Clinical

Most EMNet staff are full-time researchers and do not provide direct clinical care. However, EMNet faculty members with medical training have worked as part-time attending physicians in the MGH ED and given the nature of EMNet research (clinical, public health), such work is encouraged. EMNet fellows work approximately 12-16 clinical hours per week in clinical areas consistent with their training (e.g., emergency medicine, allergy/immunology); in that capacity, they supervise HMS-affiliated residents and medical students.

Dr. Camargo, and other EMNet-affiliated investigators, have played an active role in the development and dissemination of national guidelines on the clinical management of anaphylaxis (NIAID/NIH, 2004 and 2005), asthma exacerbations (NHLBI/NIH, 2007), and food allergy (NIAID/NIH, 2010). Three other examples of EMNet contributions in the clinical domain are summarized below:

A consensus conference on “Asthma Education in the ED” was held at the New York Academy of Medicine on April 1-3, 2001. The conference was presented by the Multicenter Airway Research Collaboration (MARC) in partnership with The National Asthma Education and Prevention Program (NAEPP), and The National Asthma Educator Certification Board (NAECB). The consensus document is in preparation. Abstract from the AHRQ Grant:

National guidelines stress patient education and encourage focused asthma education at every “asthma encounter,” including emergency visits. Although acute asthma accounts for more than 2 million emergency department visits annually in the United States, optimal educational strategies in this setting remain poorly defined. Indeed, patients presenting to the emergency department with acute asthma are “high risk” asthmatics, with excess morbidity caused, at least in part, by lack of high-quality primary care and lack of education about preventive and early treatment strategies for their asthma. Though data are sparse, a recent meta-analysis from the Cochrane Collaboration suggests that limited asthma education in this setting may improve patient outcomes. However, a survey on asthma education practices in 77 emergency departments confirmed that formal asthma education programs are infrequent, and content is variable. An expert consensus conference is planned to address these deficiencies. Experts in acute asthma and asthma education will develop an evidence-based consensus document on asthma education in the emergency department and design a research strategy to implement and assess its effects. Conference participants will: (1) examine evidence that asthma education affects health-related quality of life, missed days of work/school, and recidivism, (2) define key components of an ED-based asthma education program, (3) detail current ED practice and tools used to implement asthma education, emphasizing those effective for patients/parents with low literacy and low socioeconomic status, and (4) develop a research agenda, including a multicenter, randomized clinical trial to assess the effects of a focused asthma education program on asthma outcomes. A consensus document will be prepared for posting on the internet and for publication in the medical literature.

In 2004, Allergy & Asthma Network Mothers of Asthmatics (AANMA) distributed a poster of asthma inhalers to >500 emergency departments across the U.S. Developed in cooperation with Dr. Carlos Camargo, the poster was sponsored by an educational grant from the American College of Allergy, Asthma & Immunology (ACAAI) and endorsed by the EMNet Steering Committee. The poster was later translated into Spanish. Over the next few years, posters were sent to emergency departments and asthma clinics throughout the U.S.

If you would like to request a poster, please click here.

 

ED-SAFE was a multicenter study of suicide prevention. Materials from this study include a three-question Patient Safety Screener. To view our Patient Safety Screener please click here.