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Trauma and Injury Prevention Section Newsletter - September 2009, Vol 13, #1

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circle_arrow Letter from the Chair
circle_arrow Message from Washington – Barbara Tomar, Federal Affairs Director
circle_arrow Members in the News
circle_arrow Preventing Falls Among the Elderly
circle_arrow Nighttime Driving Restrictions for Unsupervised Teen Drivers
circle_arrow Emergency Response to Blast Injuries
circle_arrow New Section Members
circle_arrow Annual Report


Newsletter Index


Trauma and Injury Prevention Section

 

Letter from the Chair

Ernest E. Sullivent, III, MD, MPH, FACEP

Ernest E. SulliventGreetings Section Members! It is hard to believe that the Fall is rapidly approaching and Scientific Assembly is right around the corner. Those who have been to Boston in early October will tell you it is the best time of year to visit this beautiful city. For those planning to attend, we would really like to see a good turnout for our Section meeting this year. Please check the meeting agenda when it is released, and make a point to ink (rather than pencil) the TIPS meeting into your schedule. Meeting will be held on Monday, October 5th in Room 225 at the Convention Center from 1 – 3PM.

Scientific Assembly also marks the end of my term as your Chair. I have been honored to have the opportunity to serve as Section Chair and Chair-Elect for the past four years. Rebecca Cunningham, MD will be taking over as Chair, and the Section will benefit from her leadership. We will be holding elections for Chair-Elect at the Section meeting, and encourage anyone who is interested to submit your name for nomination. I would be happy to discuss the Chair-Elect position as well as the Chair position; feel free to contact me at ESullivent@cdc.gov.

We will also be seeking nominations for Editor for the Section newsletter. Unfortunately, this position remained vacant for the past 3 years. Our Section’s staff liaison, Barbara Tomar, has kindly filled the void in the interim, for which we are all very grateful. Serving as Newsletter Editor is a great way to get more involved with your Section peers and serve the College. We are scheduled to publish three issues each year. If you are interested, or would like additional information, please email Barbara at btomar@acep.org.

On an unrelated note, you would have to be living on the moon to not realize the potential problems this Fall due to H1N1. Although this is not a trauma or injury prevention issue per se, it will become one indirectly due to ED overcrowding that will impact all patients. There are efforts underway by ACEP, CDC, HHS, and the private sector to find ways to mitigate the adversity we are expected to face. Along with the vaccine and antivirals, these efforts include finding agreement on a triage algorithm to avoid overburdening EDs. Currently, the best information on preparing your ED has been posted on the ACEP website, entitled the National Strategic Plan for Emergency Department Management of Outbreaks of Novel H1N1 Influenza.

Again, thank you for the opportunity to serve as your Chair. See you in Boston!


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Message from Washington – Barbara Tomar, Federal Affairs Director

Health Reform 2009

Most of the past few months have been taken up with health reform proposals in Congress and efforts have emergency medicine provisions included. The U.S. House and Senate will return after Labor Day having left a complicated mess of healthcare reform proposals unfinished. All three House committees that share jurisdiction over the bill (HR 3200, "America's Affordable Health Choices Act") finished debating and amending the bill, but created two very different approaches to implementing changes in the U.S. health care delivery system. Meanwhile, only one of the two Senate committees with jurisdiction over healthcare issues approved a version of the "Affordable Health Choices Act." 

Many of you have been following the press accounts, public statements, and Town Hall meetings about what these legislative proposals will and will not do to improve health care in America. Terms such as public plan, individual and employer mandate, Health Insurance Exchange and premium/cost-sharing assistance, to name a few, have been used by both sides of the political argument for their own purposes. ACEP has refrained from taking a public position on the overall legislative proposals. This has been, and remains, a very fluid process and we support the provisions below which we have advocated with House and Senate committee members. 

