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March 2014

Psychiatric Assessment of Minors without Consent

Last fall, the WA State Legislature enacted RCW 71.34.600, which allows parents to bring minors in for psychiatric assessment without the minors’ consent. It requires a “trained professional” to perform a psychiatric assessment within 24 hours, and if found to be a suicide risk, to be held until appropriate disposition is found. Unfortunately, there have been no additional resources from the state.

Several WA-ACEP members have commented on increased pediatric psych visits since enactment of this legislation, with varying availability of resources to address the issue. We know of some regions in which alternative home assessment options are being used, and others in which ED are becoming congested with pediatric psych cases, sometimes for days.

In an attempt to help us coordinate an appropriate response to the problem, WA-ACEP developed a short survey. Thus far, we’ve heard from 29 ED Directors in the state. See the survey’s results.

WA-ACEP has been in communication with ACEP national on an approach to the problem. More information will be provided to WA-ACEP members as the issue evolves.

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Don’t Miss the Washington ACEP 2014 Summit to Sound Northwest Emergency Medicine Assembly

Join WA-ACEP on the beautiful Seattle waterfront, April 30-May 2 at the Bell Harbor Conference Center, for three days of effective strategies and scientific updates, featuring: Blood Products and Reversal of Anticoagulant Agents, Wilderness Wound Care, Alternative EM Revenue Streams, Palliative Care in the ED, Peri-Intubation Crash, Ultrasound Vascular Access and Peripheral Nerve Block Workshops (includes attestation form).

Register Online

View Conference Brochure

Learn More


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Creating a Learning Healthcare System in Washington State: CERTAIN's Safe and Sound Launches

CERTAIN's Safe and Sound collaborative strives to improve the availability, use, and quality of ultrasound for appendicitis in kids. Safe and Sound will increase use of ultrasound as the first imaging study for children with appendicitis by 50 percent over one year by increasing the availability of ultrasound in hospitals, galvanizing public and payer pressure to increase the use of ultrasound, and providing training so that clinicians and technologists are more confident and skilled using ultrasound in kids.

Safe and Sound held a kickoff meeting in February with 23 participants from six hospital sites, including ED physicians, radiologists, pediatricians, and surgeons. The agenda included presentations reviewing existing data on current use of ultrasound and CT in the diagnosis of appendicitis in Washington State and of implementation tools that could be used to improve ultrasound use and quality. Learn more.

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International Trauma Life Support (ITLS) Program Aims to Improve Trauma Care, Training Worldwide

ITLS is a global training program dedicated to preventing death and injury from traumatic injuries through education and trauma care. While many of you might be familiar with ITLS, you may not be aware of its history or connection with ACEP.

Founded in 1985 as Basic Trauma Life Support, it was funded from an ACEP Chapter Grant to the Alabama Chapter. The course was originally developed by John Campbell, MD, FACEP who was given the first ACEP Outstanding Contribution in EMS Award in 1989. The course has been endorsed by ACEP since 1986.

ITLS is now an independent not-for-profit organization. Since 1994 it has been managed by the Illinois College of Emergency Physicians. Many ACEP Chapters sponsor and manage ITLS Chapters for their state as well, including Ohio, Florida, New York, Virginia, West Virginia, California, Illinois, Alabama, Colorado, Texas, Arizona, Louisiana, and Missouri

ITLS has grown to be an international standard with 95 chapters and training centers in 36 countries. Chapters and training centers are located on all continents except Antarctica. To date, ITLS has trained more than 600,000 trauma care professionals in 70 countries worldwide.

ITLS courses combine classroom instruction with hands-on skill training and scenario assessment stations to challenge the students to expand their knowledge and skills in trauma care. ITLS has become accepted internationally as the standard for training pre-hospital professionals in trauma care. It is taught both as a continuing education course but also as part of many initial EMT and paramedic training programs. ITLS also offers eTrauma which is an online educational program that provides the didactic portion of the ITLS Provider course. It can be taken for CEU credit only or followed by an ITLS Completer course for skills and testing for ITLS certification.

ITLS can be taught at two levels: Basic and Advanced. ITLS Basic provides the core knowledge and skills for all levels beginning at the EMT-Basic and first responder levels. ITLS Advanced builds on this knowledge and skills to address advanced procedures for paramedics, trauma nurses, and physicians. Other related ITLS courses include ITLS Access, ITLS Pediatric and ITLS Military. ITLS Access trains EMS crews with the skills they need to access, stabilize, and extricate trapped patients. ITLS Pediatric continues the training of the Basic and Advanced courses with an emphasis on trauma in children. And ITLS Military is a custom edition of a stand-alone military edition designed for military personnel.

To learn more information about ITLS, to arrange for a class, or set up a training center, visit

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Volunteer for an ACEP Committee and Lend Your Skill and Expertise

Your participation on an ACEP Committee will make a difference, so please complete your committee interest form by May 19, 2014, to start your volunteer journey. ACEP committees provide important leadership to ACEP members, its Board and Council. Each committee is appointed by the President to assist with activities for the year. ACEP has more than 30 committees and task forces working on issues such as ethics, emergency medicine practice, pediatric emergency care, disaster medicine and more. Don't wait to get involved.

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ACEP Careers Section Longevity and Tenure Award Applications due July 18

The ACEP Section of Careers in Emergency Medicine is soliciting nominations for an award for emergency physicians in the following two categories:

  • A Longevity Award for the physician with the longest active career in emergency medicine.
  • A Tenure Award for the physician with the longest active career in the same emergency department.

Recognition is also given to those physicians who are still actively practicing emergency medicine after 20, 25, 30, and 35 years.

The deadline is July 18.

Eligibility Criteria: To be eligible, physicians must have worked an average of 1,000 or more hours per year in emergency medicine practice or teaching; hours for residency training and administration are not included. They must be a current ACEP member.

Previous applicants may apply every year; however, they may not win the same award within a 5-year period. Information is attached and can also be found at

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Stroke Risk Jumps after Head, Neck Trauma

Eleven of every 100,000 patients younger than 50 years who were seen for traumatic injury developed an ischemic stroke within 4 weeks, a study of data on 1.3 million people found.

Read the entire article

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Biphasic Reaction Risk Rises with Severity of Initial Anaphylactic Attack

The more severe an anaphylactic reaction, the more likely that a child will have a second reaction within several hours, according to data from a review of more than 400 children. The findings were presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Read the entire article

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