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
Decision Tree for Providers
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
Suspect OUD
Determine if patient has OUD through use of one of the following screening tools:
Common Acute Pain Condition
If common acute pain condition
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 (MAT) is among the leading treatments for OUD and is expanding in South Dakota:
Select the patient’s treatment plan:
- Appropriate for MAT or other treatment options
- NOT Appropriate for MAT, but may be appropriate for other treatment options
Patient Not Appropriate for MAT
Provide Education, