Did you know ACEP has 30 committees and 40 sections working year-round to advance emergency medicine? Led by emergency physician volunteers, these groups focus on specific niches or clinical topics within the field and regularly produce new policies, webinars, and resources to benefit ACEP members. Here are a few recent highlights:
Explore This IssueACEP Now: Vol 40 – No 06 – June 2021
New Clinical Policies: Opioids and Pneumonia
The Clinical Policies Committee, led by Chair Stephen J. Wolf, MD, FACEP, has published two new clinical policies this year that can be viewed here.
- Critical Issues in the Management of Adult Patients Presenting to the Emergency Department with Community-Acquired Pneumonia (October 2020)
- Critical Issues Related to Opioids in Adult Patients Presenting to the Emergency Department (June 2020)
On deck: The committee is currently drafting revisions to the appendicitis, acute heart failure syndromes, and mild traumatic brain injury clinical policies.
Task Forces Address Sepsis, Excited Delirium
In April, the multispecialty task force convened by ACEP in 2019 published its new sepsis guidelines, “Early Care of Adults with Suspected Sepsis in the Emergency Department and Out-of-Hospital Environment: A Consensus-Based Task Force Report,” in Annals of Emergency Medicine. The report covers principles of early sepsis recognition, initial care steps in the ED and out-of-hospital environments, titration of care, and related controversies. It has been endorsed by the American Academy of Emergency Medicine, the American College of Osteopathic Emergency Physicians, the American Osteopathic Board of Emergency Medicine, the Association of Academic Chairs of Emergency Medicine, the Council of Emergency Medicine Residency Directors, the Emergency Medicine Residents’ Association, the Emergency Nurses Association, the National Association of EMS Physicians, the Infectious Diseases Society of America, the Society for Academic Emergency Medicine, the Society of Critical Care Medicine, and the Society of Hospital Medicine. ACEP’s sepsis point-of-care tool, DART, was updated to reflect these new guidelines. Visit acep.org/sepsis for more information. The guidelines were authored by Donald M. Yealy, MD; Nicholas M. Mohr, MD, MS; Nathan I. Shapiro, MD; Arjun Venkatesh, MD, MBA; Alan E. Jones, MD; and Wesley H. Self, MD, MPH.
Up next: The Excited Delirium Task Force is working on revisions to the 2009 White Paper Report on Excited Delirium Syndrome.
Ultrasound Section Launches New and Improved Sonoguide
A subcommittee of ACEP’s Emergency Ultrasound Section recently published work on the new Sonoguide: Ultrasound Guide for Emergency Physicians. Led by co-authors Dasia Esener, MD, MS, FACEP, and Gabriel Rose, DO, the Sonoguide was initially developed for those with little ultrasound experience, but it includes advanced concepts and skills as well. View the guide at acep.org/sonoguide.
EM Lifestyle Series Kicks Off with Career Content
ACEP’s Young Physicians Section and Online Education Committee are collaborating on EM L.I.F.E.R.S., a new content series focused on EM lifestyle concerns including career advancement, finances, life balance, parenthood, and more. Hosted by YPS Chair John Corker, MD, FACEP, and Chair-Elect Puneet Gupta, MD, FACEP, in collaboration with Simone Lawson, MD, the first episode provided tips for job hunting during a pandemic. The second episode was a deep dive into EM employment contracts that focused on how to identify red flags and deal breakers. View the series at acep.org/EM-life.
EMPC Tackles Compensation, Staff Safety
The EM Practice Committee, led by Chair Daniel Freess, MD, FACEP, has been reviewing, revising, and drafting policy statements. The following were approved by the Board at its April 2021 meeting and are available at acep.org/policystatements.
- The revised Compensation Arrangements for Emergency Physicians statement now includes a bullet addressing emergency physicians being provided detailed itemized reports of billing and collections in their name, reflecting the language in Amended Resolution 29(20) Billing and Collections Transparency in Emergency Medicine, among other edits.
- The revised Cultural Awareness and Emergency Care statement now references the role of implicit bias.
