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Letters to All 50 Governors Calling for Protections for EPs from Malpractice during COVID-19
Dear Governor,The American Academy of Emergency Medicine represents over 8000 emergency physicians and emergency medicine residents across America, and is the only professional society for the doctors who staff our nation’s emergency departments that restricts membership to board-certified speciali …
COVID-19, Public Policy Statements
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AAEM Position Statement on the Firing of Dr. Ming Lin by TeamHealth and PeaceHealth St. Joseph Medical Center
According to public statements, TeamHealth and PeaceHealth St. Joseph Medical Center have terminated Dr. Ming Lin. If this is so, AAEM condemns TeamHealth and PeaceHealth St. Joseph Medical Center for terminating Dr. Ming Lin an emergency physician who went public with his concerns over the safety …
EM Workforce, Position Statements
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Background
Emergency physicians and other frontline clinicians are facing shortages of adequate PPE around the country amidst the COVID-19 pandemic.1 In response, they are addressing this through non-traditional means by self-supplying industrial devices meeting NIOSH standards. Unfortunately, there are numero …
Other Issues, Position Statements
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Merit Badge Requirements for Hospital Privileges During COVID-19
AAEM Signs on to Joint Statements Regarding COVID-19 Merit Badge Requirements for Hospital Privileges During COVID-19 (3/23/2020) Solidarity of Purpose to Confront COVID-19 (PDF)
COVID-19, Joint Statements
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Solidarity of Purpose to Confront COVID-19
To our fellow citizens, friends, and families, We are faced today with a health care crisis the likes of which we’ve never before encountered. This rapidly spreading pandemic will require everyone to do their part to slow and eventually stop its spread. Everything turns on our willingness to w …
COVID-19, Joint Statements
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AAEM Position Statement on Ensuring that Frontline Personnel Can Provide for their Families
Many frontline healthcare workers are being appropriately asked to self-quarantine at home after potential exposures. While employees often have vacation or sick leave time, independent contractors do not. Given the personal risk frontline healthcare workers are taking to help fight this pandemic, …
COVID-19, Position Statements
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AAEM Position Statement Advocating for Immunity From Malpractice Litigation During the COVID-19 Pandemic
In light of the COVID-19 pandemic, physicians are being asked to make difficult clinical decisions with limited resources. Patient care decisions that may be best for an individual patient may not be feasible or appropriate when viewed in context of the entire population. On March 13, 2020, Preside …
COVID-19, Position Statements
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AAEM Position Statement on Use of Self-Supplied PPE
AAEM believes that emergency physicians are entitled to wear self-supplied PPE including respirators that meet NIOSH standards when, in their medical opinion, hospital or healthcare facility supplied PPE is inadequate. AAEM will offer support to any emergency physician threatened or terminated f …
Healthcare Delivery, Position Statements
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AAEM Position Statement on Protections for Emergency Medicine Physicians during COVID-19
Adequate Personal Protective Equipment (PPE) AAEM supports the right of all physicians, nurses, physician assistants and first responders providing direct care to patients potentially infected with the novel coronavirus (COVID-19) to be provided with adequate personal protective equipment (PPE). …
COVID-19, Position Statements
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Federal Trade Commission: Non-Competes in The Workplace: Examining Antitrust and Consumer Protection Issues
Dear Chairman Simons:This letter is sent in response to the Federal Trade Commission’s (FTC) January 9, 2020 workshop concerning Non-Competes in the Workplace. The American Academy of Emergency Medicine (AAEM) welcomes any relief the FTC may bring to the unfair use of non-compete clauses in the e …
EM Workforce, Public Policy Statements
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AAEM and AAEM/RSA Position Statement on Emergency Medicine Training Programs for Non-Physician Practitioners
The American Academy of Emergency Medicine (AAEM) and the AAEM Resident and Student Association (AAEM/RSA) are aware that academic and other emergency departments sponsor additional training for non-physician practitioners (NPP), including physician assistants (PA) and nurse practitioners (NP). We …
EM Workforce, Position Statements
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Statement on the Edward-Elmhurst Health Firing of Physicians and Replacement with Non-Physician Providers
The American Academy of Emergency Medicine is expressing it concerns over the recent firing of 15 physicians from the urgent care centers operated by Edward-Elmhurst Health in Chicago. The Academy represents board-certified emergency physicians, some of whom practice in urgent care settings, and mos …
EM Workforce, Position Statements
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What Evaluations Are Needed in the Emergency Department Patients after a TASER Device Activation?
