Emergency Department Utilization During Respiratory Disease Outbreaks

Revised October 2023 with current title, June 2017, April 2011
Originally approved November 2004 titled "Emergency Department Utilization During Outbreaks of Influenza"


The American College of Emergency Physicians (ACEP) recommends close coordination between emergency physicians, health care facilities, and public health entities to educate the public regarding appropriate physician referrals and emergency department (ED) utilization during outbreaks of respiratory infectious diseases. 

To meet this goal, the following steps are recommended to mitigate the impact of respiratory infectious disease outbreaks: 

  1. Ensure that emergency physicians and other direct patient facing emergency care personnel are current in their Centers for Disease Control and Prevention (CDC) recommended immunizations and have access to and use appropriate personal protective equipment (PPE) during patient care.
  2. Implement rapid screening and appropriate respiratory infection prevention and control measures (eg, masking, isolation) for symptomatic individuals presenting to the ED.
  3. Develop and implement regional, local, and hospital surge plans to avoid unsafe overcrowding and end the dangerous practice of boarding patients in the ED. Hospitals operating at full capacity may be required to distribute boarded patients who do not require respiratory isolation to inpatient hallways, short stay units, and other spaces outside the ED.
  4. Enhance multi-directional communications networks to provide real-time guidance to emergency clinicians regarding both seasonal and sentinel disease outbreaks to include epidemiologic information (eg, outbreak notification, syndromic surveillance) as well as diagnostic and treatment recommendations.
  5. Advocate for the legal protection of emergency clinicians providing crisis care in dangerously overcrowded and resource-poor settings as in the event of a large-scale infectious disease outbreak.
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