Policy Statements
HIV Testing and Screening in the Emergency Department [Ann Emerg Med. 2014;64:563.] Early diagnosis and treatment for HIV can prolong life and reduce transmission and is a cost-effective public health intervention. HIV screening has substantial net benefits to individuals and the public health, as recognized by the US Preventive Services Task Force (USPSTF) level A grading.1 The USPSTF recommends that clinicians screen for HIV infection in the following populations: adolescents and adults aged 15 to 65 years all pregnant women, including those who present in labor who are untested and whose HIV status is unknown younger adolescents and older adults who are at increased risk for HIV infection Emergency department (ED) HIV screening programs deliver the greatest public health influence when local prevalence of HIV infection is greater than or equal to 0.1%; screening procedures are practical, are feasible, and do not interfere with the primary acute care mission of emergency medicine; integration exists between the ED and the resources of the entire health care system; policies and procedures clearly address patient confidentiality, informed consent (state dependent), provider training, opportunities for counseling, and linkage to care; adequate funding or reimbursement is available to meet the operational and personnel costs required for program sustainability; and all local and state requirements are met. HIV testing in the evaluation for acute care conditions in the ED should be available in a timely and efficient fashion, similar to testing and results for other conditions. Approved June 2014 Revised and approved by the ACEP Board of Directors June 2014 Approved by the ACEP Board of Directors April 2007 REFERENCE 1. US Preventive Services Task Force. Screening for HIV: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2013. Available at: http://www.uspreventiveservicestaskforce.org/ uspstf/uspshivi.htm. Accessed March 27, 2014. http://dx.doi.org/10.1016/j.annemergmed.2014.08.033
Participation in Activities While Distracted by Mobile Device Use [Ann Emerg Med. 2014;64:563.] Recognizing the dangers of interaction with a handheld electronic mobile device while operating any Volume 64, no. 5 : November 2014
vehicle* or walking, the American College of Emergency Physicians (ACEP) discourages the use of handheld electronic mobile devices while driving motorized vehicles, maneuvering other vehicles, or moving as a pedestrian; encourages research to quantify the magnitude and severity of injuries to distracted pedestrians and drivers using electronic mobile devices and encourages research involving prevention of these injuries; encourages public education about the dangers of distracted driving and pedestrian activities; supports primary enforcement of antitexting and distracted driving legislation to prevent injuries and change behavior; and opposes legislation that relieves insurance companies of financial responsibility for otherwise insured losses incurred by beneficiaries who experience the losses because of the actions of those distracted while using handheld electronic mobile devices. Approved June 2014 Approved by the ACEP Board of Directors June 2014 http://dx.doi.org/10.1016/j.annemergmed.2014.08.032
Emergency Ultrasound Certification by External Entities [Ann Emerg Med. 2014;64:563.] The American College of Emergency Physicians (ACEP) believes that certification by non–emergency medicine external bodies, organizations, societies, or other medical specialties or on short course completion is inadequate to demonstrate comprehensive training, knowledge, and skill in the practice of emergency ultrasound. Emergency ultrasound comprises a set of focused applications used to diagnose life-threatening conditions, guide invasive procedures, and treat emergency medical conditions. Both residency- and practicebased pathways exist for emergency physicians to demonstrate competency in emergency ultrasound, as detailed in the ACEP policy statement “Emergency Ultrasound Guidelines.” Any non–emergency medicine external certification process would impede the use of this critical clinical skill and adversely affect patient care. ACEP strongly opposes the use of any non–emergency medicine external certification process to validate competency in the use of emergency ultrasound. Furthermore, any such process should not be used as a requirement for hospital privileges or credentialing, or for reimbursement by accountable care organizations, managed care organizations, the Centers for Medicare & Medicaid Services, or other third-party payers. Approved June 2014 Approved by the ACEP Board of Directors June 2014 http://dx.doi.org/10.1016/j.annemergmed.2014.08.031 *Including but not limited to automobiles, trucks, motorcycles, bicycles, skateboards, and watercraft.
