From the President
Neil L. Christen, MD, FACEP

Alabama Receives D+ in EM Report Card

The American College of Emergency Physicians has recently released their National Report Card on the State of Emergency Medicine. Alabama received an overall D+ with poor marks in Public Health/Injury Prevention and Access to Emergency Care. The report details many trends that emergency physicians experience on a daily basis. We lack enough primary care physicians and mental health personnel to meet our population’s needs. Additionally, they show that Alabama lacks enough emergency physicians and board-certified emergency physicians as well. On the positive side, however, Alabama was commended for our efforts in Disaster Preparedness, particularly with regards to the statewide trauma system. More can be done to improve the care of emergency patients, and we hope this report card will serve as a sounding board for our issues to our hospital and government leaders. Please read the report card for yourself to see the details.

 Chapter Update

AL ACEP Hosting Regional EM Meeting
Save the date! June 15-18, 2009. This year's summer conference will be better than ever. The Sandestin Golf and Beach Resort is a wonderful location to take the family, soak in some sun...and several good lectures. The TN Chapter has partnered with us the last two years. This year, we are expanding to include chapters and lecturers from all the SE states (MS, LA, AR, AL, KY, GA, FL, SC, and TN). So we are expecting a fantastic turnout. The resident poster presentations and wine tasting were also a big hit last year. Please join us as we seek to promote better emergency care in our state and in the region....and have a lot of fun.

Hello from Dr. Pettyjohn
Many of you are aware that one of our own AL ACEP Board members, Dr. Frank Pettyjohn, is currently serving in Iraq. We recently received an email from him that I wanted to share with all of you.

“Just a quick note. I am currently in Tikrit, Iraq on active duty in the US Army. I am with the 345th Combat Support Hospital. I arrived in country on Christmas Eve. We have been moderately busy. It is my privilege to support our troops in the combat zone. As the expression goes, the war is just "outside the wire". It is clearly brought home when we receive wounded.”

Thank you Frank for your service and dedication to the country and we look forward to your safe return.

Alabama EM Practice News

SEMCC Meeting Update
Mr. Blair gave an administrative update and noted that most EMS services around the state are in compliance with the ePCR. The HEAR (hospital emergency ambulance radio) system in all hospitals nationwide, but seldom used, must be up and running as this is the heart of the national system. National Registry is not going away from use by the state. State will attempt to pass a new law concerning the legal language regarding EMT and Paramedic. This is the new national language. It would also include some language to reduce the number of people on the EMS Advisory Board from 35 to 20 or slightly less. No new printing of National Registry guidelines until after the new AHA guidelines are released in late 2010. The On-line Medical Directors Course is still not online due to the test and certificate not ready for the website. All Regional trauma plans have been submitted to the State Committee of Public Health. BREMSS and North regions are up and running. Next meeting will be June 2nd in Clanton at the Alabama Power Conference Center.

“Balance Billing” Ruling Hurts Emergency Physicians in CA
The California Supreme Court just recently ruled that emergency patients are not required to pay the balance of their charges that HMOs refuse to pay. You can read the LA Times story here. While this does not specifically impact emergency physicians in Alabama, there is certainly a trend in other states, notably Texas, where this practice is being scrutinized. The Texas state legislature is expected to address this issue soon. In the current push to curb rising healthcare costs, some believe this is a viable option take pressure off the patients. However, those of us who stand on the frontlines working in the emergency department know that placing such a financial burden on a teetering healthcare system can have disastrous consequences. The ACEP Board and staff and California chapter are working diligently to find solutions to this delicate and complicated issue.

Bedside Ultrasound Resources Available
Many emergency departments in Alabama have incorporated bedside emergency ultrasound into their practice, and it can have an immediate impact on patient care and clinical-decision making. If you want to learn more about the nuts and bolts of starting or building your current ultrasound program, the ACEP Ultrasound Section has created many resources that can help with your practice. Most recently, ACEP has updates their Ultrasound Guidelines. They have also developed a comprehensive educational website with ultrasound videos. Another free educational website was developed by Dr. Hosek at Johns Hopkins which contains valuable ultrasound case studies for your review.

Clinical News

Balance Billing Ban in California Could Have National Impact
The California Supreme Court's decision in January to ban "balance billing" in that state will force emergency care providers to dispute literally millions of underpaid claims in court, emergency medicine experts warned. And, although balance billing regulations vary by state, the influential Golden State's ruling could trigger similar shifts elsewhere.
Read the entire article.

Women Have Fewer Complications, Better Survival Following Trauma
Women are less likely than men to experience complications following acute trauma, which may account for their apparent survival advantage, according to a retrospective study of almost 700,000 patients. However, women who do experience complications from traumatic injuries are more likely to die as a result.
Read the entire article.

FDA Takes a Closer Look at Xigris Bleeding Event
The Food and Drug Administration said on Feb. 4 that it is working with Eli Lilly and Co. to review the incidence of serious bleeding events and mortality in patients receiving the company’s sepsis drug drotrecogin alfa (Xigris). The drug was initially approved in the United States in 2001 and received an updated warning in 2005. At that time, the label was amended to state that the therapy might not be appropriate for patients with single organ dysfunction and recent surgery. The FDA began its most recent review after publication of a 73-patient retrospective study that found that patients with risk factors for bleeding had a significantly higher risk of a serious bleeding event with Xigris.
Read the entire article

Hypothermia Makes Gains in Cardiac Arrest
There has been a major shift in the use of therapeutic hypothermia (TH). We've seen a substantial increase in interest," so that at the start of 2009 there is generally at least one large center routinely using TH for cardiac arrest patients in virtually every major U.S. metropolitan area, said cardiologist Dr. MaryAnn Peberdy, professor of medicine and emergency medicine at Virginia Commonwealth University in Richmond, and one of the authors of a consensusstatement on post-cardiac arrest syndrome.
Read the entire article

Upcoming Meetings

Alabama ACEP Board Meeting
Montgomery, AL
March 5, 2009

Emergency Department Directors Academy - Phase I
Dallas, TX
March 16-20, 2009

Advanced Pediatric Emergency Medicine Assembly
Westin Copley Place - Boston, MA
April 14-16, 2009

MASA Annual Session
San Destin, FL
April 17-18, 2009

Alabama ACEP Annual Meeting
San Destin, FL
June 15-18, 2009

2009 ACEP Scientific Assembly
Boston, MA
October 5-8, 2009

Welcome New Member

Sonbol Shahid-Salles

Alabama Chapter ACEP
PO Box 1265
Dothan, AL 36302
Copyright © 2008 Alabama Chapter ACEP. All rights reserved.

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