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Emergency Ultrasound

Update on Drafts of New AMA Resolutions to Promote Point-of-care, Clinical Ultrasound

With the assistance of colleagues from the ACEP Emergency Ultrasound Section, the SAEM Academy for Emergency Ultrasound, and the AMA Section Council on Emergency Medicine, the following 2 resolutions have been drafted for consideration by the Medical Society of the State of New York (MSSNY) House of Delegates next month. Support and co-sponsorship will be sought from other AMA sections and councils, prior to presentation to the AMA House of Delegates in June.

Promoting 4-Year, Vertical Ultrasound Curricula in Undergraduate Medical Education

Whereas, in AMA Policy H-230.960 “Privileging for Ultrasound Imaging” of 2010:

(1) Our AMA affirm[ed] that ultrasound imaging is within the scope of practice of appropriately trained physicians;

(2)  AMA policy on ultrasound acknowledge[d] that broad and diverse use and application of ultrasound imaging technologies exist in medical practice;

(3)  AMA policy on ultrasound imaging affirm[ed] that privileging of the physician to perform ultrasound imaging procedures in a hospital setting should be a function of hospital medical staffs and should be specifically delineated on the Department's Delineation of Privileges form; and

(4)  AMA policy on ultrasound imaging states that each hospital medical staff should review and approve criteria for granting ultrasound privileges based upon background and training for the use of ultrasound technology and strongly recommends that these criteria are in accordance with recommended training and education standards developed by each physician's respective specialty; and

Whereas, in AMA Policy H-480.950 “Diagnostic Ultrasound Utilization and Education” of 2012:

Our AMA affirm[ed] that ultrasound imaging is a safe, effective, and efficient tool when utilized by, or under the direction of, appropriately trained physicians and supports the educational efforts and widespread integration of ultrasound throughout the continuum of medical education; therefore, be it

RESOLVED, that the AMA supports 4-year, vertical instruction and training regarding the concept, implementation, and utilization in clinician-performed, point-of-care ultrasound; and be it further

RESOLVED, that the AMA communicates with US medical schools urging the inclusion of clinician-performed, point-of-care ultrasound instruction and training; including didactic and practical experiences covering the application to a broad range of organ systems and procedures for a wide variety of future specialists.

Development and Promotion of Evidence-based Ultrasound-First Radiation Mitigating Protocols

Whereas, the AMA has rich policy in both the education, avoidance, and awareness of the dangers of ionizing radiation; and

Whereas, in AMA Policy H-455.988 “Public Education on the Danger of Radiation Exposure” of 2011:

1.   Our AMA encourages the appropriate federal agency to develop a nationwide public education program on the effects of radiation exposure; and

2.   Our AMA supports public initiatives, such as the “Image Wisely” and “Image Gently” campaigns, which aim to increase awareness of radiation in the medical setting and reduce exposure; and

Whereas, in AMA Policy D-455.998 “Ionizing Radiation Exposure in the Medical Setting” of 2013:

Our AMA will convene a meeting (a) to examine the feasibility of monitoring and quantifying the cumulative radiation exposure sustained by individual patients in medical settings; and (b) to discuss methods to educate physicians and the public on the appropriate use and risks of low linear energy transfer radiation in order to reduce unnecessary patient exposure in the medical setting; and

Whereas, ultrasound does not utilize and in fact mitigates ionizing radiation exposure by reducing the use of computed tomography (CT); and

Whereas, ultrasound is less costly than both CT and magnetic resonance imaging (MRI) both in physical equipment cost and maintenance cost; therefore, be it

RESOLVED, that the AMA encourages physicians to develop evidence-based Ultrasound-First Protocols using point-of-care ultrasound as the first imaging modality when deemed clinically appropriate; and be it further

RESOLVED, that the AMA encourages physicians to develop evidence-based Ultrasound-First Protocols specifically to guide invasive procedures, to promote patient safety, and to enhance quality performance.

 

The resolutions were formatted and edited by Hilary Fairbrother, MD, FACEP [President-elect of MSSNY] to maximize the likelihood of AMA House of Delegates (HOD) approval. The full submission package included an appendix and bibliography for each of the resolutions. Please contact me at: larrymelniker@gmail.com for the complete package. All comments or suggestions for co-sponsorship are welcome through the e-list or to me directly.

 

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