Emergency Department Utilization During Respiratory Infectious 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 among emergency physicians, health care facilities, and public  health entities during outbreaks of respiratory infectious diseases.

To mitigate the impact of respiratory infectious disease outbreaks, ACEP recommends the following steps:

  1. Hospitals and physician employers should ensure that emergency physicians and other direct patient facing emergency care personnel are compliant with current Centers for Disease Control and Prevention (CDC) recommended immunizations.
  2. Hospitals and emergency departments should have appropriate protocols for rapid screening of respiratory agents of concern. Hospitals and emergency departments should implement appropriate respiratory infection prevention and control protocols measures (eg, masking, isolation) for symptomatic individuals presenting to the ED.
  3. Emergency department leaders should work with their hospitals and health systems to ensure the development and implementation of  regional, local, and hospital surge plans to mitigate the patient safety, and ED staff risks inherent with ED crowding, particularly as it may related to the unsafe practice boarding patients in the ED.
  4. Hospital leadership should ensure multi-directional communications networks to provide real-time guidance to emergency physicians regarding both seasonal and sentinel disease outbreaks to include epidemiologic information (eg, outbreak notification, syndromic surveillance) as well as diagnostic and treatment recommendations.
  5. ACEP, ACEP chapters, and local emergency medicine leaders should advocate for the legal protection of emergency physicians 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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