Nurse Expert Witness in Emergency Medicine

Specialties & Experience of this Expert Witness

Additional Information

As a current charge nurse, clinical nurse, triage nurse, and Mobile Intensive Care Nurse (MICN) at a Level I Trauma Center, I bring over 23 years of emergency nursing experience, with advanced expertise in triage precision, stroke activation, psychiatric crisis management, and maintaining safety during emergency department overcrowding. I provide comprehensive care coordination from EMS field communication to hospital-based critical decision-making. I am a recognized expert in the triage process, with advanced proficiency in applying the Emergency Severity Index (ESI) to determine clinical urgency and anticipate resource needs. I have extensive experience identifying and preventing triage errors, particularly in high-volume settings where subtle but life-threatening presentations—such as early stroke, sepsis, or myocardial infarction—may be overlooked. I provide expert insight into common pitfalls in triage, including under-triaging of time-sensitive conditions, failure to recognize high-risk vital signs, and delays in escalation that deviate from the standard of care. In stroke care, I apply BEFAST criteria and the NIH Stroke Scale (NIHSS) to recognize and quantify neurologic deficits. I lead and enforce compliance with time-sensitive stroke benchmarks including door-to-physician, door-to-CT, door-to-needle, door-to-stroke team, and CT interpretation. I also treat Central Retinal Artery Occlusion (CRAO) as a true ischemic stroke emergency, activating the stroke team for patients presenting with sudden, painless monocular vision loss to prevent permanent visual loss and assess for embolic etiology. As a Mobile Intensive Care Nurse, I direct paramedics, coordinate incoming ambulance traffic, and ensure prehospital-to-hospital transitions are seamless and clinically optimized. As a charge nurse, I oversee ER operations during critical surges, coordinate staff assignments, and implement safety measures for patients at risk of deterioration, falls, or prolonged delays in care while held in overcrowded waiting areas. I have extensive expertise in psychiatric crisis management, including the initiation and maintenance of 5150 and 5585 legal holds for patients presenting with suicidal ideation, grave disability, or danger to others. I am well-versed in legal detainment protocols and ensure patients with behavioral health needs are kept safe, closely monitored, and managed with appropriate collaboration across psychiatry, security, and law enforcement. With 7+ years of experience as a certified instructor in Crisis Prevention Intervention (CPI) at UCLA Medical Center, I have educated physicians, nurses, and allied health professionals on verbal de-escalation techniques, suicide prevention, restraint safety, and emergency response to behavioral health crises. My combined experience across triage, EMS coordination, clinical leadership, and behavioral health positions me as a nurse expert in emergency department standards of care, particularly in the areas of triage error analysis and prevention, stroke and CRAO activation, psychiatric crisis intervention, ESI application, and safety in overcrowded ER environments.