- The revised Transition of Care for ED Patients statement includes new language emphasizing physician autonomy as defined by the prudent layperson standard.
- The revised Emergency Department Planning and Resource Guidelines statement now references the role of the emergency physician as the leader of the emergency department team. Language was added to address the level of patient literacy for understanding discharge instructions and family transport in private vehicles, to name a few.
- The revised Emergency Physician Contractual Relationships statement adds language to state emergency physicians are entitled to detailed itemized reports on a semiannual basis for what is billed and collected for their services. Language was added that emergency physicians shall not be asked to waive access to billing and collection reports. An existing section concerning the honoring of contractual agreements was expanded to include honoring contracts prior to the initiation of employment or in cases of deferred/delayed employment, such as that of a graduating resident.
- The revised Emergency Physician Rights and Responsibilities statement now includes addressing the provision of detailed itemized reports of billings and collections on a semiannual basis and more specific language related to due process before adverse action is taken related to employment or contract status, among other edits related to contract negotiations and restrictive covenant agreements.
- The revised Non-Discrimination and Harassment statement includes the role of implicit bias and the potential impact of cognitive load on bias.
- The new policy statement Safer Working Conditions for Emergency Department Staff addresses the importance of leadership promotion of safety, interior and exterior facility infrastructure, safety planning, reporting and training, written and posted behavioral standards, and the availability of equipment to prevent workplace injury.
- The revised Patient-Centered Medical Home Model statement emphasizes the importance of the patient-centered medical home providing timely care, integration of acute care services for patients to receive efficient evaluation, and recognition of the safety-net role of emergency medicine.
Diversity Section Addresses Vaccine Hesitancy
Vaccine hesitancy has been front of mind this spring, so the ACEP Diversity, Inclusion & Health Equity (DIHE) Section produced both a webinar and a toolkit to equip clinicians with historical context and strategies to counsel patients on this important decision. The webinar “This Is Our Shot: How EM Docs Can Empower Patients to End the Pandemic,” moderated by Tracy MacIntosh, MD, MPH, FACEP, and including panelists Ugo Ezenkwele, MD, MPH; Pilar Ortega, MD; and Robert Rodriguez, MD, is now available to watch on demand at ecme.acep.org. View the toolkit, led by DIHE Chair Andrea Green, MD, FACEP, and Merle Carter, MD, FACEP, at acep.org/covid-19-alert.
New Smart Phrases, Disease Screening Statement
ACEP’s Public Health and Injury Prevention Committee (PHIPC), led by Chair Antony Hsu, MD, FACEP, revised the smart phrase “Coronavirus Concern–Confirmed or Suspected” with the new title “Coronavirus Discharge–Confirmed or Suspected” and added a new smart phrase: “Monoclonal Antibodies for COVID-19 Infections.” View all of ACEP’s smart phrases at acep.org/smart-phrases.
In April, the Board approved the PHIPC’s request to rescind the previous policy statement “HIV Testing and Screening in the ED” to be replaced with the new, more encompassing statement “Screening for Disease and Risk Factors in the ED.” View the new policy statement at acep.org/policystatements.
Webinar Series Digs Deep into EMTALA
The Medical-Legal Committee, led by Chair Rade Vukmir, MD, JD, FACEP, developed a new series around an oft-requested topic: EMTALA. This series, available to watch on-demand at acep.org/emtala-webinars, breaks this complicated law into digestible sections without losing the details. Webinar hosts included Dr. Vukmir; Michael Bresler, MD, FACEP; Keri Gardner, MD, MPH, FACEP; Hugh Hill, MD, JD, FACEP; and Robert Bitterman, MD, JD, FACEP.
- Overview and Evolution
- Why EMTALA Is Actually GOOD for EM Physicians
- EMTALA and the Medical Screening Exam
- Minimizing Risk of EMTALA Violations During Transfers
- Managing Psychiatric Patients in the ED Under EMTALA
- The EMTALA Complaint Process
Ms. Grantham is ACEP communications manager.