Reviewed and approved by the AAEM Board of Directors. (10/7/2019) Recommendations: The routine performance of EKGs, prolonged ED observation or hospitalization for ongoing cardiac monitoring is not indicated after CEW exposure in an otherwise asymptomatic awake and alert patient with a s …
Clinical Practice Statements, Other Issues
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Management of Opioid Use Disorder in the Emergency Department: A White Paper Prepared for AAEM
Over 2 million Americans misuse prescription or illicitly-obtained opioids, and opioid overdose deaths rose to a record 47,600 in 2017, representing a nearly 600% increase in 18 years. (NCHS 2019, NIH 2019) Because patients with opioid use disorder (OUD) are often socioeconomically and functionally …
Other Issues, Pain & Addiction, Position Statements
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Balance Billing and Out of Network Charges
Position Any regulations or laws that restrict out-of-network fees and balance billing from the emergency department should provide that insurers reimburse emergency physicians for their professional services at rates consistent with “usual and customary charges.” The “usual and c …
EMTALA, Position Statements
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Position Statement on the Role of Freestanding Emergency Centers in Natural Disaster
The role of the freestanding emergency department is to serve the community and to provide surge protection in the event of a natural disaster. That being said, the freestanding emergency center should only stay open IF POSSIBLE. This decision should be made based on a predetermined disaster plan wh …
EM Workforce, Position Statements
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Should Antiemetics be Given Prophylactically with Intravenous Opioids While Treating Acute Pain in the Emergency Department?
Parenteral opioids are the most common analgesics used in the emergency department (ED) for relief of acute pain. Gastrointestinal side effects such as nausea and vomiting are common following opioid analgesia in long-term therapy for malignant and chronic pain and are considered a limiting factor …
Clinical Practice Statements, Other Issues
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What Is the Role of Intravenous and Intraoral Contrast in CT Evaluation of Acute Appendicitis?
Reviewed and approved by the AAEM Board of Directors. (6/7/2019) IntroductionPatients presenting to the emergency department (ED) with abdominal pain and concern for appendicitis typically require diagnostic imaging to confirm the diagnosis. Computer tomography (CT), magnetic resonance imaging ( …
Clinical Practice Statements, Other Issues
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AAEM Position Statement on the Emergency Medicine Workforce
AAEM is concerned with the rapid growth in the emergency medicine workforce, fueled by the accelerating growth in emergency medicine residencies, as well as the increasing number of advanced practice providers. AAEM notes that the historic emergency physician shortage is rapidly resolving, and …
EM Workforce, Position Statements
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The Use of qSOFA in the Emergency Department
Introduction:The concept of sepsis has recently been redefined by an International Task Force. The task force recommended the use of the qSOFA score instead of SIRS criteria to identify patients at high risk of mortality from sepsis outside of the ICU, including in Emergency Departments. However, t …
Clinical Practice Statements, Other Issues
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Updated Position Statement on Non-Physician Practitioners
The American Academy of Emergency Medicine (AAEM) believes that emergency department (ED) patients should have timely and unencumbered access to the most appropriate care led by a board certified emergency physician (ABEM or AOBEM). AAEM and AAEM/RSA oppose the expansion of scope of practice regulat …
EM Workforce, Position Statements
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What is the Role of Thrombolysis in Intermediate Risk Pulmonary Embolism? with references
Reviewed and approved by the AAEM Board of Directors (11/28/2018) IntroductionPulmonary embolism (PE) remains a leading cause of cardiovascular mortality1 resulting in an estimated 150,000 deaths annually2 in the United States. With a 3-month mortality rate of 9-15%,3,4 PE presents an important …
Clinical Practice Statements, Other Issues
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Is Lactate Measurement in the Emergency Department Valuable as a Predictor of Poor Outcomes in Adult Patients with Sepsis?