  • Identification of ED services as part of the essential health care benefits package;
  • Authorization of the Emergency Care Coordination Center (ECCC) within the HHS Office of the Assistant Secretary of Preparedness and Response (ASPR), as well as the ECCC Council on Emergency Medicine and a requirement that the Center provide an annual report to Congress on its programs (with a focus on ED crowding and boarding);
  • Grants to conduct at least four emergency care/trauma regionalization pilot projects;
  • Grants for economically troubled trauma centers;
  • Medicare physician payment reforms (addressing the underlying problems of the sustainable growth rate (SGR) including resetting the budget baseline for the Medicare payment system, eliminating the current debt accrued under the SGR, removing physician-administered drugs from the SGR, and providing increased payments for physicians who provide E&M services);
  • Emphasis on ED patient through-put as a measure used to foster quality improvement;
  • HHS incentive payments to states that establish medical liability reforms, such as Certificate of Merit and/or "early offer;" and
  • HHS demonstration project to reimburse privately owned psychiatric hospitals that provide EMTALA services to Medicaid beneficiaries 

FDA Efforts to Safeguard Opioid Use

ACEP has attended several meetings over the past few months hosted by FDA as it considers imposing a Risk Evaluation and Mitigation Strategy (REMS) for time release opioids including Fentanyl and Oxycodone. While the most significant concerns are over illegal diversion of these drugs, the FDA will focus on physician prescribing. 

Physicians voiced support improved education in pain management for themselves and their patients, but voiced concerns over significant restrictions placed on the availability of these drugs, citing loss of access to pain medication for those who need it and use it appropriately. Great concern exists that if REMS imposes barriers to prescribing Schedule II extended-release opioids, more doctors will prescribe immediate release products or Schedule III products such as Vicodin that are either less effective, have greater risks of toxicity, or both. Concerns were also raised about the impact that elements of a restricted distribution program (ie, certification, patient-provider agreements and documentation, expanded counseling responsibilities) would have on already overburdened primary care physicians.


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Members in the News

News About SAVIR by: Michael J. Mello, MD, MPH, FACEP

Emergency Medicine and injury prevention research has a rich history of collaboration. As incoming President of The Society for Advancement of Violence and Injury Research (SAVIR), I wanted to inform the section about SAVIR and the value of participation in both. SAVIR was founded in 2005 and brings together the leading researchers in the field of injury prevention to provide the practical knowledge families and communities need to reduce traumatic injuries and their consequences. Several members of our section are already active SAVIR members but I would love to have more colleagues of our specialty involved.

SAVIR is devoted to promoting scholarly activity in the science of injury control and addressing issues relevant to the prevention, acute care and rehabilitation of injury and violence. Our goal is to advance education and scholarly activity among our members, and to further develop injury and violence research. SAVIR’s uniqueness stems from the challenge of promoting cohesion, shared knowledge, collaboration and an integrative approach between groups and individuals working in different disciplines across the spectrum of injury prevention and control research. This is accomplished through a wide range of research, policy, program development and teaching activities that synthesize expertise from emergency medicine as well as multiple clinical and nonclinical disciplines, settings and perspectives.

SAVIR provides an exciting opportunity to participate in key activities focused on strengthening violence and injury research. We aim to: promote training and education of future injury and violence researchers and practitioners, promote injury and violence research, and serve as an umbrella organization for injury and violence researchers and practitioners working in diverse disciplines.

I know many of you are involved in injury and violence research and would encourage you to visit our website www.savirweb.org or contact me: Michael J. Mello, MD, MPH, FACEP at mjmello@lifespan.org for more information on SAVIR.

A Health Based Perspective – Dr. Peggy Goodman

Dr. Peggy Goodman is the author of the chapter entitled "Intimate Partner Violence and Pregnancy" in the recently released "Intimate Partner Violence: A Health Based Perspective (Mitchell, editor; Oxford University Press). This book, edited by ACEP member Dr. Connie Mitchell, also includes chapters by many other ACEP members, including Deb Houry, Greg Larkin, Sheryl Heron, Dierdre Anglin, Ellen Taliaferro and Carolyn Sachs. Dr. Goodman also authored a chapter entitled "Intimate Partner Violence" in the recently released Emergency Care of the Abused (Gallahue, Melville editors; Cambridge University Press).


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Preventing Falls Among the Elderly

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Source: National Council on Aging


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Nighttime Driving Restrictions for Unsupervised Teen Drivers

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Source: Insurance Institute for highway Safety & National Conference of State Legislatures, 2009


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Emergency Response to Blast Injuries

The Centers for Disease Control and Prevention, in collaboration with the, Terrorism Injuries Information Dissemination & Exchange (TIIDE Project), has published fact sheet for health care providers and industry professionals. Information is included on  specific types of injuries, background, diagnostic evaluation and treatment and is available in multiple languages.   
  


