Better Communication Can Enhance U.S. Chemical Exposure Incident Response, New Evaluation Says
Aug 31, 2018
WASHINGTON, Aug. 31, 2018 /PRNewswire/ — First responders to major chemical exposure incidents in the United States can improve treatment protocols for at-risk casualties with better communication strategies, according to new analysis in Annals of Emergency Medicine.
The evaluation, Operation DOWNPOUR, was funded by the U.S. Department of Health and Human Services (HHS) Biomedical Advanced Research and Development Authority (BARDA), part of the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR).
The authors note that existing processes are nearly 100 percent effective. But, enhancing communication processes would better serve people with chronic illnesses, disabilities or language barriers. And, for the first time, experts endorsed revised guidelines that call for immediate disrobing to ensure optimal decontamination.
“Should a large-scale chemical exposure occur, clear communication from first responders can save lives. Making sure everyone can hear you, understand you, and is physically able to follow safety procedures will speed the decontamination process and limit toxic exposure, especially for children, the elderly and the most vulnerable victims,” said Robert P. Chilcott, PhD, professor at the University of Hertfordshire (UK) and lead study author. “First responder staffing levels and resources may need to be re-evaluated in order to avoid casualties and ensure safe and effective rapid response.”
Hearing and communicating instructions in an emergency can be difficult, according to feedback from first responders and participants that is included in the analysis. Concerns were raised that first responder staffing levels would need to increase, and resources would need to be allocated, so that victims deemed “at-risk” (unable for any reason to comply with verbal instruction) were able to follow the time-sensitive decontamination instructions as directed.
The evaluation supports the introduction of an immediate “disrobe and dry” decontamination stage while victims wait for further treatment. The analysis notes that the most effective decontamination methods start by disrobing then include a triple combination of dry, ladder pipe and technical decontamination. “This should be adopted as the standard approach,” Dr. Chilcott said.
The initial “dry decontamination” involves rapidly wiping down the victim with any absorbent material (toilet paper, paper towels, diapers, or materials typically carried on an ambulance, such as wound dressings) and does not rely on specialist resources. Dry decontamination enables first responders to reassure victims, start providing instructions and offer situational information.
Next, “ladder pipe decontamination,” involves positioning victims of chemical exposure in a corridor between two parallel fire engines then spraying them with water from a hose strapped to an overhead ladder. This procedure was occasionally performed on fully-clothed individuals. Now, the guidelines have been updated to emphasize the need for disrobing prior to any form of wet decontamination. A third step, “technical decontamination,” involves specialist units, privacy, warm water and waste containment.
Adding disrobe and dry procedures before ladder pipe decontamination enables more effective time management, the authors note. While setting up the ladder pipe system, first responders should not miss the critical window of opportunity to remove toxic chemicals from hair or skin.
Disrobing may limit the likelihood of a panicking victim fleeing the scene of the incident and prevents contamination on clothes from spreading to skin, the authors write in “Evaluation of US Federal Guidelines (Primary Response Incident Scene Management: ‘PRISM’) for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident.”
The evaluation looked at the clinical and operational efficacy of the recently revised PRISM (Primary Response Incident Scene Management) response, the United States federal guidance for first responders to mass chemical exposure incidents. The simulation took place in August 2017 and included more than 80 volunteers who were exposed to a chemical warfare agent simulant (methyl salicylate, curcumin and baby oil mixture). Fire department and emergency medical service personnel in Rhode Island participated alongside representatives from the Federal Emergency Management Agency (FEMA).
“If a chemical attack or catastrophic accident occurs on American soil, first responders would be relied on to act as quickly and effectively as possible in order to save lives.” Dr. Chilcott said. “The revised PRISM guidance should double first responders’ efficiency. And, the introduction of the disrobe and dry decontamination stage should further improve clinical outcomes for victims.”
The full analysis is available here.
New CDC Guidelines Detail Treatment of Pediatric Mild Traumatic Brain Injury
Sep 5, 2018
WASHINGTON, Sept. 5, 2018 /PRNewswire/ — New evidence-based guidelines, developed by the Centers for Disease Control and Prevention (CDC) with input from the American College of Emergency Physicians (ACEP) and others, put forward recommendations for a broad range of health care providers responsible for detection and management of pediatric mild traumatic brain injury, most of which are concussions.