Reviewed and approved by the AAEM Board of Directors (11/28/2018) Introduction Current emergency department (ED) management of sepsis includes serial measurements of serum lactate. Since the initial publication of the Surviving Sepsis Campaign Guidelines and the landmark study by Rivers and coll …
Clinical Practice Statements, Other Issues
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Position Statement on Inquiries about Diagnosis and Treatment of Mental Disorders in Connection with Professional Licensing and Credentialing
AAEM endorses the following points regarding inquiries about diagnosis and treatment of mental disorders in connection with professional licensing and credentialing: AAEM believes that state licensing boards and credentialing organizations should require physicians to disclose mental disorders on …
Credentialing & Qualifications, Position Statements
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Emergency Departments Utilizing a “Provider in Triage”
Emergency departments utilizing a “provider in triage” model should: Ensure that providers have an opportunity to perform an appropriate history and physical prior to ordering diagnostic testing; Conduct appropriate reviews to verify that over-testing is not occurring from triage bas …
Other Issues, Position Statements
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Emergency Treatment and Discharge of Patients with Psychiatric and Social Problems
AAEM endorses the following points regarding the emergency treatment and discharge of patients with psychiatric and/or social problems: AAEM believes that all ED patients should be discharged under conditions that are safe and account for their personal dignity. AAEM encourages communities to es …
Healthcare Delivery, Position Statements
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Options for Submitting a Board Approved CPC Paper for JEM Consideration
Submit the paper in initial format as written by the author(s) to Dr. Gary Vilke, our JEM "expediter.” He can send it to the appropriate editor for expedited review. (no sharing of authorship with this route and it is presumably not as involved as getting it published as an outsider sen …
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Position Statement on Electronic Medical Records (EMRs)
The introduction of the electronic medical records system into the practice of medicine has brought great benefits and presented great challenges to the doctor patient relationship. &nbs …
Other Issues, Position Statements
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Position Statement on Emergency Physician-to-Patient ED Staffing Ratios
Whereas the volume of ED visits continues to rise and now exceeds 100 million in the United States annually; and Whereas the scope of Emergency Medicine requires a high intensity of service for many conditions, especially during the first hour of treatment; and Whereas emergency medicine involves …
EM Workforce, Position Statements
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Joint Policy Statement Against Medical Merit Badges
The American Board of Emergency Medicine (ABEM) and the American Osteopathic Board of Emergency Medicine (AOBEM) define the standards for the specialty of Emergency Medicine. Certification by ABEM or AOBEM obviates any additional certifications required for medical staff privileges or disease-specif …
Credentialing & Qualifications, Position Statements
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AAEM White Paper on Acute Pain Management in the Emergency Department
AAEM White Paper on Acute Pain Management in the Emergency Department Sergey Motov, MD FAAEM Reuben Strayer, MD FRCP FAAEM Bryan Hayes, PharmD Mark Reiter, MD MBA FAAEM Steven Rosenbaum, MD FAAEM Melanie Richman, MD FAAEM Zachary Repanshek, MD FAAEM Scott Taylor, MBBS Benjamin Friedman, MD F …
Pain & Addiction, Position Statements
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AAEM Endorses the ACP Policy Recommendations on Reducing Administrative Tasks
These recommendations by ACP are free, non-specialty specific and promote removing obstacles and distractions from providing actual care and improving quality of health care. These recommendations can be referenced by AAEM members for use in their home institutions with a goal of putting clinical ca …
Endorsed Statements, Practice Rights
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Position Statement on Oversight and Management of Emergency Medicine Residency Programs by Contract Management Groups
AAEM opposes the oversight and management of emergency medicine residency programs by contract management groups with lay ownership. AAEM is concerned that this arrangement raises significant conflicts of interests between a residency program's educational mission and the contract managemen …
Other Issues, Position Statements
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During the Emergency Department Evaluation of a Well Appearing Neonate with Fever, Should Empiric Acyclovir be Initiated?
Reviewed and approved by the AAEM Board of Directors (7/10/2017) IntroductionDuring the assessment of a febrile neonate, defined as less than 28 days of age, initiation of a full septic work-up including blood, urine and cerebrospinal fluid (CSF) analysis followed by administration of broad spec …
Clinical Practice Statements, Other Issues
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What is the Role of Reversal Agents in the Management of ED Patients with Dabigatran-Associated Hemorrhage?
Reviewed and approved by the AAEM Board of Directors (6/7/2017) IntroductionDabigatran was approved by the Food and Drug Administration (FDA) in 2010 and was the first nonwarfarin oral anticoagulant (NOAC) to be introduced to the U.S. market. Dabigatran is a direct thrombin inhibitor that inhibi …
Clinical Practice Statements, Other Issues
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Can an Age-Adjusted D-Dimer be Used to Safely Rule Out Pulmonary Embolism in Emergency Department Patients?
Reviewed and approved by the AAEM Board of Directors (3/20/2017) Introduction: Pulmonary embolism (PE) is a serious, potentially fatal condition, but is difficult to safely rule out using only clinical features. Studies have demonstrated that a combination of risk-stratification and D-dimer test …
Clinical Practice Statements, Other Issues
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Ultrasound for the Diagnosis and Management of Ureterolithiasis in the Emergency Department
Reviewed and approved by the AAEM Board of Directors (3/17/2017) IntroductionThe work-up of uncomplicated suspected ureterolithiasis has been shown to be expeditious when ultrasound is the diagnostic modality of choice. Classically, a non-contrast cat scan (CT) of the abdomen and pelvis has been …
Clinical Practice Statements, Other Issues
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What is the Preferred Resuscitation Fluid for Patients with Sepsis and Septic Shock?