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New Section Members
Total = 157

Name

Location/City

Abdullah Al Hadhira, MD

Dhahran, Saudi Arabia

Abraham L Warshaw, MD, FACEP

New York, NY

Alejandro Villatoro, MD

Cuajimalpa, Mexico

Alun D. Ackery, MD 

Toronto, Canada

Amit Rahman, MD

Syracuse, NY

Andrew C Allison, DO, FACEP

Weirton, WV

Andrew R Zinkel, MD

St Paul, Bloomington, MN

Anne M DeLonais-Turner, MD, FACEP

Hannibal, MO

Arlo F Weltge, MD MPH FACEP

Houston, TX

Avraham J Schreiber, MD

Cortlandt Manor, NY

Azzah Al-jabarti, MD

Winnipeg, MB Canada

Badrinath Kulkarni, MD

Madera, CA

Beau A. Briese, MD.

Long Beach, CA

Beth Ellen Lapka, MD, FACEP

Sioux Falls, SD

Bo E Madsen, MD

Boston, MA

Bonnie Simmons, DO, FACEP

Brooklyn, NY

Carolyn Kay Synovitz, MD MPH FACEP

Altus, OK

Chad Darling, MD, FACEP

Worcester, MA

Chin Chung Tang, MD

New York, NY

Christo C Courban, MD

Conway, SC

Christopher Baugh, MD

Boston, MA

Christopher Fee, MD, FACEP

San Francisco, CA

Colman O'Leary, MD

Limerick, Ireland

David M Somand, MD

Ann Arbor, MI

Dean E Johnson, MD, FACEP

York, PA

Debra M. Feldman, MD FACEP

Cincinnati, OH

Dickson S Cheung, MD, FACEP

Lone Tree, CO

Drew C Fuller, MD

Baltimore, MD

Elizabeth S Plemmons, MD, FACEP

Wyandotte, MI

Eric R. Hawkins, MD

Charlotte, NC

Eric S Kenley, MD

Chicago, IL

Geoffrey Bauer, MD

Gary, IN

Glenn W Mitchell, MD MPH FACEP

Chesterfield, MO

Gregory T Guldner, MD, FACEP

Loma Linda, CA

Griffin L Davis, MD, FACEP

Washington, DC

Hyun Soo Chung, MD

Seoul, South Korea

J Thomas Ward, Jr., MD, FACEP

Plano, TX

James A Espinosa, MD, FACEP

Stratford, NJ

Jamira Jones, MD

Dallas, TX

Jason K Fleming, MD, FACEP

Honolulu, HI

Jean C Ling, MD

Leesburg, VA

Jesse Pines, MD, MBA

Philadelphia, PA

JoAnne McDonough, MD

Glens Falls, NY

John R Fowler, Jr, MD, FACEP

Izmir, Turkey

Joseph Minardu, MD

Morgantown, WV

Kavita Babu, MD

Providence, RI

Keith J Kuhfahl, DO

Mt. Holly, NJ

Kenneth John Robinson, MD, FACEP

Hartford, CT

Kevin Brady Whatley, MD, FACEP

Tomball, TX

Kevin Michael Klauer, DO, FACEP

Canton, OH

Kimberly Ann Markuns,

Quincy, MA

Kristie Nelson Keyser, MD

Denver, CO

Kurtis A Mayz, MD

Champaign, IL

Laura J Snyder, MD

Long Branch, NJ

Lee Virn Leak, Jr, MD, FACEP

Brooklyn, NY and Perth Amboy, NJ

Maisa Liana Haney, MD

Orlando, FL

Matthew Judd, DO

Newark, DE

Maurice J Montag, Jr, MD, FACEP

Kent, WA

Maya R Heinert, MD

Roseville, CA

Michael J Schull, MD

Toronto, ON (Canada)