The CDC recommendations are outlined in an Annals of Emergency Medicine editorial and span diagnosis, prognosis, management and treatment in a variety of clinical settings. From 2005-2009, there were almost 3 million emergency visits for pediatric mild traumatic brain injury, according to the CDC.
“The experts in emergency departments are often the first care providers to evaluate a child’s head injury,” said Angela Lumba-Brown, MD, pediatric emergency physician, lead author and Clinical Assistant Professor of Emergency Medicine at Stanford University. “These guidelines standardize a framework for recognizing, treating and managing a child’s recovery from mild traumatic brain injury – encouraging appropriate use of diagnostic imaging, safe prescribing, and making sure each child, family or caretaker is equipped with the information they need for a quick and safe recovery.”
Key recommendations include that mild traumatic brain injury does not require imaging in an acute care setting. Computed tomography (CT) imaging should be considered when there is suspicion of more severe forms of injury, the authors wrote. The CDC suggests that clinicians screen for risk factors because recovery will vary by individual characteristics. Non-opioid analgesics should be prescribed by the emergency department along with counseling about risks of overuse. The child and family should be educated before discharge about the warning signs for more serious injury and the expected course of recovery. And, the new recommendations call for providers to describe healthy sleep habits and other strategies to help facilitate recovery.
The CDC is offering new tools that can help health care providers with implementation of the guidelines, including a checklist for diagnosis and management; patient discharge instructions; recovery tips for parents to support their child; and a letter to schools to be filled in by healthcare providers.
More information about the guidelines is available at http://www.cdc.gov/HEADSUP.
WASHINGTON — Nearly six percent of urinary tract infections analyzed by a California emergency department were caused by drug-resistant bacteria in a one-year study period, according to new research in Annals of Emergency Medicine. The bacteria were resistant to most of the commonly used antibiotics. And, in many cases, patients had no identifiable risk for this kind of infection, the study found.
“The rise of drug-resistant infections is worrisome,” said Bradley W. Frazee, MD, attending physician, Alameda Health System Highland Hospital and lead study author. “What’s new is that in many of these resistant urinary tract infections, it may simply be impossible to identify which patients are at risk. Addressing the causes of antibiotic resistance, and developing novel drugs, is imperative. A society without working antibiotics would be like returning to preindustrial times, when a small injury or infection could easily become life-threatening.”
The authors urge some immediate changes to clinical practice such as wider use of urine culture tests and a more reliable follow-up system for patients who turn out to have a resistant bug; improving emergency physician awareness of their hospital’s antibiogram (a chart showing whether certain antibiotics work against certain bacteria); adherence to treatment guidelines and knowing which antibiotics to avoid in certain circumstances.
The Centers for Disease Control and Prevention (CDC) estimates that currently 23,000 Americans die each year from antibiotic-resistant infections.
The bacteria analyzed in this study were mostly E coli, that were resistant to cephalosporin antibiotics. Historically, such resistant bacteria were found in hospital-based infections. But, the authors note that they have been infecting more people outside of the hospital, particularly those with urinary tract infections. More than two in five (44%) of the infections analyzed were community-based (contracted outside of the hospital), the highest proportion reported in the United States to date.
The study, “Emergency Department Urinary Tract Infections Caused by Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae: Many Patients Have No Identifiable Risk Factor and Discordant Empiric Therapy is Common,” involved retrospective analysis of 1,745 urinary cultures from patients with urinary tract infections at an urban Northern California Emergency Department between August 2016 and July 2017.
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians (ACEP), the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit www.acep.org.
We are continuing to work with our legislators regarding the future of the TCD program in Missouri. On Tuesday, there was a budget hearing. We were represented at that hearing. Additionally, our lobbyist was also able to speak directly with Governor Parsons. We are hopeful that a resolution to this will be forthcoming soon. We shall keep you updated as we learn more and the situation develops.
For more information about the hearing, here is an article from the Missouri Times.
House Budget committee lambasts DHSS and Parson administration over trauma care program
Missouri’s top budget lawmaker in the House of Representatives is not happy.
Rep. Scott Fitzpatrick, the chairman of the House Budget Committee, led Tuesday’s barrage against Gov. Mike Parson’s administration, angry about the blundering of a program housed within the Department of Health and Senior Services that looks to help stroke and heart attack patients get care from the most appropriate facility in the quickest amount of time.
