Bouncebacks! Critical Care

This edition of Bouncebacks! Emergency Medicine books examines the bounceback visit, putting the reader in the footsteps of the clinician as the patient deteriorates. The story pauses at important decision points as possible management strategies are reviewed in a literature-based fashion, followed by a revelation of the path chosen by the actual provider. As the patient's course progresses, we reach additional decision points and address further clinical questions. In addition to our chapter authors, many with expertise in critical care emergency medicine, we have an all-star lineup of expert-whisperers: first an EM/critical care section editor (below) and second, EMCRIT.org's double-boarded critical care guru, Scott Weingart. Their comments are inserted in grey boxes and are intended to give tips and tricks borne of experience and to provide context to the literature, 'as if' they are standing over our shoulder and advising during a resuscitation.Additionally, there are three chapters where we address the medical-legal aspects of care. Enter Greg Henry MD, past president of The American College of Emergency Physicians (ACEP) and one of the most experienced physician medical-legal experts in the country. He opines on the approach that both the defense and plaintiff would likely pursue and, by extension, how we can make patients safer through our evaluation and documentation before there is an adverse outcome. Whereas, these chapters contain the actual documentation from the ED chart, a very few chapters have slight modifications to the final aspects of the return visit at decision point 3, to allow for exploration of different critical care scenarios. There is still plenty of commentary on the documentation, missed red-flags, and what could have been done to improve care at the initial visit. Our goal is to make each chapter challenging, dynamic, and realistic... to move us from 'standard of care' to 'excellence in care.'