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SAN FRANCISCO -- The nationwide shortage of flu vaccine prompted emergency physicians gathered here for their annual meeting to issue a national call to action to prepare the nation's emergency departments and hospitals for a
surge of severely ill influenza patients this winter.
"Without swift action, the vaccine shortage could cripple our health care
system," said Arthur Kellermann, MD, a member of the American College of
Emergency Physicians' board of directors and chairman of the Department of
Emergency Medicine at Emory University School of Medicine in Atlanta. "We
all hope and pray for a mild flu season, but wishful thinking is a poor
substitute for prudent planning."
ACEP, the national organization representing the specialty of emergency
medicine with more than 23,000 members, calls on the U.S. Department of
Health and Human Services to convene within the next two weeks a "crisis
summit" of key federal agencies, nongovernmental organizations, and patient
advocacy groups to establish crisis plans for the coming flu season.
"The goal of this process must be to ensure that every American who falls
seriously ill during the influenza season has access to safe, effective
emergency care, and if necessary, admission to a hospital bed or intensive
care unit," said Kellermann. "The combination of the vaccine shortage,
more than 80 million Americans at high risk of flu complications, and a
nationwide emergency department crowding crisis, means America's emergency
physicians and nurses are faced with the prospect of the 'perfect storm' - a
surge of critically ill flu patients and no resources to care for them."
To meet this goal, leaders of ACEP outlined six steps that must be taken
1. Ensure that emergency care and critical care
providers (EMS providers, nurses, physicians, and ancillary staff involved
in direct patient care) are immunized so they aren't stricken in the midst
of a national epidemic.
2. End the practice of boarding admitted
patients in the emergency department when no inpatient beds are available.
This may require hospitals operating at full capacity to distribute boarded
patients to inpatient hallways, solariums, admission units, and other spaces
outside the emergency department, but this is preferable to packing
seriously ill flu patients together in the hallways of an emergency
3. Implement regional protocols to monitor hospital inpatient and emergency department capacity, as well as ambulance-diversion status.
4. Adopt regional protocols to govern when, how, why, and for how long overloaded hospital emergency departments can divert inbound ambulances.
5. Require hospitals and communities that are severely affected by influenza to postpone elective admissions until the crisis has abated.
6. Provide federal and state emergency funding to compensate hospitals and emergency departments for the un-reimbursed costs of meeting this grave public health challenge.
"ACEP pledges to do everything we can to meet the needs of our patients during the coming flu season," said Dr. J. Brian Hancock, immediate-past president. "Together we call on federal, state, and local governments; professional organizations; and patient advocacy groups to join us in meeting that challenge and safeguarding the public's health."
ACEP is a national medical specialty society representing more than 23,000
members who specialize in emergency medicine. ACEP is committed to improving
the quality of emergency care through continuing education, research and