Reviewed and approved by the AAEM Board of Directors (3/17/2017). Answer: Crystalloid solutions remain the resuscitative fluid of choice for patients with sepsis and septi shock. Balanced crystalloid solutions may improve patient-centered outcomes and should be considered as an alternative to 0. …
Clinical Practice Statements, Other Issues
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tPA and Ischemic Stroke: Focused Update of 2010 Clinical Practice Advisory from the AmericanAcademy of Emergency Medicine
Reviewed and approved by the AAEM Board of Directors (3/17/2017) Executive Summary:No new studies published between 2010 and 2016 meaningfully reduced uncertainty regarding our understanding of the benefits and harms of tPA for acute ischemic stroke. Discussions regarding benefit and harm should …
Clinical Practice Statements, Other Issues
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AAEM Position Statement on Follow-Up Care
Position Statement: Emergency Physicians are Not Responsible for Providing Routine Follow-Up Care and Screening It is the position of The American Academy of Emergency Medicine that follow-up care is beyond the scope of practice of emergency physicians and that care in the Emergency Depar …
Healthcare Delivery, Position Statements
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AAEM Position Statement on Threat of Violence to Hospital or Emergency Department
It is AAEM’s position that physicians at work in an emergency department should be notified in real time as soon as a threat of violence to their hospital or emergency department becomes known. Approved: 9/14/16
Healthcare Delivery, Position Statements
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Does Early Goal-Directed Therapy Decrease Mortality Compared with Standard Care in Patients with Septic Shock?
Reviewed and approved by the AAEM Board of Directors (2/17/2016) Answer: No. However, standard care has significantly improved since the publication of the original EGDT trial. Early recognition of sepsis, prompt administration of appropriate antimicrobial therapy, urgent source control, intrave …
Clinical Practice Statements, Other Issues
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Is There a Role for Intravenous Sub-Dissociative-Dose Ketamine Administered as an Adjunct to Opioids or as a Single Agent for Acute Pain Management in the ED?
IntroductionSub-dissociative dose ketamine (low-dose ketamine) is useful and safe to use alone or in combination with opioid analgesics for the treatment of acute pain in the Emergency Department (ED) and in pre-hospital settings. Its use is associated with higher rates of minor but well tolerated …
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Intra-Arterial Thrombectomy (“Clot Retrieval”) for Selected Patients with Acute Ischemic Stroke
Executive SummaryAppropriate patients may be eligible for mechanical thrombectomy whether or not they have previously received intravenous t-PA, and whether or not they presented to a center capable of this specialized technique. Based on several recent randomized controlled trials, mechanical trea …
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Use of Intravenous Fat Emulsion in the Emergency Department for Cardiovascular Collapse in the Poisoned Patient
IntroductionThe successful use of intravenous fat emulsion (IFE) for the adverse effects associated with local anesthetics has led to its consideration as an effective antidote for multiple xenobiotics/substances (1, 2, 3, 4, 5, 6) . Similar to most toxicology research, the evidence is completely r …
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Timing of Acute Cholecystectomy in the Emergency Department Patient with Acute Cholecystitis
Position StatementCurrent evidence suggests that patients with acute cholecystitis who are under 70 years of age and without risk factors should undergo early cholecystectomy during their initial hospital stay, preferably within 24-48 hours after onset of symptoms. DiscussionAcute cholecystitis …
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The Pertinent ED Information Concerning the Vaccination Efficacy, Sensitivity of Diagnostic Testing, and Role for Antiviral Medications for Seasonal Influenza
IntroductionInfluenza is an acute respiratory virus that is responsible for both epidemic and pandemic outbreaks of disease. There are three types of Influenza (A, B, and C) that are further subtyped based on surface proteins. Currently, A (H1/N1) and A (H3/N2) are the subtypes circulating in human …
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CTA of the Brain Is a Reasonable Option to Consider to Help Rule out Subarachnoid Hemorrhage in Select Patients
Executive summaryComputed tomography angiography (CTA) of the brain is a reasonable test to consider when evaluating select patients for subarachnoid hemorrhage after a negative non-contrast computed tomography of the brain. The benefits and risks of CTA of the brain need to be considered by the tr …
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Emergency Physicians Should Determine the Need for Involuntary Hold Status
Emergency physicians have the responsibility for all emergency patients’ care and disposition — including which patients require involuntary holds. The regulations concerning psychiatric holds or detainments vary from state to state. Some states require that law enforcement places a pati …
Position Statements, Practice Rights
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Position Statement on Medical Scribes
Medical scribes should be considered ancillary staff members employed to assist the emergency physician with data entry and documentation requirements. Their function should be to free the emergency physician to focus on clinical duties. All information entered or generated in a health ca …
Position Statements, Practice Rights
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Psychiatric Boarders in the Emergency Department