That program, called the Time Critical Diagnosis System, has become a major concern in the past few weeks, as Gov. Parson vetoed $153,000 from the program, which equates to three full-time staff members, which many say means the discontinuation of the program.
The TCD System is a statewide system that brings together the 911 response system, ambulance services, and hospitals in a coordinated way to provide patients the right care, at the right place, in the right amount of time.
Members of the House Budget Committee on Tuesday questioned why the program was vetoed without having a plan in place to sustain the program, which proponents say has improved recovery times, reduced complications and saved lives, particularly in rural Missouri.
The veto caused a scare among hospitals, EMS providers, and patient advocates, as well as several legislators.
“As a stroke survivor, I am very concerned about these cuts. Every second counts,” Rep. Rocky Miller tweeted.
Those testifying in support on Tuesday said that delays in care could have “devastating impacts.”
Parson’s administration and DHSS Director Randall Williams attempted to downplay the potential issues, saying there wouldn’t be a break in service.
“I don’t think there’s going to be any change in the services provided by that budget cut,” Parson told reporters on Monday afternoon. “I don’t think you’re going to see any change in service.”
Prior to Tuesday’s budget meeting, DHSS issued a news release, stating that they were working with partners “to ensure funding for the Time Critical Diagnosis (TCD) System will remain steady moving forward.”
“We remain committed to working closely with our hospitals, providers and emergency medical services professionals to provide time-sensitive care to patients in a coordinated manner. As we transition the time-critical diagnosis system forward, we will ensure the funding remains steady and continue to provide this essential service for Missourians,” Williams stated in the Tuesday morning release.
But that assertion proved to be a major issue as the committee questioned Williams, who told the committee that the purpose of the veto was to get hospitals talking about changing the source of funding for the program.
He said there will be a meeting next week to discuss a plan that
would require hospitals to pay about $1,000 per year to pay for accreditation.
“It was never our intent to interrupt services,” Williams said. “We thought this was a viable alternative.”
And after the backlash the veto brought on, Williams said he had brought back the employees who had been doing those jobs to keep the program going.
That proved to be the final straw for Fitzpatrick, who said that the funding for that program had been removed, and that didn’t mean that DHSS could simply move the program to be housed under other offices. He said that the funding had been vetoed and that it would be unconstitutional for DHSS to reallocate money that had been granted by the legislature for a specific purpose.
“Gov. Parson vetoed the funding, and it sounds like to me like you regret that decision and want to walk that back,” Fitzpatrick said, telling them that they couldn’t spend money on something they vetoed. “That’s not how this works.”
“We feel we’ve got flexibility within that section to move things around,” the Office of Administration’s budget director Dan Haug said.
“I disrespectfully disagree because I am pissed,” Fitzpatrick replied. “You guys messed up… You shouldn’t be doing that. You won’t be doing that.”
“You are going to lose big time on this eventually,” he told Haug, saying that if the department went forward with a plan ignoring the will of the legislature and the budget process put forward in the Consitution, there “will be hell to pay.”
“These inspections are important, but the governor made his decision. Everybody knew what the consequences were when it was made.”
Fitzpatrick said the only ways to fix it would be to have no inspections until the legislature passes a supplemental budget in January, or DHSS agreed a mistake was made and asked the legislature to override the veto.
The program could be able to continue until the legislature’s veto session in September, and Williams said that two hospitals are scheduled to be recertified by then.
The TCD veto cut was the only one to be truly debated by the committee, though nearly all of Parson’s 21 vetoed items were met with calls for overrides, ranging from cuts to higher education institutions like Harris-Stowe and Missouri Southern State University, as well as funding for employees in the Office of Child Advocate, which is housed in the Office of Public Defenders. Rep. Justin Hill also pushed for the override of a $50,000 veto meant to pay for emergency rescue tourniquets to supply to law enforcement agencies across the state.
On June 25, 2018 ACEP President-Elect John Rogers resigned his position. The root of John’s decision was continuing criticism about his lack of emergency medicine residency training and board certification in surgery. As ACEP celebrates its 50th birthday this year in San Diego, John did not want his lack of emergency medicine board certification to divide emergency medicine organizations at a crucial time in our history. Despite the protests of the ACEP Board and the ACEP Council urging him to continue on as ACEP President in 2018-2019, John decided to resign.
