American Academy of Emergency Medicine 555 E. Wells St., Suite 1100, Milwaukee, WI 53202-3823 OFFICERS WILLIAM T. DURKIN, JR., MD MBA President Alexandria, VA MARK REITER, MD MBA Vice President Brentwood, TN KEVIN RODGERS, MD Secretary-Treasurer Indianapolis, IN HOWARD BLUMSTEIN, MD Immediate Past President Winston-Salem, NC ROBERT M. MCNAMARA, MD Past Presidents Council Representative Philadelphia, PA Board of Directors KEVIN BEIER, MD Brentwood, TN JOHN CHRISTENSEN, MD Felton, CA MARK FOPPE, DO Boynton Beach, FL DAVID LAWHORN, MD Gallatin, TN ROBERT E. SUTER, DO MHA Dallas, TX DAVID D. VEGA, MD York, PA ANDY WALKER, MD Nashville, TN LESLIE ZUN, MD MBA Chicago, IL YPS Director MICHAEL PULIA, MD Madison, WI AAEM/RSA President LEANA WEN, MD MSc Boston, MA Editor, JEM ([2IÀFLR %RDUG 0HPEHU STEPHEN R. HAYDEN, MD San Diego, CA Executive Director KAY WHALEN, MBA CAE Associate Executive Director JANET WILSON, CAE President William T. Durkin, Jr., MD MBA – 2014 Vice President Mark Reiter, MD MBA – 2014 Secretary-Treasurer Kevin Rodgers, MD – 2014 Past President Howard Blumstein, MD – 2014 Past Presidents Council Representative Robert M. McNamara, MD – 2014 AAEM Board of Directors Kevin H. Beier, MD – 2015 John B. Christensen, MD – 2014 Mark Foppe, DO – 2015 David W. Lawhorn, MD – 2014 Robert E. Suter, DO MHA – 2015 David D. Vega, MD – 2014 Andy Walker, MD – 2015 Leslie Zun, MD MBA – 2015 YPS Director Michael S. Pulia, MD AAEM/RSA President Leana Wen, MD MSc Editor, JEM – Ex-Officio Board Member Stephen R. Hayden, MD The American Academy of Emergency Medicine (AAEM) announces the 2013 election results for the AAEM board of directors. AAEM Written Board Review Course Unmatched Preparation for the Qualifying Exam and ConCert Exam August 21-23, 2013 Hyatt Regency Grand Cypress Orlando, FL Named as one of EMRA’s Top Written Qualifying Examination Preparation Courses For more information, visit www.aaem.org/education/written-board-review-course or call 800-884-2236
Transcript
American Academy of Emergency Medicine555 E. Wells St., Suite 1100, Milwaukee, WI 53202-3823
OFFICERSWILLIAM T. DURKIN, JR., MD MBA PresidentAlexandria, VA
MARK REITER, MD MBA Vice PresidentBrentwood, TN
KEVIN RODGERS, MDSecretary-TreasurerIndianapolis, IN
HOWARD BLUMSTEIN, MDImmediate Past PresidentWinston-Salem, NC
ROBERT M. MCNAMARA, MDPast Presidents Council RepresentativePhiladelphia, PA
Board of DirectorsKEVIN BEIER, MDBrentwood, TN
JOHN CHRISTENSEN, MDFelton, CA
MARK FOPPE, DOBoynton Beach, FL
DAVID LAWHORN, MD Gallatin, TN
ROBERT E. SUTER, DO MHADallas, TX
DAVID D. VEGA, MDYork, PA
ANDY WALKER, MDNashville, TN
LESLIE ZUN, MD MBAChicago, IL
YPS DirectorMICHAEL PULIA, MDMadison, WI
AAEM/RSA PresidentLEANA WEN, MD MScBoston, MA
Editor, JEM
STEPHEN R. HAYDEN, MDSan Diego, CA
Executive DirectorKAY WHALEN, MBA CAEAssociate Executive DirectorJANET WILSON, CAE
President
William T. Durkin, Jr., MD MBA – 2014
Vice President
Mark Reiter, MD MBA – 2014
Secretary-Treasurer
Kevin Rodgers, MD – 2014
Past President
Howard Blumstein, MD – 2014
Past Presidents Council
Representative
Robert M. McNamara, MD – 2014
AAEM Board of Directors
Kevin H. Beier, MD – 2015 John B. Christensen, MD – 2014 Mark Foppe, DO – 2015 David W. Lawhorn, MD – 2014Robert E. Suter, DO MHA – 2015 David D. Vega, MD – 2014 Andy Walker, MD – 2015 Leslie Zun, MD MBA – 2015
YPS Director
Michael S. Pulia, MD
AAEM/RSA President
Leana Wen, MD MSc
Editor, JEM – Ex-Officio Board
Member
Stephen R. Hayden, MD
The American Academy of Emergency Medicine (AAEM) announces
the 2013 election results for the AAEM board of directors.
