Statement Type

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, […]

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 physicians should insist on timely attending radiologist interpretations of radiological studies, even during off-hours. BackgroundIn order […]

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 further evaluation. Telemetry monitoring […]

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 abrupt onset of non-pitting, non-pruritic swelling that involves the reticular dermis, subcutaneous, and submucosal layers. Lesions are […]

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 Association recommends a door-to-balloon time of 90 minutes or less. In […]

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 that interfere with the normal operation of emergency services. Accordingly, the American Academy of Emergency Medicine […]

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 departments play an integral role in our healthcare system.  In addition to treating urgent and emergency […]

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 alleging negligence for emergency department care, and for subsequent care to stabilize emergency […]

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 departments play an integral role in our healthcare system.  In addition to treating urgent and emergency […]

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-urgent medical problems of hospitalized patients. Emergency physicians should not provide […]

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 direct contact with the front […]

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 inducements may include bonuses, penalties or linkage of admission rates to the rewarding or renewal […]

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 effective pain therapy. (1) Despite clear and supporting evidence, it has […]

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 reaction andcontrast nephropathy. There is sufficient literature to support the use of unenhanced CT […]

Reviewed and approved by the AAEM Board of Directors 2/14/2010 Answer: Yes. Though adoption of EGDT has been slow and multiple barriers exist, it appears that EGDT improves mortality in adult patients with septic shock. Further study is needed, however, to quantify the exact effect size of each individual component and the protocol in its […]

Reviewed and approved by the AAEM Board of Directors 2/14/2010.

Reviewed and approved by the AAEM Board of Directors 2/14/2010.

Reviewed and approved by the AAEM Board of Directors 1/11/2010.

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: 2) Organized hospital medical staffs have the primary responsibility of credentialing physicians to work in their emergency departments and may decide how to best […]