• 2014 EMS LLSA Reading List

    The primary goal of LLSA is to promote continuous learning by diplomates. The EMS Examination Committee facilitates this learning by identifying a set of LLSA readings every other year to guide diplomates in self-study of recent EMS literature. The readings are designed as study tools and should be read critically. They are not intended to be all-inclusive and are not meant to define the standard of care for the practice of emergency medical services.

    One criterion for choosing articles is that they be easily available from a variety of sources, such as common medical texts, libraries, and Internet websites. Whenever possible, ABEM provides online links to publishers’ websites or to the readings themselves. Accessibility and fees are at the discretion of the publisher, and are not related to ABEM in any way. All questions regarding fees or login information required to access the readings should be directed to the publisher or organization that published the article.

    Prehospital Neurologic Emergencies

    Silbergleit R, Durkalski V, Lowenstein D, et al; NETT Investigators. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med. 2012;366(7):591-600. doi: 10.1056/NEJMoa1107494.

    Prehospital Cardiac Emergencies

    Verbeek PR, Ryan D, Turner L, Craig AM. Serial prehospital 12-lead electrocardiograms increase identification of ST-segment elevation myocardial infarction. Prehosp Emerg Care. 2012;16(1):109-14. doi: 10.3109/10903127.2011.614045.

    EMS System Issues

    Galvagno SM Jr, Haut ER, Zafar SN, et al. Association between helicopter vs ground emergency medical services and survival for adults with major trauma. JAMA. 2012;307(15):1602-10. doi: 10.1001/jama.2012.467.

    Blanchard IE, Doig CJ, Hagel BE, et al. Emergency medical services response time and mortality in an urban setting. Prehosp Emerg Care. 2012;16(1):142-51. doi: 10.3109/10903127.2011.614046. Epub 2011 Oct 25.

    Bakalos G, Mamali M, Komninos C, et al. Advanced life support versus basic life support in the pre-hospital setting: a meta-analysis. Resuscitation. 2011;82(9):1130-7. doi: 10.1016/j.resuscitation.2011.04.006. Epub 2011 Apr 17.

    Patient Safety and Medical Errors

    Lammers R, Byrwa M, Fales W. Root causes of errors in a simulated prehospital pediatric emergency. Acad Emerg Med. 2012;19(1):37-47. doi: 10.1111/j.1553-2712.2011.01252.x.

    Prehospital Trauma Care

    Kragh JF Jr, Littrel ML, Jones JA, et al. Battle casualty survival with emergency tourniquet use to stop limb bleeding. J Emerg Med. 2011;41(6):590-7. doi: 10.1016/j.jemermed.2009.07.022. Epub 2009 Aug 31.

    Haut ER, Kalish BT, Efron DT, et al. Spine immobilization in penetrating trauma: more harm than good? J Trauma. 2010;68(1):115-20; discussion 120-1. doi: 10.1097/TA.0b013e3181c9ee58.

    Cardiopulmonary Resuscitation

    Aufderheide TP, Frascone RJ, Wayne MA, et al. Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: a randomised trial. Lancet. 2011;377(9762):301-11. doi: 10.1016/S0140-6736(10)62103-4.

    Aufderheide TP, Nichol G, Rea TD, et al; Resuscitation Outcomes Consortium (ROC) Investigators. A trial of an impedance threshold device in out-of-hospital cardiac arrest. N Engl J Med. 2011;365(9):798-806. doi: 10.1056/NEJMoa1010821.

    Bobrow BJ, Spaite DW, Berg RA, et al. Chest compression-only CPR by lay rescuers and survival from out-of-hospital cardiac arrest. JAMA. 2010;304(13):1447-54. doi: 10.1001/jama.2010.1392.

    Out-of-Hospital Cardiac Arrest - Defibrillation

    Stiell IG, Nichol G, Leroux BG, et al; ROC Investigators. Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest. N Engl J Med. 2011;365(9):787-97. doi: 10.1056/NEJMoa1010076.

    Out-of-Hospital Cardiac Arrest - Pharmacologic Therapy

    Hagihara A, Hasegawa M, Abe T, Nagata T, Wakata Y, Miyazaki S. Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. JAMA. 2012;307(11):1161-8. doi: 10.1001/jama.2012.294.