The number of psychiatric patients who present to emergency departments (EDs) has increased in the last few years; many of these patients will need to be admitted to an inpatient bed. The care of psychiatric patients in the ED is commonly delayed by limited involvement of psychiatric specialty perso …
Other Issues, Position Statements
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Routine Laboratory Testing of Psychiatric Patients in the Emergency Department is Unnecessary
AAEM believes that evidence for testing psychiatric patients as part of medical clearance process clearly states that the testing should be clinically based, similar to other patients in the ED, and, individually based upon the particular patient presentation. Consistent with the literature on …
Other Issues, Position Statements
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Ultrasound Should be Integrated into Undergraduate Medical EducationCurriculum
Policy StatementIt is the position of the American Academy of Emergency Medicine that ultrasound should be integrated into the core curriculum of undergraduate medical education. BackgroundMedical diagnostic ultrasound has been used by various specialties since the 1950s. Contemporary point of c …
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Prescription Drug Monitoring Programs
AAEM encourages prescriber and pharmacist access to prescription drug monitoring programs (PDMPs), which can be a useful tool to identify possible prescription drug abuse. AAEM supports the interstate data sharing between state PDMPs and calls for standardization between states and the eventual crea …
Other Issues, Position Statements
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Emergency Department Wait Time Guarantees
The American Academy of Emergency Medicine (AAEM) opposes emergency department wait time guarantees. Wait time guarantees potentially compromise patient care by forcing emergency physicians to reduce their attention on truly emergent patients to ensure that less-emergent patients are seen within the …
Crowding, Position Statements
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Joint Ventures between a Hospital/Hospital System & CMG
The American Academy of Emergency Medicine (AAEM) opposes joint ventures between a hospital or hospital system and a corporate emergency medicine contract management group (CMG) whereby a portion of the emergency physician professional fee is distributed to the hospital or hospital system …
Other Issues, Position Statements
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The Pulmonary Embolism Rule-Out Criteria (PERC) meets the standard of care for Emergency Medicine (EM)
It is the position of the American Academy of Emergency Medicine that, when properly applied to an individual patient for whom the clinician already has a low clinical suspicion for PE, based on a gestalt impression, the Pulmonary Embolism Rule-Out Criteria (PERC) meets the standard of care for EM. …
Other Issues, Position Statements
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Emergency Department Opioid Prescribing Guidelines for the Treatment of Non-Cancer Related Pain
Executive summaryPain is one of the most common chief complaints among emergency department patients with a reported rate of over 50%.(1) There is great variability among emergency clinicians in the management of pain, especially with respect to the use of opioid medications.(2) Importantly, morbid …
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AAEM Position Statement on Screening and Redirection of Emergency Department Patients
Emergency departments and emergency physician’s primary directive is to care for ill and traumatized patients presenting in an unscheduled fashion. This is constructed without regard for ability to pay and with a high expectation for accurate and timely evaluation and management to exclude and …
Other Issues, Position Statements
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Ultrasound Should Be Strongly Considered as the Initial Imaging Modality in Acute Appendicitis in the Pediatric Patient
It is the position of the American Academy of Emergency Medicine that when appropriate expertise is available ultrasonography (US) should be strongly considered as the initial imaging modality when evaluating the pediatric patient with suspected acute appendicitis who requires imaging. Backgrou …
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Utility of Ultrasound in the Initial Evaluation of Adult Patients with Suspected Appendicitis
Clinical Policy StatementUtilization of ultrasound (US) as the initial imaging screening tool for appendicitis in adults can reduce the need for computer tomography (CT) and exposure to ionizing radiation. SummaryAcute appendicitis continues to be the most frequent cause of acute abdominal emerg …
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Safety of Droperidol Use in the Emergency Department
Droperidol (Inapsine®) is a butyrophenone used in emergency medicine practice for control of psychosis/agitation (1), as an antiemetic (2), for vertigo (3), as an adjunct analgesic (especially in opioid-tolerant patients) and as a treatment for benign headache (4). Initially produced in 1961, it h …
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Model ED Pain Treatment Guidelines
Introduction Prescription drug abuse has become an issue of national importance. The number of deaths from prescription opioids now exceeds those caused by heroin and cocaine combined. In order to help stem this epidemic there has been a call for more judicious prescribing on the part of physicians …
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Propofol and Other Sedating Agents Can Be Safely Used by Emergency Physicians without an Anesthesiologist Present
Clinical Policy StatementIt is the position of the American Academy of Emergency Medicine that emergency physicians must be permitted by hospital bylaws and credentialing procedures to utilize propofol (and other sedating agents) for the induction of procedural sedation, without an anesthesiologist …
