How the ACEP Clinical Policies Standardize and Improve Patient Care Andy Jagoda, MD, FACEP Professor of Emergency Medicine Mount Sinai School of Medicine New York, New York. Objectives. Introduce the process of how clinical policies / practice guidelines are developed
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How the ACEP Clinical Policies Standardize and Improve Patient CareAndy Jagoda, MD, FACEPProfessor of Emergency MedicineMount Sinai School of MedicineNew York, New York
“Do the authors seriously believe that patients with a first seizure can be discharged from the ED after a serum glucose and a pregnancy test without additional lab testing? This flies in the face of common sense and would perhaps be considered malpractice in some parts of the country.”
Journal Reviewer 1995
Q. Do you read the policies of the American College of ER physicians?
A. I don’t recall reading that policy. Is it something published by ACEP?
A. I don’t recall reading it.
Q. So if torodol releives a headache, does that cause you to believe the patient does not have meningitis in a patient in whom you are suspecting meningitis a a possible cause of their headache
A. It’s an indicator that would decrease the likelihood.
Q. If torodol relieved their headache, would you rely on that as a factor in ruling out meningitis?
A. It is part of the package.
Clinical Policy: Critical issues in the evaluation and management of patients presenting to the ED with acute headache. Ann Emerg Med 2002; 39:108-122
Strength of evidence (Class of evidence)
Strength of evidence can be downgraded based on methodologic flaws
Huizenga et al. Guidelines for the management of severe head injury: Are emergency physicians following them? Acad Emerg Med 2002; 9:806-812