1. IAEM Clinical Guidelines Development Abel Wakai, MD FRCSI FRCEM IAEM Clinical Guidelines Committee (CGC) National Emergency Medicine Programme Conference Wednesday 10 th February 2016

2. Outline Background CGC Principles & Terms of Reference CGC Membership Guideline Development Process Future Developments Take Home Messages

3. ‘Systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances’ Institute of Medicine (IOM), 1992

4. IAEM Clinical Guidelines Development History: – Previously managed by IAEM Academic & Research Committee – IAEM Clinical Guidelines Committee (CGC) established in October 2014

5. IAEM Clinical Guidelines Development Principles: – Improve quality of ED patient care – Increase likelihood of desired health outcomes in ED patients – Consistent with current professional knowledge

6. IAEM Clinical Guidelines Committee (CGC) Terms of Reference: – Apply agreed IAEM criteria for quality assurance of emergency department (ED) clinical guidelines in Ireland – Disseminate a template on how IAEM clinical guideline development should be structured, and with what methodology it should be pursued – Recommend non-IAEM ED clinical guidelines which have been quality-assured against agreed IAEM criteria

7. IAEM Clinical Guidelines Committee (CGC) Terms of Reference: – Ensure the timely update of published IAEM clinical guidelines based on the best available current evidence – Facilitate with other agencies the dissemination of endorsed guidelines to front-line ED staff in an appropriate format

8. IAEM Clinical Guidelines Committee (CGC) Terms of Reference: – Report periodically to IAEM Executive on the development of new clinical guidelines, updating of published guidelines and implementation of endorsed guidelines

9. IAEM Clinical Guidelines Committee (CGC) Current Membership: 1.Dr. Abel Wakai (Chair) 2.Dr. Nigel Salter (Secretary) 3.Dr. Áine Mitchell (Trainee Representative) 4.Dr. Termizi Hassan 5.Dr. Karen Harris

10. IAEM Clinical Guidelines Development

11. Steps: 1.Guideline developer(s) submits local guideline to IAEM CGC 2.Local guideline reviewed by IAEM CGC regarding its validity, acceptability and practicality 3.IAEM CGC works with guideline developer(s) to adapt guideline to IAEM format 4.Draft guideline sent to all IAEM members 5.Feedback comments reviewed by IAEM CGC

12. IAEM Clinical Guidelines Development Steps: 6.IAEM CGC works with guideline developer(s) to address IAEM members’ feedback comments 7.Guideline published

13. IAEM Clinical Guidelines Development

14. Published IAEM Clinical Guidelines Emergency Department Analgesia in Adults (July 2013) Emergency Department Analgesia in Children (July 2013) Emergency Department Management of Renal Colic & Suspected Renal Calculus (May 2014)

15. Published IAEM Clinical Guidelines Emergency Department Management of Patients with Implantable Cardioverter Defibrillators (ICDs) (June 2014) The Use of Tranexamic Acid in Trauma Patients (December 2015)

16. Future Developments Updating Guidelines: Emergency Department Analgesia in Adults (July 2013) Emergency Department Analgesia in Children (July 2013) Emergency Department Management of Renal Colic & Suspected Renal Calculus (May 2014) Emergency Department Management of Patients with Implantable Cardioverter Defibrillators (ICDs) (June 2014)

17. Future Developments New Guidelines: Thromboprophylaxis in Ambulatory Trauma Patients Requiring Temporary Limb Immobilisation (expected publication in 2016) Emergency Department Management of Older Patients with Suspected Neck of Femur Fracture Emergency Department Resuscitation Room Minimum Volume Drug Infusions

18. IAEM Clinical Guidelines Mobile app Future Developments

20. Take Home Messages Participative ‘bottom-up’ approach End-user feedback Cross-specialty & inter-agency stakeholder involvement (e.g. ED Management of Patients with ICDs IAEM Guideline)

21. Thank You! guidelines@iaem.ie