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Indemnification Clause in Emergency Medicine
Emergency physician contracts should not include indemnification or “hold harmless” agreements regarding the hospital or practice site. These agreements unfairly shift risk to emergency physicians and this risk is not generally insurable. Published: 2/10/12
Position Statements, Practice Rights
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Mortality Related to Delay of ICU Patient Transfer from the Emergency Department
Critically ill emergency department (ED) patients that require admission to the intensive care unit (ICU) often utilize significant personnel, time, and equipment when compared to patients who do not require ICU level care. In many EDs, critical resources can quickly be depleted. This has the poten …
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AAEM Response to CMS 2009 Revision of Anesthesia Services Interpretive Guidelines
On December 11, 2009, the Centers for Medicare and Medicaid Services (CMS) published revised Hospital Anesthesia Services Interpretive Guidelines. These guidelines apply to the Conditions of Participation of hospitals in Medicare. The American Academy of Emergency Medicine (AAEM) Board of Directors …
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The Value of Board Certification and Residency Training in Emergency Medicine
Heatherlee Bailey, MD FAAEM Director of Critical Care Education, Division on Emergency Medicine, Duke University Medical Center Michael C. Bond, MD FAAEM University of Maryland School of Medicine Mark Reiter, MD MBA FAAEM St. Luke’s Hospital, Bethlehem, PA Lisa Moreno-Walton, MD MSCR FAA …
Board Certification, Position Statements
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Radiology Interpretation in Emergency Department After 5:00PM
SummaryAccurate, timely interpretations of radiologic studies by board-certified radiologists are necessary to provide the best patient care and promote patient safety. This can only be accomplished if attending radiologists are interpreting studies while clinical care is being provided. Emergency …
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Telemetry Bed Usage for Patients with Low Risk Chest Pain
Every year, more than 8 million Americans present to the emergency department (ED) with chest pain, making it the 2nd most common complaint in the ED [1]. Although <5% of low-risk chest pain patients are found to have an acute myocardial infarction (MI) [2], many are admitted to the hospital for …
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What is the Emergency Department Management of Patients with Angioedema Secondary to an ACE-inhibitor?
Update to 2006 guideline reviewed and approved by the AAEM Board of Directors 4/11/2011. Angiotensin-converting-enzyme (ACE) inhibitors are one of the most commonly prescribed antihypertensive medications worldwide. A known adverse effect of ACE-inhibitors is angioedema, characterized by the abr …
Clinical Practice Statements, Other Issues
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Informed Consent for Procedures Performed by Other Physicians
It is the position of the American Academy of Emergency Medicine that emergency physicians should not obtain informed consent for any procedure they will not personally perform or supervise. DiscussionWith respect to patients who present to the Emergency Department with STEMI, the American Heart …
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American Academy of Emergency Medicine Statement on Access to Emergency Care
The American Academy of Emergency Medicine, recognizing recent international reports of governmental interference with emergency care and at the request of our emergency physician colleagues in some of the affected countries, condemns any activities by governmental or non-governmental agencies tha …
Other Issues, Position Statements
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Emergency Services Reimbursement Provisions in the Patient Protections and Affordable Care Act (PPACA)
The American Academy of Emergency Medicine opposes the emergency services reimbursement provisions outlined in the interim final rule of the Patient Protections and Affordable Care Act (PPACA) that sets insurer compensation rates for out-of-network providers of emergency services. Emergency d …
Healthcare Delivery, Position Statements
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Definition of Negligence for EMTALA-Mandated Emergency Care
The American Academy of Emergency Medicine (hereinafter AAEM or the Academy) supports an increased level of scienter for EMTALA mandated care.1 Specifically, AAEM supports state laws that require plaintiffs to prove gross negligence or recklessness, by clear and convincing evidence, in cases a …
EMTALA, Position Statements, Tort Reform
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Emergency Services Reimbursement Provisions in the Patient Protections and Affordable Care Act (PPACA)
The American Academy of Emergency Medicine opposes the emergency services reimbursement provisions outlined in the interim final rule of the Patient Protections and Affordable Care Act (PPACA) that sets insurer compensation rates for out-of-network providers of emergency services. Emergency de …
Healthcare Delivery, Position Statements
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Emergency Physicians Dual Coverage in Emergency Department and on Inpatient Floors
The American Academy of Emergency Medicine is aware that some emergency physicians (EPs) are being compelled to provide dual simultaneous coverage for both the ED and the inpatient hospitalist services. This dual-coverage requires EPs to leave the emergency department (ED) to manage routine and non …
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What Evaluations Are Needed in Emergency Department Patients After a TASER Device Activation?
