1
|
Alabdulqader S, Alabdulqader R, Madadin M, Kashif H, Al Jumaan MA, Yousef AA, Menezes RG. Emergency Physicians' Awareness of Medico-Legal Case Management: A Cross-Sectional Study from Saudi Arabia. Saudi J Med Med Sci 2023; 11:60-66. [PMID: 36909002 PMCID: PMC9997858 DOI: 10.4103/sjmms.sjmms_267_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/16/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023]
Abstract
Background Emergency department physicians often encounter medico-legal cases when patients initially present to the hospital, and thus there is a strong need for them to have robust medico-legal management and reporting knowledge. Objective To assess the awareness of emergency department physicians of two major hospitals in the Eastern Province of Saudi Arabia in managing medico-legal cases. Methods This descriptive cross-sectional survey-based study included all adult and pediatric emergency physicians working at King Fahd Hospital of the University and King Fahd Specialist Hospital, two major government hospitals in the Eastern Province of Saudi Arabia. The questionnaire included questions about demographic information, the workload in the emergency department, previous medico-legal training, and information about physicians' perspectives regarding medico-legal situations. Results A total of 85 physicians completed the questionnaire, with most being Saudis (78.8%) and consultants (44.7%). Most participants (84.7%) immediately notified the police authority through the official procedure on suspicion of a case being criminal. However, only 28.2% of the participants were aware of how to complete the medico-legal report, and the majority (82.4%) had not received any specific training or attended specific courses in writing medico-legal reports. Most participants (91.8%) expressed the need for additional medico-legal case training programs, with continuous education (29.4%) being the preferred mode. In addition, 60% of the consultants were dissatisfied with the current medico-legal reporting and management workflow in their hospital. About half of the participants did not obtain photographs in medico-legal cases and did not know if their workplace provided a protocol for collecting evidentiary material such as clothes, swabs, bullets, remnants of foreign bodies, etc. Conclusions The results of the present study indicate the necessity to consider periodical continuing medical education programs and workshops for emergency department physicians in the Eastern Province of Saudi Arabia to help them in appropriately handling medico-legal cases.
Collapse
Affiliation(s)
- Shahad Alabdulqader
- Department of Pathology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rana Alabdulqader
- Department of Pathology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Madadin
- Department of Pathology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Haider Kashif
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mohammed A. Al Jumaan
- Department of Emergency Medicine, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah Abdulsalam Yousef
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ritesh G. Menezes
- Department of Pathology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
2
|
Madadin M, Alqarzaie AA, Alzahrani RS, Alzahrani FF, Alqarzea SM, Alhajri KM, Al Jumaan MA. Characteristics of Medico-Legal Cases and Errors in Medico-Legal Reports at a Teaching Hospital in Saudi Arabia. Open Access Emerg Med 2021; 13:521-526. [PMID: 34880689 PMCID: PMC8648094 DOI: 10.2147/oaem.s341893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction A medico-legal case (MLC) involves any injury or medical condition in which law enforcement agencies investigate and fix the responsibility regarding of an injury or medical condition. Incorrect or incomplete medico-legal reports (MLRs) may trigger a pause or delay in legal proceedings and patients’ rights could be violated. The aim of this study is to describe the characteristics of MLCs and to identify errors in the MLRs. Materials and Methods This retrospective, descriptive study was conducted in a teaching hospital in the Eastern Province of Saudi Arabia. In total, 418 MLRs furnished during a 6-month period and reviewed for characteristics of MLCs and identification of errors. Results A total of 418 MLRs were included in the present study. Fights or physical assault and battery formed the major proportion of MLCs amounting to 83% of MLCs. Blunt injury was the dominant type of injury in most of the cases (81.8%). In relation to errors in MLRs, no MLR in the present study were without errors. Conclusion Fights or physical assault and battery formed the major proportion of MLCs. Multiple errors were identified in the MLRs furnished by the physicians. Writing MLRs must follow standardized guidelines as it has a bearing on legal proceedings and patients’ rights. We recommend training for physicians in writing MLRs in the interest of proper administration of justice.
