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Emergency medicine pharmacists on an international scale
  1. Zlatan Coralic1,
  2. Bryan D Hayes2
  1. 1 Clinical Pharmacist, Emergency Medicine, University of California San Francisco, San Francisco, California, USA
  2. 2 Clinical Pharmacist, Emergency Medicine and Toxicology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Bryan D Hayes, Clinical Pharmacist, Emergency Medicine and Toxicology, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts 02114, USA; bryanhayes13{at}gmail.com

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Emergency Medicine (EM) clinical pharmacy services in the USA were first described in the literature in the 1970s. Initially, the role was confined mainly to medication distribution, but has evolved significantly into clinical practice while the number of EM pharmacists has steadily increased.1 Inclusion of clinical pharmacists in EM has been supported by the American Society of Health-System Pharmacists, Agency for Healthcare Research and Quality (AHRQ), American College of Medical Toxicology; and most recently, the American College of Emergency Physicians.2

This support is due to decades of bedside practice and evidence of benefit. The contribution of clinical pharmacists on multidisciplinary teams has been shown to reduce patient mortality,3 hospital readmissions4 and medication errors.5 Further, EM clinical pharmacists have demonstrated improvement in time-sensitive therapies in the ED, such as reductions in time to administration of antibiotics in sepsis,6 analgesics in trauma,7 sedatives and analgesics after rapid sequence intubation,8 and thrombolytic therapy in acute ischaemic stroke.9

The daily responsibilities of EM clinical pharmacists are broad and may differ slightly between institutions. Most EM pharmacists support the ED team with bedside medication procurement and provision of patient-specific pharmacotherapy recommendations (eg, selection of appropriate antibiotics, review of cultures and follow-up after discharge, assistance with medication history gathering, high-risk medication evaluation, drug information and toxicology consultation, participation in code or trauma response).10

The studies by De Winter et al (Belgium)11 and Perez-Moreno et al (Spain) add to the expanding …

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