Use of Conducted Energy Weapons (CEW) such as the TASER includes delivery of a series of brief electrical pulses, which result in pain and muscular contractions. The pulses may be delivered via a pair of sharp metal probes fired from the device, commonly referred to as “probe mode”, or by direc …
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AAEM Position Statement on Hospital Admission Inducements
The American Academy of Emergency Medicine discourages the practice of setting admission goals or admission rates for emergency department patients. The Academy further discourages inducements from hospitals or other interested parties meant to encourage or enforce these admission goals. Such induce …
Healthcare Delivery, Position Statements
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Should Antiemetics be Given Prophylactically with Intravenous Opioids While Treating Acute Pain in the Emergency Department?
Parenteral opioids are the most common analgesics used in the Emergency Department for relief of acute pain. Gastrointestinal side effects such as nausea andvomiting are common following opioid analgesia in long-term therapy for malignant and chronic pain and are considered a limiting factor in …
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Is an Unenhanced CT Scan of the Abdomen and Pelvis Accurate in Diagnosing Acute Appendicitis in Adults?
With the advent of more sophisticated CT scanners, imaging without contrast (unenhanced) is increasingly utilized in the evaluation of adults with suspectedacute appendicitis. Oral contrast presents a significant delay to imaging. Intravenous contrast presents the small, but real risks of allergic …
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Does Early Goal Directed Therapy Decrease Mortality in Patients with Septic Shock?
Reviewed and approved by the AAEM Board of Directors 2/14/2010 Define the Issue and State the Question A. Topic Area: Sepsis B. General Issue: Early goal directed therapy C. Specific Question: Does early goal directed therapy decrease mortality in patients with septic shock? D. Execut …
Clinical Practice Statements, Other Issues
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Does the Urine Dipstick and/or the Urine Microanalysis Correlate with a Culture Positive UTI in Febrile Children?
Reviewed and approved by the AAEM Board of Directors 2/14/2010. Define the Issue and State the Question A. Topic Area: _______Pediatric fever_____________ B. General Issue: __Urinary tract infection ___________ C. Specific Question: _Does the urine dipstick and or the urine microana …
Clinical Practice Statements, Other Issues
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Do Steroids Administered in the Emergency Room Improve Mortality or Shock Reversal in Patients with Septic Shock?
Reviewed and approved by the AAEM Board of Directors 2/14/2010. Define the Issue and State the Question A. Topic Area: Sepsis B. General Issue: Steroid administration in septic shock C. Clinical Question: Do steroids administered in the emergency room improve mortality or shock reversa …
Clinical Practice Statements, Other Issues
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During the Emergency Department Evaluation of a Well Appearing Neonate (<30 days of age) with a Fever, Should Empiric Acyclovir be Initiated?
