Statement Type
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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 most of whom receive patients sent from urgent care centers when their […] -
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: Introduction: Use of Conducted Energy Weapons (CEW) such as the TASER includes delivery of a series of brief electrical pulses, which result in painful muscular contractions. The pulses may be delivered via three possible mechanisms. The delivery may be via a pair of metal […] -
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 marginalized, the primary point of contact with healthcare for many is […] -
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 customary charge” for a service should be defined using a source of unbiased, third party data such […] -
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 which should include the following points: Each […] -
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 in effective pain therapy.1 Despite the lack of clear and […] -
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 (MRI), and ultrasound (US) are the imaging modalities that can be used to diagnosis appendicitis. For non-pregnant […] -
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 if current trends continue, an oversupply of emergency physicians is likely to develop, […] -
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, there are concerns from ED clinicians using qSOFA in […] -
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 regulations at the state and federal level, and do not support […] -
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 problem. Until recently, there has been little change in the treatment options […] -
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 colleagues in 2001, numerous lactate measurement strategies have been introduced, including lactate clearance and […] -
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 only when the disorder currently impairs their judgment or ability to practice. AAEM believes that state licensing boards […] -
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 based providers; Provide advance practice providers with supervision and support by board certified emergency physicians. Approved […] -
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 establish effective options for persons in need that would enable them to avoid […] -
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 sending it to JEM for […] -
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. Multiple studies have shown both benefits and detriments with EMRs. Benefits include a reduction in medication errors, which is the number one cause of adverse events,1 and fast […] -
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 patient evaluation, interval assessments, complex decision-making, time-intensive procedures, […] -
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-specific care center designations, such as that needed for trauma or stroke centers. Major Emergency […] -
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 FAAEM Effective, efficient, and safe pain management is […] -
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 care first and improving work-life balance. View the position paper […] -
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 management group's fiduciary duty to its shareholders. Approved: 9/7/17 -
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 spectrum antibiotics is standard. Consideration of testing and treatment for possible […] -
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 inhibits both free and fibrin-bound thrombin. Current indications include prevention and […] -
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 testing can essentially rule-out PE. The prevalence of PE increases with age, but D-dimer […]