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 testing can essentially rule-out PE. The prevalence of PE increases with age, but D-dimer […] -
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 used to determine the size and location of a suspected ureteral stone […] -
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 0.9% normal saline (when available) in patients with sepsis. The use of albumin does […] -
tPA and Ischemic Stroke: Focused Update of 2010 Clinical Practice Advisory from the American<br>Academy 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 occur for patients and risk prediction scores may facilitate or expedite the conversation. […] -
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, intravenous fluid, and maintenance of adequate mean arterial pressure are critical interventions in the care of […] -
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 the topic, AAEM opposes routine laboratory testing of psychiatric patients in the […] -
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 personnel and lack of psychiatric resources in […] -
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 creation of a federal PDMP. PDMPs should report prescriptions in real-time and be […] -
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. When a patient is PERC negative […] -
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 and the CMG in excess of fair market value for services performed. Such an arrangement […] -
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 treat emergent and urgent life and limb-threatening conditions. Increasingly limited resources […] -
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 abrupt onset of non-pitting, non-pruritic swelling that involves the reticular dermis, subcutaneous, and submucosal layers. Lesions are […] -
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 that interfere with the normal operation of emergency services. Accordingly, the American Academy of Emergency Medicine […] -
Does Early Goal Directed Therapy Decrease Mortality in Patients with Septic Shock?
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 […] -
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. -
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. -
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. -
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. -
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 other and to the patients they serve. The Compact’s purpose is to provide institutional GME […] -
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 using these questionnaires in their determinations of compensation and […] -
AAEM Policy Regarding Other Organizations
AAEM continues to encourage its members to belong to any professional organizations of their choosing; AAEM promotes and defends its policy positions; that AAEM policy positions stand on their own merit; that policy positions of AAEM enhance the work of practicing emergency physicians; AAEM, its leaders, and spokespersons continue to focus on issues of vital […] -
Joint Task Force Resolution
Whereas, many emergency physicians would prefer that the emergency medicine professional societies work closely together for the betterment of emergency medicine; and Whereas, the American Academy of Emergency Medicine has clearly laid out a Vision Statement to advocate for the rights of emergency physicians and welfare of emergency department patients, therefore be it RESOLVED, that […] -
Guidelines for Researchers Involved in Manufacturer-Sponsored Trials
Background As medical research of drugs and devices has evolved, the quality of available evidence has benefited from increasing numbers of well designed randomized controlled trials, leading directly to reductions in selection bias. An additional source of potential bias is found when manufacturers with interests vested in positive trial outcomes sponsor trials themselves. In order […] -
New AAEM Board Policy Addresses “On-Call” Crisis
The AAEM Board of Directors established the following position statement during its May 18, 2002 Board meeting which was held in conjunction with the SAEM meeting in St. Louis, MO. AAEM On-Call Crisis Position Statement The American Academy of Emergency Medicine believes the crisis in “on call” coverage represents a very serious threat to […] -
Position Statement on the Role of Government in Securing Emergency Medical Care
The AAEM Board of Directors established the following position statement during its September 2001 Board meeting which was held in conjunction with the First Mediterranean Emergency Medicine Congress in Stresa, September 2-5th, 2001. Preamble: Governments have a responsibility for the total health of their societies. The health of a people depends on much more […]