I’ve known John for almost ten years. He has been an ardent supporter of the ACEP Rural EM Section as we dreamed of a rural EM textbook and the Journal of Rural EM. As an ACEP Board member, he routinely checked in to learn how he could be of assistance and was always available to act as a sounding board for our messaging with the Board and ACEP Council. I didn’t always see eye-to-eye with him, but I always respected his opinion and was glad that he understood the challenges of rural emergency medicine with the vision that ACEP could and should do more to assist acute care in non-urban settings.
In response to John’s selfless resignation this week, the Georgia Chapter of ACEP (John’s home state) would like to submit the attached proposal to ACEP Council and is hoping to obtain the endorsement of 100% of state chapters and ACEP Sections. As a member of MOCEP, I would like to propose that our state chapter endorse this resolution honoring John’s work to improve emergency care for all patients (elderly, rural, etc.). Thank you for considering.
Here is the Resolution
for Dr. John Rogers thanking him for his service to ACEP and all that he has done to advance emergency care.
In March of this year, ABEM announced that it would be working on an alternative to ConCert (the recertification exam)—tentatively named MyEMCert, and that some modifications would be made to ConCert.
Please answer three questions to help develop MyEMCert and improve ConCert, plus a few demographic questions to assure we have answers representative of all ABEM-certified physicians.
ABEM has talked with several groups of ABEM-certified physicians in developing MyEMCert and in making the modifications to ConCert. We are interested in hearing from every ABEM-certified physician before we move ahead.
If you did not receive a survey or have questions, please email MOC@abem.org.
There are five surveys, but you should just receive one version; this is also why you shouldn’t use someone else’s link. Every survey has the same first and second question, while one or two other questions are different. That way, ABEM will have a sampling of answers to several questions, yet every physician will have only three main questions to answer. These questions are followed by six demographic questions.
ABEM surveys thousands of emergency physicians every year. In coming up with MyEMCert, ABEM met with representatives from 26 state ACEP chapters, AAEM leadership, previous members of the ABEM Board of Directors, and held a summit with representatives from every major EM organization. Although we have heard from many, we would like the thousands of ABEM-certified physicians we have not talked with to have a voice. We think it is critically important to have your input as we develop this new recertification process.
Save the Date: ACEP Town Hall on Gun Safety June 5, 2018
Please save the date for an ACEP Town Hall with Congressman Seth Moulton on June 5th from 6-6:30pm EST. Congressman Moulton will provide a brief overview of his work and experiences as a Member of Congress working to enact commonsense gun safety legislation. Congressman Moulton is also eager to engage in Q&A with ACEP members to learn more about what members care about, how he can help support your work, and how together we can work on creating solutions to gun violence that keep our communities and families safer. Keep an eye on your inbox for additional details regarding the town hall.
ACEP recently joined with 80 national medical, public health, and research organizations to send a joint letter to House and Senate leaders regarding CDC funding for firearms injury prevention. In the letter, we asked the leadership to provide $50 million in funding for the Centers for Disease Control and Prevention (CDC) to conduct public health research into firearm morbidity and mortality prevention as consider appropriations for Fiscal Year (FY) 2019. To view the full letters, please use these links: Senate letter and House letter.
MO HelathNet has started mailing letters about opioid prescribing. So far 8,000 letters have been mailed to physicians. They are generally sent for being outside the CDC guidelines for opioid prescribing. We are sending further requests for information about how this will impact emergency care (the CDC guidelines were not exactly meant for emergency medicine) and to make sure this does not negatively impact care from emergency physicians or make it so more people come to the ED because their doctor won’t prescribe narcotics. However if you get a letter, you must respond in 20 days. For more details, please go to https://dss.mo.gov/mhd/providers/opi-program.htm.
If you weren’t aware, ACEP turns 50 this year. To commemorate this and emergency medicine over the past 50 years the book, Bring ‘Em All, is being released which tells the story of 50 emergency departments across the United States. If you are interested in more information, please click here to watch a video.
You can also click here for more information about the book.
The Missouri Hospital Association (MHA) just released their Trajectories publication for December.
It has a lot of useful information regarding patient trends in the ED, including total MO ED visits and admissions in 2016.
Additionally the MHA focuses on innovations occurring in MO EDs regarding the care of super-utilizers and patients with opioid use disorders.
