Emergency Department Provider Toolkit
This toolkit supports Emergency Department Providers (ED) in preventing overdoses and improving care for patients at risk for opioid use disorder (OUD) and overdose.
The ED toolkit is an interactive guide for providers and hospital administrators. It provides strategies to incorporate best practices for screening and diagnosis, referral to treatment, safe prescribing, and community resources in various healthcare and non-healthcare settings. Its content was developed for ED providers with considerations for rural and urban hospitals.
If you are interested in receiving FREE, individualized training for your facility or if you have questions about the Emergency Department Provider Toolkit, please contact the South Dakota Association of Healthcare Organization (SDAHO):
- Call us at 605-789-7531 or 605-789-4995 and ask to speak with a Clinical Improvement Consultant,
- Email us at info@SDAHO.org, or
- Fill out our Contact Us form and an RN from SDAHO will be in touch within 1-2 business days
Is the patient stable?
Patient is Stable
During your consultation:
- Review the patient’s history.
- Conduct a physical exam and pain assessment.
- Review PDMP. Then, identify/calculate MME/day.
- Ask if the patient has a primary care provider.
Based on findings from these steps, choose which path best fits the patient:
Unstable Overdose
If patient is unstable
- Follow standard procedures for stabilization of the patient
- Follow internal toxicology protocol—and submit samples to the SD Public Health Lab Non-Fatal Overdose Toxicology Protocol
- Encourage screening, review of PDMP, diagnosis, and treatment once medically stable
Suspect OUD
Determine if patient has OUD through use of one of the following screening tools:
Consider combining with patient self-assessment:
- The COMM tool improves the ability to detect opioid misuse and further help to mitigate the potential of opioid exposure with patients and populations.
Common Acute Pain Condition
If common acute pain condition
- Use SDSMA Acute Pain Guidelines for non-opioid or non-pharmacological treatment of acute pain as first-line intervention. The guidelines summarize the current evidence for optimal management of acute pain and lists key recommendations.
Diagnosing of OUD in the ED is necessary for treatment, intervention, and patient care:
- Follow the DSM-5 Diagnostic Criteria Checklist to determine the severity of OUD.
- Ensure that the appropriate opioid-related ICD-10 Codes are assigned for diagnosis.
Choose the patient’s diagnosis:
Medication-Assisted Treatment (MOUD) is among the leading treatments for OUD and is expanding in South Dakota:
Select the patient’s treatment plan:
Patient Appropriate for MOUD
Recommend and explain treatment
Reminder: your assessment and recommendation for treatment can make all the difference in the lives of your patients and their families. Thank you for helping educate and support efforts that move individuals toward recovery.
For more on how you can help, please explore the Education and Clinical Resources below.
Patient Not Appropriate for MOUD
Provide Education, Refer to a Primary Care Provider, and Prescribe Naloxone
- Provide education on harm reduction, resources, and encourage treatment
- Refer to a primary care provider or find a community health clinic and/or resources via the Helpline’s 211 service.
- Find a behavioral health provider via Care Coordination
- Prescribe or co-prescribe naloxone
Recommend and explain treatment
Reminder: your assessment and recommendation for treatment can make all the difference in the lives of your patients and their families. Thank you for helping educate and support efforts that move individuals toward recovery.
For more on how you can help, please explore the healthcare professionals page below.
Patient Agrees to MOUD
Connect to treatment and support:
- Initiate MOUD in ED or refer to MOUD provider in South Dakota.
- Provide education on harm reduction, resources, and encourage treatment.
- Prescribe or co-prescribe naloxone.
Refer to:
-
Reminder: Recovery is different for everyone. The more support your patients can get from providers, behavioral health specialists, family, and peer groups—the better the chances of successful outcomes. These services support the whole person and their community.
For more on how you can help, please explore the Education and Clinical Resources below.
Patient Declines MOUD
Provide Education, Encourage Care Coordination, Refer to a Primary Care Provider, and Prescribe Naloxone
- Provide education on harm reduction, resources, and encourage treatment.
- Prescribe or co-prescribe naloxone
- Refer to a primary care provider. Find a community health clinic and/or resources via the Helpline’s 211 service
- Find a behavioral health provider via Care Coordination.