    Out-of-Hospital Cardiac Arrest - Airway Management

    Wang HE, Szydlo D, Stouffer JA, et al; ROC Investigators. Endotracheal intubation versus supraglottic airway insertion in out-of-hospital cardiac arrest. Resuscitation. 2012;83(9):1061-6. Epub 2012 Jun 1.

    Prehospital Respiratory Care

    Austin MA, Wills KE, Blizzard L, Walters EH, Wood-Baker R. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ. 2010;341:c5462. doi: 10.1136/bmj.c5462.


  • ABEM Computer-delivered Testing Experience

    ABEM offers a short computer-delivered testing experience in Pearson VUE testing centers. This offering is designed for candidates who have not previously taken an examination in a testing center. Physicians will have an opportunity to see how an actual ABEM examination is formatted on the computer, practice navigating a computer-based demonstration examination, and experience the same security procedures and opening and closing activities of an actual ABEM examination.

    To allow candidates to practice navigating a computer-based examination, ABEM provides a 20-25 question demonstration test that candidates can take during the computer-delivered testing experience. The demonstration test is not designed to assist candidates in preparing for the content of an actual ABEM examination. The demonstration test will not be scored, and the questions do not represent the examination content, subject matter, or level of difficulty of an actual ABEM examination.

    To see a list of the questions and answers used on the Computer-Delivered Testing Experience, click here.

    Diplomates may register for the demonstation test through their ABEM MOC Online Personal Page. Follow the instructions given at the end of registration to contact Pearson VUE to schedule an appointment to take the demonstration test.

    Please be aware that a free tutorial that simulates the experience of navigating through a general computerized test is available for free download to your own computer from the testing company's website (http://www.vue.com/sponsors/tutorial), and the examination itself will also include a tutorial for taking the examination prior to beginning the actual examination.

  • Medical Toxicology - Cognitive Expertise Examination Requirements and Process

    Medical Toxicology


    Status with Home Board
    The Medical Toxicology subspecialty is co-sponsored by the American Board of Emergency Medicine (ABEM), the American Board of Pediatrics (ABP), and the American Board of Preventive Medicine (ABPM).  The board through which a physician receives Medical Toxicology certification is known as the home board.  The home board is responsible for setting Medical Toxicology eligibility criteria for its diplomates and for ensuring that diplomates are eligible to take the cognitive expertise examination.

    Only Medical Toxicology diplomates and former diplomates who meet their home board’s eligibility criteria may take the Medical Toxicology cognitive expertise examination.

    Requirements for ABEM Medical Toxicology Diplomates and Former Diplomates
    Medical Toxicology Maintenance of Certification (MOC) requirements for diplomates and former diplomates whose Medical Toxicology certification was earned through ABEM, including requirements for taking the cognitive expertise examination, can be found in the document, Medical Toxicology Maintenance of Certification Program

    Registration and Scheduling Process

    ABP and ABPM Medical Toxicology Diplomates
    Physicians whose home boards for Medical Toxicology are ABP or ABPM will apply and register for the Medical Toxicology cognitive expertise examination through their home board.  During each home board’s application/registration period, they will periodically send ABEM a list of physicians they have approved to take the examination.  ABEM will notify the physician when he or she may call Pearson VUE, ABEM’s testing vendor, to schedule an appointment to take the examination.

    ABEM Medical Toxicology Diplomates
    Physicians whose Medical Toxicology home board is ABEM may register for the Medical Toxicology cognitive expertise examination through the ABEM website, www.abem.org,  starting in the early spring of each even-numbered year.   View Medical Toxicology Exam Dates and Fees for specific registration and scheduling periods and examination dates. 

    Diplomates should use their ABEM user ID and password to sign in from the ABEM website.  Physicians whose Medical Toxicology certificates were issued by ABEM may obtain their user IDs and passwords online by clicking on the link, “need user ID or password?”  When sign-in is complete, physicians should select the button, “Medical Toxicology MOC,” then “Register or Take a Test.” 