For more information please go to https://www.mhanet.com/mhaimages/Trajectories_Dec2017.pdf
Applications and nominations are now being accepted for several awards and grants provided to MOCEP members. Nominate yourself or a peer today!
RR Hannas Physician of the Year
RR Hannas Resident of the Year
Bill Jermyn Advocacy Grant
Student Advocacy Grant
Physicians gathered at the Annual Meeting of the American Medical Association (AMA) voted for David O. Barbe, M.D., M.H.A., a family physician from Mountain Grove, Mo., to be the next president-elect of the nation’s premier physician organization. Following a year-long term as president-elect, Dr. Barbe will assume the office of AMA president in June 2017.
Join the Discussion
The MOCEP General Membership Meeting was held May 5, 2016, at the Hammons Heart Institute, Springfield, in conjunction with the Tom Steele Emergency Symposium. Election of the new Board of Directors was held during the meeting. You can view a list of the new Board of Directors and Officers here.
MOCEP committee members provided updates on their activities over the past year. This information has been compiled into a single document so members can stay up-to-date on the priorities and progress of the association. You can review the MOCEP update here.
Tom Steele Conference Ultrasound 2016 Flyer
This is a pre-conference for the 2016 Dr. Tom Steele Emergency Care Symposium. This conference will consist of a morning session and an afternoon session with a 1 hour lunch break between sessions. Lunch will not be provided. Topics will include both FAST and RUSH exams as well as pelvic and cardiac sessions. The target audience for this conference is physicians caring for critically ill patients.
Registration fee includes electronic access to syllabus materials and an electronic certificate of attendance.
Register online at www.onlineregistrationcenter.com/ultrasound2016
This conference is limited to 20 participants, early registration is encouraged.
Registration by Friday, April 29, 2016 is encouraged. A $25 processing fee will be deducted from all cancellation requests made before Friday, April 29, 2016. No refunds will be made thereafter. If Mercy cancels the symposium a full refund will be issued. The liability of Mercy is limited to the symposium fee. Mercy will not be responsible for any losses incurred by registrants including, but not limited to, airline cancellation charges or hotel deposits. Layered clothing is recommended to allow for room temperature variations. For registration information, please contact Mercy Talent Development and Optimization at (417) 820-3005. For specific program content information, please contact SPRG_TDO@Mercy.net.
2016 Tom Steele Symposium
Here is more information about the upcoming ACEP Souteastern Chapter Educational Conference. This will be the second year that MOCEP is participating in the conference. The conference will take place at the Sandestin Golf and Beach Resort in Destin, Florida. Lots of great speakers, up to 21.5 hours of CME available, and the afternoons are all free to play golf or enjoy the beach!
Please click here to download the flier for more information.
At the MOCEP annual membership meeting on May 5th in Springfield, voting will take place for board of director and councilor positions. Please see the attached job description document. If you are interested in running, please contact Douglas@mocep.org or email@example.com.
MOCEP Leadership job descriptions
For those members that were good enough to man the department on New Year’s Eve, or for those that have ever worked a holiday, I hope you enjoy the following article from ABC News.
Tales from the ER
Tales From the Emergency Room on New Year’s Eve
· By JULIE BARZILAY
Dec 31, 2015, 3:14 PM ET
Even on the calmest day of the year, emergency medicine doctors are prepared to expect the unexpected. But on New Year’s Eve, all bets are off.
Ask any doctor and he or she will tell you; the only place crazier than Times Square on New Year’s is the hospital emergency room, where physicians tackle traumas and tend to revelers who have partied a little too hard.
To See the Start of 2016…Make Sure And Keep Your Eyes Open
Take one of Dr. Robert Glatter’s most memorable New Year’s Eve patients, for example. Glatter, a New York-based emergency medicine physician and a spokesman for the American College of Emergency Physicians (ACEP), recalls treating a young woman who accidentally glued her eyes shut an hour before midnight one New Year’s Eve. She had inadvertently dripped super glue into her eyes instead of the antibiotic eye drops in her medicine cabinet.
“In her haste to get to the ER, she reached into her bag and then used what she thought was breath-spray, but it turned out to be pepper spray, instead,” Glatter said. “She came in screaming with chest pain with her eyes glued shut, saying her chest was on fire.”
What’s an ER doc to do? He treated her eyes with lubricant, then administered medications to ease her chest pain.
