Statement Type

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 treatment reduces long-term disability in properly selected patients with acute ischemic stroke due to large […]

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 reliant on animal experiments and human case reports. In addition to […]

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 (AC) is an acute inflammation of the gallbladder. In the US, gallstones are present in over […]

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 humans (1). The annual global prevalence of seasonal influenza […]

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 treating physician. DiscussionAcute onset headache is a common presenting complaint […]

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 patient in an involuntary hold status without physician input. EPs should have the responsibility for patient […]

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 care record by a medical scribe should be reviewed for accuracy by the treating […]

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 personnel and lack of psychiatric resources in […]

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 the topic, AAEM opposes routine laboratory testing of psychiatric patients in the […]

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 care ultrasound (POCUS) was first researched and utilized byemergency physicians in the mid 1980s. Emergency […]

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 creation of a federal PDMP. PDMPs should report prescriptions in real-time and be […]

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 wait time guarantee interval. As wait-time guarantees do not take into account patient acuity […]

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 and the CMG in excess of fair market value for services performed.  Such an arrangement […]

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. When a patient is PERC negative […]

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, morbidity and mortality have increased as the frequency of opioid use for […]

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 treat emergent and urgent life and limb-threatening conditions. Increasingly limited resources […]

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. Background A growing body of research supports the use of ultrasonography as the initial imaging […]

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 emergency in the United States. However, the diagnosis of appendicitis is challenging. As a […]

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 has numerous sites of biochemical activity, mostnotably as a dopamine receptor antagonist […]

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.1 The AAEM offers this model guideline to […]

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 present. SummaryA large body of research supports the assertion that propofol and other sedating […]

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  

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 potential to adversely affect the care provided to these critically […]

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 is particularly concerned with the provision stating, All services along the continuum of anesthesia […]

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 FAAEM Louisiana State University Health Sciences Center – New Orleans Mary Claire O’Brien, […]