    There are five steps in the online registration process:

    1. Select the Medical Toxicology cognitive expertise examination.
    2. Update medical license information and affirm that your medical license(s) comply with ABEM’s Policy on Medical Licensure.
    3. Verify that your contact information is correct.
    4. Pay for the examination.  The payment step involves entering appropriate credit card information and obtaining immediate approval, or selecting the option of paying by mail.  View the Policy on Fees for more information about examination fees.
    5. Review billing information to make sure it is correct. 

    When registration is complete, physicians will see the information needed to schedule an appointment to take the examination with Pearson VUE testing centers.  Physicians will be sent a follow-up email notifying them that they may call Pearson VUE to schedule their appointment.  If 24 hours have passed without receiving this email, physicians should call Pearson VUE to schedule.  View information about Pearson VUE.

    Physicians receive their choice of test site on a first-come-first-served basis and seating at each test site is limited.  Physicians are strongly encouraged to register and schedule early.

    Taking the Medical Toxicology Cognitive Expertise Examination

    Physicians are expected to appear on time for their Medical Toxicology cognitive expertise examination appointments.  The assigned seat may become unavailable if the physician appears more than 30 minutes after the appointment time.

    Upon arrival at the Pearson VUE testing center, a physician must be prepared to show his or her government issued picture identification.  A physician’s guests may not remain within the testing center while the physician is taking the ConCertTM examination.

    To protect examination validity and ensure a consistent, fair examination administration across all its testing centers, Pearson VUE maintains strict security measures, including tight restrictions on what personal items may be taken into the testing room.  These security procedures also include multiple checks to confirm each examinee's identity, such as taking a digital signature, photograph, and fingerprint image.  Note that this information is used solely for the purpose of confirming identity, is held in the strictest confidence by Pearson VUE, and is not released to any third parties. 

    Physicians may take health-related items that they will need, such as eyeglasses and hearing aids. Visually impaired candidates may use magnifying visual aids.

    Physicians may not take any items other than those listed above into the examination room. Prohibited items include, but are not limited to, food and beverages, computers and electronic information storage system devices; hand-held, pocket and laptop computers, and any similar devices; watches, cell phones, PDAs, beepers, pagers, cameras, tape or CD players or recorders, calculators and timepieces with calculators; coats, backpacks, briefcases, purses, wallets, and “fanny” packs; notepaper, pens, books, luggage, or study materials.  Prohibited electronic items are not permitted in the testing room even if turned off. Physicians will be provided with erasable notepads.

    Pearson VUE testing centers are equipped with lockers for storing personal items during the examination appointment.

    Notification of Results

    Physicians will receive the results of their Medical Toxicology cognitive expertise examination from their home board.

  • Communication / Professionalism Activity

    Increasingly, emergency physicians are required to be evaluated through a patient experience of care feedback process. As part of the American Board of Medical Specialty (ABMS) requirements for member boards’ Maintenance of Certification (MOC) programs, diplomates must use an experience of care survey that measures physician behaviors from the three categories listed below.

    Diplomates may use any formal method of assessing communication skills including patient surveys, interviews, or focus groups, administered at the institutional, departmental, or individual level. Some patient feedback methods that may meet ABEM requirements include Press-Ganey, CAHPS/HCAHPS, and MAPPS. However, not all hospitals use a patient experience of care survey. ABEM has developed a survey form that is an adaptation of the CAHPS Clinician and Group Survey and Reporting Kit 2008. Diplomates who do not have access to an existing survey may download the form and use to fulfill their ABEM MOC APP Communication/Professionalism requirement. Click here for more information about the ABEM patient experience of care survey form.

    At least ten of the diplomate’s patients must be included. A minimum of one physician behavior must be measured from each of the following three categories:

    1. Communications/listening, for example
    * Communicate clearly with patients and other medical staff by listening carefully and couching language at the appropriate level for the listener

    2. Providing information, for example
    * Explain the clinical impression and anticipated management course to the patient and the patient’s family
    * Provide information about tests and procedures
    * Give the patient options

    3. Showing concern for the patient, for example
    * Show respect to the patient and other medical staff
    * Make the patient feel comfortable by asking if they have any questions or concerns and act to address their concerns
    * Ask the patient about adequate pain relief

    See a Sample CP Online Attestation Form.