“She felt much better, and wished us a happy New Year as she was discharged home much happier than when she arrived,” he recalled.
Unfortunately, not all New Year’s injuries are so innocuous.
Two to three times more people die in alcohol-related crashes during Christmas and New Year’s than during comparable periods the rest of the year, according to the National Highway Traffic Safety Administration. And a much higher percentage of these crashes involve a driver who is alcohol-impaired.
In New York, alcohol-related emergency room visits more than double on New Year’s Day compared to what is typically observed, according to the New York City Department of Health and Mental Hygiene.
New Year’s Nudity: Another Accident to Avoid
Drugs are also a concern, even bath salts, apparently. Dr. Eric Ketcham, an ACEP spokesman and the medical director of the emergency department and urgent care at San Juan Regional Medical Center in New Mexico, treated a young man who was high on bath salts one New Year’s Eve.
The man was running around naked in sub-zero temperatures, and was caught using an extension ladder to break into a second story window. Unfortunately, this man ended up arrested, but first Ketcham treated him for excited delirium, hypothermia and frost bite to his feet, which had severe abrasions from running around barefoot in the cold.
Dr. Angelique Campen, medical director of the emergency department at Providence Saint Joseph Medical Center and an ACEP spokeswoman, says that for ER docs, New Year’s is just business as usual.
“This is the essence of ER doctors,” she said. “We are available 24 hours a day, 7 days a week, even on New Year’s Eve, to help you when you most need. We sacrifice our own celebration to be available for the public, but do so with pleasure. We treat everyone’s emergency as such, no matter how big or small, with compassion, respect, and privacy.”
For That Midnight Kiss, Watch Where You Put Your Lips
Speaking of smaller emergencies, Campen recalls a New Year’s Eve kissing mishap that brought a young woman into her ER. This woman had turned around at midnight and kissed who she thought was her boyfriend only to find it was a completely different man with a giant cold sore. She then came into the ER to get checked for herpes simplex.
As funny as some of these tales may sound, Vanderbilt Department of Emergency Medicine Chairman Dr. Corey Slovis emphasized that much of what emergency doctors see on New Year’s is troubling, as they witness how “amazingly dangerously people can behave due to drugs and alcohol.” At all costs, he says, make a plan so you won’t end up driving while impaired.
Glatter had an additional warning for 2016: Beware of hoverboards. Combining alcohol with these precarious devices could be deadly, he said.
People always resolve to get healthy for the New Year, Glatter said, “but to do that, you first need to survive into the New Year.”
By now I hope you have all heard about wellness week Jan 24-30. Please go to www.acep.org/emwellnessweek and sign up! Encourage your partners and coworkers (good for nurses, APPs and other staff).
Go to https://www.facebook.com/ACEPFan and share with your friends.
Send this info to your ED Director and get your entire team on board
It’s just 1 week!
Created and spearheaded by the American College of Emergency Physicians, the 2016 Emergency Medicine Wellness Week™ is an opportunity all emergency physicians and their colleagues to take the time to self-renew while staying dedicated to the highest quality patient care.
The inaugural event is slated for January 24-30, 2016. To participate, visit the website, www.acep.org/EMWellnessWeek, and sign up for daily wellness tips, print a personal pledge card, find resources and videos about better wellness, and share your stories of personal improvement.
“As emergency physicians, we care a lot about our patients. That’s why we chose this specialty. But all too often we are so busy caring for others, we forget to care about ourselves,” said ACEP President Jay A. Kaplan, MD, FACEP. “We want this week to be about action rather than just ideas. Everyone makes resolutions around the New Year; we hope that this week will help us and our colleagues make commitments to become more healthy, less burned out, and more resilient.”
First, fill out an anonymous pledge card from the website, selecting areas that you will focus on for the week. Print it out and stick it on your refrigerator, your mirror, anywhere you’ll see it every day. There will be suggested improvements in three major areas, such as:
Drink water, not soda
Get at least 7 hours of sleep per night in blocks of at least 4 hours
Spend time with family, friends
Spend time connecting to your spiritual self
Do one community project
Learn to recognize burnout and decrease it
Develop a new networking contact
Plan your next career move
Next, sign up to receive daily messages about wellness for that week to help you keep on track, and introduce resources that will help improve your wellness that week and beyond. At the end of the week, ACEP will ask you how you did and what worked for you.
