experts for medical malpractice cases. She had been searching for resources to help in her efforts to support victims of medical malpractice in her home country. She shared multiple stories of negligence that were almost unimaginable and confided that although many Jamaican doctors were educated to North American standards, their underfunded, undersupplied and poorly managed public health-care system was struggling greatly, leaving too many patients injured as a result. There was little recourse for injured patients and minimal accountability for health-care providers.

The stories are frequent enough; surgical sponge left inside patient. Surgeon leaves forceps in abdomen. 3 foot guide wire found in patients' chest. Retained surgical items can include sponges, towels, medical device components, surgical instruments, needles, scalpel blades and entire instruments.

They can be discovered months or even years after the initial procedure and cause significant morbidity, serious infection and mortality. The risk is higher for obese patients, during abdominal surgery and lengthy operations involving multiple surgical teams. The risk for retained items is 9-fold higher during emergency surgeries and 4-fold higher when an unexpected change of procedure takes place.

Media

NursesPushingStretcher-smallIt is a busy Monday night in the emergency department.  You've arrived with your 2 year old child. You cannot get in to see your family doctor and she's got a fever of 39.5 C, a sore throat and an earache.Your daughter's crying and miserable. There is a long line up at triage. Eventually you are seen and assessed by a triage nurse and then sent to the waiting room. The waiting room is packed, your child is miserable and you are wondering how long are you going to have to wait for?

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