August Annals Audio is posted!

Check out the August audio here. New format! More clinician-focused than ever. Highlights include:

-ED visits and healthcare reform in Massachusetts: what happens when more people become insured?

-Chest pain risk tolerance: does anyone know what they’re talking about?

-Pediatric minor head injury: we found the rule you should be using….

-MOLST/POLST: get to know it — this changes everything.

Pleeeease give us your feedback, at annalsaudio@acep.org

D&A

Annals audio for July: POSTED!

July’s audio/podcast for Annals of EM is now posted here. Highlights:

-Early vs late rhythm analysis in OOHCA
-Ground based EMS transports and complications
-When do sepsis patients become septic? Usually NOT on arrival. Time to change the metric?
-Botulism outbreak
-Diethylene glycol outbreak
-Much, much more!

Enjoy, and email with any comments or questions any time,
D&A

ACEP Clinical Policies Committee to Develop Independent tPA Policy

The ACEP Board Directors accepted a recommendation last week from its Clinical Policies Committee to begin working on a tPA policy exclusive to ACEP instead of a joint project with the American Academy of Neurology.

The 2013 Council had asked that ACEP reconsider its current “Clinical Policy: Use of Intravenous tPA for the Management of Acute Ischemic Stroke in the Emergency Department,” which had been developed with the AAN and published in February 2013.

After an open 60-day comment period in early 2014 and a subcommittee review of the comments and literature findings, the Clinical Policies Committee recommended to pursue an independent policy, which will include updated evidence and grading criteria. The Board unanimously approved this recommendation.

Once the draft is developed, it will be available for members to review and comment for 60 days prior to the Committee’s presentation to the Board. An estimated timeline was not available.

Additionally, the Board confirmed its commitment to the clinical policy development process and agreed to add three methodologists to the committee, additional meetings, and another staff person to ensure a robust review process.

ACEP Clarifies Campaign Rules

By James M. Cusick, MD, FACEP
Chair, Candidate Forum Subcommittee of the ACEP Council

ACEP is a member-driven organization with a representative body of our peers – the ACEP Council – chosen through component bodies, including our chapters (1 representative per 100 members), our Sections of Membership, and other aligned organizations.

Each year, this body democratically votes to establish ACEP policy and elect leadership positions. Candidates present themselves to the Council through written statements, scheduled speeches, and unrehearsed Question and Answer sessions during the Candidate Forum, which is open to all members. Elections must be fair, follow guidelines applicable to all, and be free of undue influence or pressure on candidates.

The ACEP Council’s Candidate Forum Subcommittee recently performed its annual review of the campaign rules to ensure a fair campaign and elections process for all Board of Directors and President-elect candidates. The changes were approved by the Council Steering Committee.

This year, restrictions on the use of social media were substantially relaxed to allow forms of communication most of us use on a daily basis.

In addition, protections were incorporated into the rules to keep candidate interviews in ACEP publications. Our goal is to avoid candidates being put in the position of commenting on College policy without adequate preparation and to ensure that the campaign process is fair and equal for all candidates.

Certain candidates may unfairly benefit from coverage in non-ACEP publications, while some may be disadvantaged. In order to ensure a fair election, campaign questions and the vetting of candidates is the responsibility of ACEP, its Council and its Council Committees.

If there are specific questions you would like asked of the candidates prior to the election, please send them to communications@acep.org. The Candidate Forum Subcommittee will consider them, the selected questions will be posed to candidates and their responses will be made public.

Elections will occur during the Council meeting on Oct. 26 in Chicago. The Nominating Committee has selected the final slate of candidates for 2014:

President-Elect Candidates
Jay Kaplan, MD, FACEP
Robert O’Connor, MD, FACEP
Rebecca Parker, MD, FACEP

Board of Directors Candidates (4 positions to be filled)
Stephen Anderson, MD, FACEP (WA)
Jon Mark Hirshon, MD, FACEP (MD)
Hans House, MD, FACEP (incumbent – IA)
Mark Mackey, MD, FACEP (incumbent – IL)
John Rogers, MD, FACEP (incumbent – GA)
Mark Rosenberg, DO, FACEP (NJ)

 

June audio is up!

The Annals of EM June audio is posted and available. Highlights:

-How important is isolated vomiting in children as a predictor of TBI?
-The yield of ‘clearance’ laboratory testing for pediatric psych patients
-Confirming femoral lines with a saline flush—it works
-Should hydromorphone dosing be weight-based?
-Intranasal fentanyl for EMS
-Transgender populations in the ED: the experience
-Incidence of delayed anaphylaxis in the ED

And much much more…

Email any time at annalsaudio@acep.org.

D&A

Annals Clinical Case: Female With Lower Abdominal Pain and Bleeding

AnnalsMay 2014, Annals of Emergency Medicine

By Justin McNamee, DO; Nilesh Patel, DO; and Joseph Affortunato, DO

Department of Emergency Medicine
St. Joseph’s Regional Medical Center, Paterson, New Jersey

A 26-year-old woman presented to the emergency department, complaining of a 3-day history of lower abdominal pain and vaginal bleeding. She reported positive home pregnancy test results and that her last menstrual period was 17 weeks ago. On examination, the patient appeared comfortable and was afebrile, with a blood pressure of 131/67 mm Hg, pulse rate of 100 beats/min, and respiratory rate of 16 breaths/min.

Click here to read the full case, see the images and get the diagnosis.