“More importantly, at the end of the week, we want you to feel better – about yourself, about your family and friends, about your patients and your work,” Dr. Kaplan said. “We’d like you to remember, once again, why you chose medicine, and emergency medicine, for your life’s work. And to be proud and happy with that decision.”
EMF Grants Available!
Apply Here! www.emfoundation.org/applyforagrant
Deadline for proposals is December 18, 2015
NIDA/EMF Training Awards Available!
The Emergency Medicine Foundation (EMF) has partnered with the National Institute on Drug Abuse (NIDA) to support two $20,000 Training Awards. The goals of the award are to promote knowledge of treatments for patients with substance use disorders (SUD) and facilitate the development of future emergency medicine practitioners and researchers in SUD. The Applicant may be a resident in an ACGME approved emergency medicine residency training program, a first year graduate, or entering first year faculty member. Eligible candidates will not have a career development award and must be based in United States programs and institutions.
Deadline soon! Apply here today! www.emfoundation.org/applyforagrant
Deadline for proposals is February 12, 2016
22 Grants to be Awarded in 14 Categories
The Emergency Medicine Foundation (EMF) is excited to provide up to 22 grants in a variety of topics in the 2016-2017 award year. Medical students, residents, basic science investigators, health policy researchers and others interested in emergency medicine research are encouraged to apply. Two new grants are available this cycle: Emergency Department Planning, Operations, and Design, co-funded by the Academy of Architecture for Health Foundation and Emergency Medicine Education Research, co-funded by the Council of Emergency Medicine Residency Directors. Get started on your applications today at www.emfoundation.org/applyforagrant!
MoCEP Councilors in Boston 2015
We are happy to announce that Missouri now has 3 residency programs with 100% of their residents as members of ACEP/MOCEP/EMRA. MOCEP continues to support the involvement of emergency medicine residents in ACEP through a funding match program with Missouri residency programs. For programs that commit to funding the membership of all of their residents, MOCEP has pledged to match 50% of the cost.
Programs with 100% resident membership:
Washington University in St. Louis
University of Missouri – Columbia
University of Missouri Kansas City/ Truman Medical Center
MARK YOUR CALENDARS NOW AND MAKE PLANS TO ATTEND!!
It is with great excitement that MOCEP has decided to join the Southeastern Chapters Education Conference which will take place next year from June 6-9th in SanDestin, FL. This meeting combines great educational sessions with beautiful Florida beaches. We hope to see many Missouri attendees next year. This is a family friendly event. The SanDestin resort provides plenty of activities to keep you occupied when not in sessions. The lecture component ends each day by 1pm in order to allow for recreational time.
Brochures will be mailed in early 2016.
MOCEP Policy on Specific CME Requirements
The Missouri College of Emergency Physicians (MOCEP) believes that board certification or board eligible status by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM) demonstrates comprehensive training, knowledge, and skill in the practice of emergency medicine.
Additionally, maintenance of board certification requires mandatory retesting and continuing medical education (CME), making extraneous CME or required short courses redundant and undermines the ability of emergency physicians to participate in comprehensive continuing education that addresses the full spectrum of emergency medicine.
Accordingly, for physicians certified by ABEM or AOBEM, MOCEP strongly opposes the use of a specified number of CME hours in a sub-area of emergency medicine, as requirements for privileges, renewal of privileges, employment, or qualification by hospitals, city or state agencies, or any other credentialing organization to provide care for conditions as already outlined in the Model of the Clinical Practice of Emergency Medicine.
ACEP Wants YOU!
The process to select members to serve on ACEP committees for FY 2015-16 is now open.
Having representation from the Missouri Chapter on committees will strengthen our voice in ACEP and will keep MOCEP members better informed. We ask you to please consider submitting your name for one of the committees. Join the Discussion
Dr. Douglas Char, MoCEP President, was accompanied by Wash U Emergency Medicine residents, Lydia Luangruangrong and Daniel Lackey to the Grassroots Advocacy Training Workshop, sponsored by the Missouri State Medical Association. They had the opportunity to learn advocacy techniques and meet State Representatives and Senators Frederick, Neely, Onder, Schaaf (who are also Missouri physicians) to discuss upcoming legislative issues.
Here is the recently released 2014 ACEP Urgent Care Poll Results.
2014 ACEP Urgent Care Report
Following is the revised list of councillors and alternates who will represent the Missouri Chapter at the 2014 Annual Council Meeting in 2 weeks.