Annals of Emergency Medicine 563
HIV Testing and Screening in the Emergency Department [Ann Emerg Med. 2014;64:563.] Early diagnosis and treatment for HIV can prolong life and reduce transmission and is a cost-effective public health intervention. HIV screening has substantial net benefits to individuals and the public health, as recognized by the US Preventive Services Task Force (USPSTF) level A grading.1 The USPSTF recommends that clinicians screen for HIV infection in the following populations: adolescents and adults aged 15 to 65 years all pregnant women, including those who present in labor who are untested and whose HIV status is unknown younger adolescents and older adults who are at increased risk for HIV infection Emergency department (ED) HIV screening programs deliver the greatest public health influence when local prevalence of HIV infection is greater than or equal to 0.1%; screening procedures are practical, are feasible, and do not interfere with the primary acute care mission of emergency medicine; integration exists between the ED and the resources of the entire health care system; policies and procedures clearly address patient confidentiality, informed consent (state dependent), provider training, opportunities for counseling, and linkage to care; adequate funding or reimbursement is available to meet the operational and personnel costs required for program sustainability; and all local and state requirements are met. HIV testing in the evaluation for acute care conditions in the ED should be available in a timely and efficient fashion, similar to testing and results for other conditions. Approved June 2014 Revised and approved by the ACEP Board of Directors June 2014 Approved by the ACEP Board of Directors April 2007 REFERENCE 1. US Preventive Services Task Force. Screening for HIV: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2013. Available at: http://www.uspreventiveservicestaskforce.org/ uspstf/uspshivi.htm. Accessed March 27, 2014. http://dx.doi.org/10.1016/j.annemergmed.2014.08.033
Participation in Activities While Distracted by Mobile Device Use [Ann Emerg Med. 2014;64:563.] Recognizing the dangers of interaction with a handheld electronic mobile device while operating any Volume 64, no. 5 : November 2014
vehicle* or walking, the American College of Emergency Physicians (ACEP) discourages the use of handheld electronic mobile devices while driving motorized vehicles, maneuvering other vehicles, or moving as a pedestrian; encourages research to quantify the magnitude and severity of injuries to distracted pedestrians and drivers using electronic mobile devices and encourages research involving prevention of these injuries; encourages public education about the dangers of distracted driving and pedestrian activities; supports primary enforcement of antitexting and distracted driving legislation to prevent injuries and change behavior; and opposes legislation that relieves insurance companies of financial responsibility for otherwise insured losses incurred by beneficiaries who experience the losses because of the actions of those distracted while using handheld electronic mobile devices. Approved June 2014 Approved by the ACEP Board of Directors June 2014 http://dx.doi.org/10.1016/j.annemergmed.2014.08.032
Emergency Ultrasound Certification by External Entities [Ann Emerg Med. 2014;64:563.] The American College of Emergency Physicians (ACEP) believes that certification by non–emergency medicine external bodies, organizations, societies, or other medical specialties or on short course completion is inadequate to demonstrate comprehensive training, knowledge, and skill in the practice of emergency ultrasound. Emergency ultrasound comprises a set of focused applications used to diagnose life-threatening conditions, guide invasive procedures, and treat emergency medical conditions. Both residency- and practicebased pathways exist for emergency physicians to demonstrate competency in emergency ultrasound, as detailed in the ACEP policy statement “Emergency Ultrasound Guidelines.” Any non–emergency medicine external certification process would impede the use of this critical clinical skill and adversely affect patient care. ACEP strongly opposes the use of any non–emergency medicine external certification process to validate competency in the use of emergency ultrasound. Furthermore, any such process should not be used as a requirement for hospital privileges or credentialing, or for reimbursement by accountable care organizations, managed care organizations, the Centers for Medicare & Medicaid Services, or other third-party payers. Approved June 2014 Approved by the ACEP Board of Directors June 2014 http://dx.doi.org/10.1016/j.annemergmed.2014.08.031 *Including but not limited to automobiles, trucks, motorcycles, bicycles, skateboards, and watercraft.
Annals of Emergency Medicine 563