Reviewed and approved by the AAEM Board of Directors 1/11/2010. Define the Issue and State the Question A. Topic Area: PEDIATRIC FEVER: NEONATAL HERPES INFECTION B. General Issue: NEONATAL HERPES INFECTION C. Specific Question: DURING THE EMERGENCY DEPARTMENT EVALUATION OF A WELL A …
Clinical Practice Statements, Other Issues
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Use of Non-Emergency Medicine Specialists in the Emergency Department
1) The American Academy of Emergency Medicine, believing that emergency department care is best provided by physicians properly board certified in emergency medicine, reiterates the relevant portions of its Mission Statement: Every individual should have unencumbered access to quality emergency …
Board Certification, Position Statements
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Freestanding Emergency Departments
Freestanding emergency departments (FSED) have the potential to address several intractable problems in emergency medicine, especially overcrowding and lack of access to emergency care, a loss of autonomy for emergency physicians, and widespread violation of emergency physician practice rights at ho …
Healthcare Delivery, Position Statements
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The Measurement of Time to Antibiotics for Admitted Patients with Community-Acquired Pneumonia (CAP) in the ED
Reviewed and approved by the AAEM Board of Directors 3/1/2009. Define the Issue and State the Question A. Topic Area: The measurement of time to antibiotics for admitted patients with community-acquired pneumonia (CAP) in the ED. B. General Issue: Unintended consequences of the implementati …
Clinical Practice Statements, Other Issues
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Emergency Care Psychiatric Clinical Framework
SUMMARY DEVELOPMENT OF EMERGENCY CARE PSYCHIATRIC CLINICAL FRAMEWORK By default, the emergency department (ED) has become the "portal to the community" and the entry point where most patients are introduced to the health care system. It is also a logical place to expedite needed reform t …
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Restrictive Covenant White Paper
AAEM WHITE PAPER ON RESTRICTIVE COVENANTS A Policy Paper of the American Academy of Emergency Medicine J Emerg Med 2006; 30:473-475 Larry D. Weiss, MD, JD, FAAEM Professor of Emergency Medicine University of Maryland School of Medicine Approved with revisions by the American Academy of Emergen …
Position Statements, Practice Rights
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Procedural Sedation Consensus Statement
The immediate availability of interventions including procedural sedation is critical to serving the needs of our patients. Preserving life, restoring health, and alleviating suffering have been fundamental to the practice of nursing and medicine for centuries. We are challenged as health care profe …
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Due Process White Paper
AAEM WHITE PAPER ON DUE PROCESS RIGHTS FOR PHYSICIANS J Emerg Med 2007; 33:439-440 Larry D. Weiss, MD, JD, FAAEM Professor of Emergency Medicine University of Maryland School of Medicine Approved with revisions by the American Academy of Emergency Medicine Board of Directors, May 15, 2007 INTR …
Due Process, Position Statements, Practice Rights
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AAEM Position Statement on ED Boarding
The practice of boarding patients in the ED is defined as holding admitted patients in the ED until a staffed, in-patient bed becomes available and this period usually lasts several hours (and sometimes days). Boarding is not in the best interest of the patient being boarded as it compromises their …
Crowding, Position Statements
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AAEM Position Statement Opposing the Creation or Recognition of an American Board of Disaster Medicine (ABDM) under the auspices of the American Board of Physician Specialists (ABPS)
The American Academy of Emergency Medicine (AAEM), a national professional society of board-certified emergency physicians, has serious concerns about the creation of the American Board of Disaster Medicine (ABDM) by the American Board of Physician Specialists (ABPS). We note that: A. The creation …
Board Certification, Position Statements
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Clinical Practice Guideline: Initial Evaluation and Management of Patients Presenting with Acute Urticaria or Angioedema
AAEM statements are not to be construed as dictating an exclusive course of action nor are they intended to replace the medical judgment of healthcare professionals. The unique circumstances of individual patients and environments are to be taken into account in any diagnosis and treatment plan. AAE …
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Compact Between Resident Physicians and Their Teachers
January 2006 (endorsed 5/17/06) www.aamc.org/residentcompact The Compact Between Resident Physicians and Their Teachers is a declaration of the fundamental principles of graduate medical education (GME) and the major commitments of both residents and faculty to the educational process, to each oth …
Endorsed Statements, Other Issues
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AAEM Position Statement on Patient Satisfaction Surveys in the Emergency Department
The American Academy of Emergency Medicine believes that a healthy physician-patient relationship is a core principle of the practice of emergency medicine. There is a growing trend to use patient satisfaction surveys as a tool to assess the quality of this interaction. As more organizations are usi …
Other Issues, Position Statements
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Emergency Nurses Association and American Academy of Emergency Medicine Joint Position on a Code of Professional Conduct
DATE: May, 2006 SUBMITTED BY: Nancy Bonalumi, RN, MS, CEN; ENA President Tom Scaletta, MD FAAEM; AAEM President It is ideal for emergency nurses and physicians to practice in an optimal working environment where, working as a team, we can provide safe and excellent emergency patient care. Inappr …
Position Statements, Practice Rights
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AAEM Position Statement on Improving Service Quality
(from White Paper on Improving Service Quality) On behalf the American Academy of Emergency Medicine, we proposed this position statement for consideration by the Board of Directors: It is the mission of emergency medicine to provide continuous access to board certified emergency physicians to p …
Other, Position Statements
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AAEM Position Statement on Ethical Expert Conduct and Testimony
The American Academy of Emergency Medicine believes the following principles to be essential to the ethical conduct of an expert offering opinions or testimony in medical legal matters. Violation of these principles constitutes a violation of the Academy’s Ethics policy and may be subject to sancti …
Ethics, Position Statements, Tort Reform