8 things to know about the role of pharmacists in the ER

An emerging field of practice for pharmacists is emergency medicine. The Emergency Medicine Pharmacist (EMP) role at HCA Healthcare performs a variety of duties essential to both direct patient care and administration.

Deanna Pouliot, PharmD, an emergency medicine pharmacist at affiliate TriStar Skyline Medical Center says:

“We see a wide variety of patients and disease states, ranging from ambulatory care to trauma and everything in between- all of which we are relied upon by the medication expert. I love being an integral part of a multidisciplinary team whose goal is to provide optimal patient care. It’s an ever-changing environment and I learn from the experience that the emergency department provides each day.”

The Centers for Disease Control and Prevention (CDC) states that there were 130.4 million visits to the emergency department (ED) in 2013. Learn more about a day in the life of an EMP below:

Direct Patient Care Roles

• Direct Patient Care Rounds: In this role, pharmacists prevent medication errors at the source by looking at the patient and actively participating in the medication selection and prescribing process.
• Medication Order Review: Although most drug orders in the emergency department fall into the “exceptions” category of Joint Commission standards on medication order review, pharmacists should provide the same excellent care to patients in the emergency department as they would throughout the hospital. To prevent delays in patient care, emergency medicine pharmacists must evaluate the appropriateness of medication therapy quickly and accurately.
• Medication Therapy Monitoring: After medication administration, emergency medicine pharmacists must evaluate the efficacy and safety of each medication based on patient-specific factors, including goals of therapy, adverse effects, and signs of an allergic reaction. Recommendations for adjustments may be necessary.
• Patient Care Involving High-Risk Medications and Procedures: This may include selecting and recommending the right dose for high-risk medications, and monitoring therapy to ensure patient safety. In this role, pharmacists may provide high-risk medication education and training to other emergency department healthcare providers.
• Resuscitation: Pharmacists prepare medications for immediate administration, suggest alternative routes of administration, answer drug information questions, and recognize and treat patients presenting with a toxicologic emergency.
• Medication Procurement and Preparation: Due to the urgent needs of the emergency department, medications must be made readily available. Emergency medicine pharmacists make recommendations for which medications to keep in the automated dispensing cabinets, and suggest workflow improvements for efficient medication procurement and preparation.
• Medication Information: Emergency department health care providers are much more likely to use pharmacy medication information services if a pharmacist is readily available in the emergency department, as opposed to calling the central pharmacy. Emergency medicine pharmacists retrieve information efficiently and are able to provide answers to diverse emergent situations.
• Documentation: Using documented interventions, emergency medicine pharmacists look for trends that warrant education of the healthcare team or a change in medication use procedures. Documentation also justifies the emergency medicine pharmacists role in the emergency department in terms of improved patient outcomes.

October 15-21, 2017 is National Pharmacy Week. Thanks to all of the emergency medicine pharmacists who play an important role on the healthcare team throughout HCA Healthcare. For more information, please visit ASHP Guidelines on Emergency Medicine Pharmacist Services.­­­­