Attached is the compendium of 2014 Council Resolutions. The councillors would appreciate your comments and thoughts on the resolutions so that they can speak with the full voice of the membership. You may reply directly to any or all of the councillors, or you may send your comments to Cecile@mocep.org in the MOCEP office.
Douglas Char, MD, FACEP firstname.lastname@example.org
Jonathan Heidt, MD email@example.com
Christine Sullivan, MD Christine.Sullivan@tmcmed.org
Sebastian Rueckert, MD, FACEP firstname.lastname@example.org
Larry Slaughter, MD, FACEP email@example.com
Jacob Keeperman, MD firstname.lastname@example.org
Scott Haight, MD email@example.com
Yue Dai, MD, M.B.A. firstname.lastname@example.org
EMRA has recently created a new ACEP/EMRA Medical Student Elective in Healthcare Policy and Government Relations.
This course is designed to provide medical students who intend to enter into Emergency Medicine (EM) with the opportunity to research legislative issues pertinent to the practice of EM, and to gain hands-on experience as an advocate for the profession through interactions with local, state and/or federal legislators. Students will work with representatives from ACEP’s Washington, DC office and from their State Chapter office, to determine an appropriate research focus, and to schedule meetings with legislators and their staff members. This is intended to be a 1-month/4 week experience, during which 2 weeks will be spent with ACEP’s Washington, DC staff. The remaining time should be spent at the student’s home institution working closely with the State Chapter office staff.
This course is reserved for 4th year medical students with current ACEP/EMRA membership, and is designed to be for elective credit. However, individuals not seeking credit are still encouraged to apply.
Click here for more information http://www.emra.org/students/health-policy-elective/
Applications are due by July 15 of each year. EMRA will provide a stipend of $1500 each for 2 students per year. Two additional students per year may be offered unfunded elective/internship acceptance (depending on availability in the DC Office). There is flexibility in scheduling the project to accommodate the schedules of the student, ACEP DC office and the state chapter office.
CODE BLACK, a new feature-length documentary film that follows a dedicated team of charismatic, young doctors-in-training at Los Angeles County Hospital. As they wrestle openly with both their ideals and with the realities of saving lives in a complex and overburdened system, the film brings us face to face with America’s only 24/7 safety net, the Emergency Department. CODE BLACK has garnered multiple awards including Best Documentary at the Los Angeles Film Festival, and enjoyed successful premieres in NY and LA. Please find more details about the film below my signature and watch the trailer here.
About the Movie
Join the Discussion
WASHINGTON, July 8, 2014 / PR Newswire / — “We are all a heartbeat away from needing emergency care” is one of key messages of the Saving Millions campaign of the American College of Emergency Physicians (ACEP), highlighting the incredible value of emergency medicine to every community and the efficiency and economic benefits of medical care provided in the nation’s emergency departments.http://www.acep.org/savingmillions.
“Emergency physicians are critical to our communities,” said Dr. Alex Rosenau, president of ACEP. “America’s emergency physicians save more than lives. We are dedicated specialists who can mobilize resources and coordinate care for our patients. And we have special hours — all day, all night and all year.” Join the Discussion
The work of the Missouri state chapter focuses on 6 areas – Education & Programing, Research Grants & Awards, Legislative Affairs & Health Policy, Membership, Communication and Chapter Finances. Each of those committees depend on physician members to make things happen. This is your opportunity to get involved in MOCEP. We know you are busy but hope that you’ll volunteer a few hours to work with colleagues from across Missouri to:
1) Raise awareness and fight for issues that impact our patients, practices and families
2) To create education opportunities, and identify research projects worthy of our support
3) To share news about what we are doing with peers and the public
4) Ensure that our chapter has the people and resources need to address the issues that impact Emergency Care in Missouri
Please send an email to me (email@example.com) or our Executive Director (Cecile Landrum at firstname.lastname@example.org ) and we’ll get you assigned to one of the committees. A list of the committees is included below.
We greatly appreciate your time and involvement!
Douglas Char, MD
Wash Univ Emergency Medicine
Join the Discussion
MoCEP President Douglas Char is quoted in this New York Times piece about the lack of a Prescription Drug Monitoring Program in Missouri.
Missouri Alone in Resisting Prescription Drug Database NYTimes