Michael Kermit Frye, MD, FACEP

Huntersville, NC

Nathan G Ruch, MD

New Hope, PA

Neal J Edelson, MD, FACEP

Elgin, IL

Neil B Baum, MD

Greensburg, PA

Neil Partain, MD, MPH&TM

San Marcos, CA

Nestor R Zenarosa, MD, FACEP

Dallas, TX

Nisha Susan Mathew, MD

Newark, DE

Norman A Chapin, MD

Hudson, NY

Pamela Andrea Ross, MD, FACEP

Charlottesville, VA

Philip D Anderson, MD, FACEP

Boston, MA

Renee D Reid, MD

Richmond, VA

Richard C Winters, MD, FACEP

Fresno, CA

Robert F Poirier, Jr, MD, FACEP

St Louis, MO

Robert Flint, MD, FACEP

Hagerstown, MD

Robert Verne Oliver, MD

Rocklin, CA

Robert Wayne Wolford, MD, FACEP

Cleveland, OH

Ronald B Low, MD, FACEP

New York, NY

Rosemary Cunningham, MD, FACEP

Dhahran, Saudi Arabia

Ross Philip Berkeley, MD, FACEP

Las Vegas, NV

Rupen Girish Modi, DO, MBA

Camp Hill, PA

Sharon Lee, MD

Orange, CA

Stanley L. Allen, III, MD

Austin, TX

Steven Stelts, MD

Tauranga, Tauranga (New Zealand)

Suresh G Wable, MD, FACEP

Philadelphia, PA

Suzanne Hiramatsu, MD

Chicago, IL

Thomas B Pinson, MD, FACEP

Neosho, MO

William G Fernandez, MD, FACEP

Boston, MA

Zachary Meisel

Philadelphia, PA


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Annual Report

AMERICAN COLLEGE OF EMERGENCY PHYSICIANS
Trauma and Injury Prevention and Control Section
Meeting Summary and Annual Report
October 2007 – October 2008

Officers for 2007-2008:

Chair Ernie Sullivent, MD
Chair-elect Rebecca Cunningham, MD
Immediate Past Chair Mark R. Sochor, MD. MS
Secretary Vacant
Newsletter Editor Vacant
Councillor Gregory Luke Larkin, MD, FACEP
Alternate Councilor Mark R. Sochor, MD. MS
Board Liaison Robert Solomon, MD, FACEP
Staff Liaison Barbara Tomar

Dr. Sullivent, TIP Section Chair, welcomed the attendees to the October 28, 2008 annual meeting in Chicago and introduced the guest speaker, Italo Subbarao, DO, MBA, who gave a fascinating and detailed presentation on Preventing Injuries and Deaths: Evidence-based Disaster Response. Dr. Subbarao, who is Director of Public Health Readiness for the AMA, described the efforts of a large group (that included several ACEP members) to design a system for risk assessment and mitigation of risks. For example, in a flood or earthquake prone area the level of vulnerability of the infrastructure and the potential for injury is assessed and steps are taken - subject to budget limitations – to reduce the probably of large-scale destruction and loss of life . Dr. Subbarao passed out copies of the AMA’s publication "Disaster Medicine and Public Health Preparedness" as well.

Business Meeting:

2007-2008 Activities to date:

  1. Dr. Rebecca Cunningham, Chair elect, Principal Investigator on the Section "Injury Prevention Efforts at U.S. Trauma Centers: ED Director Survey in Level I and II Trauma Centers" gave an update on the project. A mail/online survey of all Level I and II trauma center ED directors was initiated in April 2007. The survey was designed to assess ED physician awareness and activities to comply with the new ACS requirement to provide alcohol screening and brief interventions in trauma center EDs. After two rounds of mailings, Dr. Cunningham sought additional funds and a time extension to conduct a 3rd round to increase the survey response rate. An additional $1,000 was added to the Section grant and the final mailing went out August 1, 2008. Preliminary findings were shared at the meeting and reflected that approximately 15% of respondents have a formal written policy for brief screening and intervention. A final report will be submitted and plans to sue the findings for member education will be explored.
  2. Two Section newsletters were produced last year and we still need an editor for 2008-2009.
  3. Section membership currently stands at 164.

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This publication is designed to promote communication among emergency physicians of a basic informational nature only. While ACEP provides the support necessary for these newsletters to be produced, the content is provided by volunteers and is in no way an official ACEP communication. ACEP makes no representations as to the content of this newsletter and does not necessarily endorse the specific content or positions contained therein. ACEP does not purport to provide medical, legal, business, or any other professional guidance in this publication. If expert assistance is needed, the services of a competent professional should be sought. ACEP expressly disclaims all liability in respect to the content, positions, or actions taken or not taken based on any or all the contents of this newsletter.

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