Collapse
Affiliation(s)
- Mohammed Madadin
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah A Alqarzaie
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rashed S Alzahrani
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal F Alzahrani
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saleh M Alqarzea
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalid M Alhajri
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed A Al Jumaan
- Department of Emergency Medicine, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| |
Collapse
|
3
|
Alshahrani MS, Asonto LP, El Tahan MM, Al Sulaibikh AH, Al Faraj SZ, Al Mulhim AA, Al Abbad MF, Al Nahhash SA, Aldarweesh MN, Mahmoud AM, Almaghraby N, Al Jumaan MA, Al Junaid TO, Al Hawaj FM, AlKenany S, ElSayed OF, Abdelwahab HM, Moussa MM, Alossaimi BK, Alotaibi SK, AlMutairi TM, AlSulaiman DA, Al Shahrani SD, Alfaraj D, Alhazzani W. Study protocol for a randomized, blinded, controlled trial of ketamine for acute painful crisis of sickle cell disease. Trials 2019; 20:286. [PMID: 31133061 PMCID: PMC6537144 DOI: 10.1186/s13063-019-3394-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 05/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is an inherited hematological disorder where the shape of red blood cells is altered, resulting in the destruction of red blood cells, anemia, and other complications. SCD is prevalent in the southern and eastern provinces of the Arabian peninsula. The most common complications for individuals with SCD are acute painful episodes that require several doses of intravenous opioids, making pain control for these individuals challenging. Instead of opioids, some studies have suggested that ketamine might be used for pain control in acute pain episodes of individuals with SCD. This study aims to evaluate whether the addition of ketamine to morphine can achieve better pain control, decreasing the number of repeated doses of opiates. We hypothesize that early administration of ketamine would lead to a more rapid improvement in pain score and lower opioid requirements. METHODS AND ANALYSIS This study will be a prospective, randomized, concealed, blinded, pragmatic parallel group, controlled trial enrolling adult patients with SCD and acute vaso-occlusive crisis pain. All patients will receive standard analgesic therapy during evaluation. Patients randomized to the treatment arm will receive low-dose ketamine (0.3 mg/kg in 0.9% sodium chloride, 100 ml bag) in addition to standard intravenous hydration, while those in the control group will receive a standard dose of morphine (0.1 mg/kg in 0.9% sodium chloride, 100 ml bag) in addition to the standard intravenous hydration. All healthcare providers will be blinded to the treatment arm. Data will be analyzed according to the intention-to-treat principle. The primary outcome is improvement in pain severity using the Numerical Pain Rating Score. TRIAL REGISTRATION Clinicaltrials.gov, NCT03431285 . Registered on 13 February 2018.
Collapse
Affiliation(s)
- Mohammed S Alshahrani
- Emergency and Critical Care Departments, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia.
| | - Laila Perlas Asonto
- Emergency and Critical Care Departments, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Mohamed M El Tahan
- Anesthesia Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, Kingdom of Saudi Arabia, Mansoura University, Mansoura, Egypt
| | - Amal H Al Sulaibikh
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Sukayna Z Al Faraj
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Abdullah A Al Mulhim
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Murad F Al Abbad
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Samar A Al Nahhash
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Moath N Aldarweesh
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Alaa M Mahmoud
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Nisreen Almaghraby
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Mohammed A Al Jumaan
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Thamir O Al Junaid
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Faisal M Al Hawaj
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Samar AlKenany
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Omaima F ElSayed
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Haitham M Abdelwahab
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Mohamed M Moussa
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Bader K Alossaimi
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Shaikah K Alotaibi
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Talal M AlMutairi
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Duaa A AlSulaiman
- Pharmacy Department, King Fahad Hospital of the University, AlKhobar, Kingdom of Saudi Arabia
| | - Saad D Al Shahrani
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Donia Alfaraj
- Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University-Dammam, AlKhobar, Kingdom of Saudi Arabia
| | - Waleed Alhazzani
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| |
Collapse
|