AAEM Written Board Review CourseUnmatched Preparation for the Qualifying Exam and ConCert Exam
August 21-23, 2013 Hyatt Regency Grand Cypress Orlando, FL
Named as one of EMRA’s Top WrittenQualifying Examination Preparation Courses
For more information,visit www.aaem.org/education/written-board-review-course or call 800-884-2236
A M E R I C A N A C A D E M Y O F E M E R G E N C Y M E D I C I N E
American Academy of Emergency Medicine Model ED Pain Treatment Guidelines
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 its members. It may be adopted in whole or in part and should be modified to address local circumstances and state and local laws and regulations.
Guidelines for treating non-cancer pain:
This document is a guideline and is not meant to replace the individual judgment of the treating physician who is in the best position to determine the needs of the individual patient.1. Narcotic analgesics are appropriate to treat acute illness or injury. Discharge prescriptions should be limited to the amount needed until follow-up and should not exceed 7 days worth.2. The patient should not receive narcotic prescriptions from multiple doctors. Emergency physicians should not prescribe additional narcotics for a condition previously treated in their ED or by another physician unless there are extenuating circumstances.3. Patients with chronic non-cancer pain should not receive injections of narcotic analgesics in the ED.4. Emergency physicians should not prescribe long acting narcotic agents such as oxycontin, extended release morphine or methadone. Oxycodone (ex. Percocet), hyrdocodone (ex. Vicodin) and hydromorphone (Dilaudid) have high abuse potential and the physician should consider using alternative agents.5. Emergency physicians should not replace lost or stolen prescriptions for controlled substances.6. Emergency physicians should not fill prescriptions for patients who have run out of pain medications. Refills are to be arranged with the primary or specialty prescribing physician.7. Narcotic pain medication is discouraged for certain conditions including: a. Back pain whether acute or chronic b. Routine dental pain c. Migraines d. Chronic abdominal or pelvic pain and gastroparesis8. Patients with suspected substance abuse behavior should be referred to appropriate resources.9. If circumstances warrant, EM physicians should consider accessing their state’s prescription data base (for states with physician access to this).10. Patients identified with multiple ED visits for pain, problematic or dishonest behavior (abusive, altering prescriptions, false reports or use of multiple hospitals for pain should be reviewed by the ED physician leadership team which should consider the following actions: a. Sending a certified letter stating the patient will no longer be provided narcotics in the ED. b. Adding an internal code (ex. 555) identifying probable drug seeking behavior into their medical record
Reference:(1) Alexander GC, Kruszewski, SP, Webster DW. Rethinking opioid prescribing to protect patient safety and public health. JAMA 2012;308:1865-66.
Disclaimer: This document is solely a model guideline and it should not be used to establish any standard of care or conduct. Any deviation from these guidelines should not be considered as a basis for, or as evidence of, a breach of professional conduct or any professional standard. These guidelines should be modified as necessary to reflect applicable state and local laws and regulations.
These guidelines are not intended as a substitute for medical or legal advice and the content should not be relied as a primary basis for providing ED pain treatment in any particular instance. Readers should make their own independent determinations as to: (1) what constitutes appropriate medical and/or administrative practices or procedures in any particular instance, and (2) how best to comply with laws, regulations and relevant administrative and medical standards relevant to the reader’s own institution. It is recommended that the reader consult, as to any medical matters referenced in these materials, a qualified physician, and, as to any business or legal matters, an attorney familiar with pertinent legal concepts and state and federal laws. By using these guidelines, the user agrees and acknowledges that he or she assumes all risk arising out of such use and releases the American Academy of Emergency Medicine, Inc. and its directors, officers, and agents from and against any loss, damage, claim or liability arising out of such use.
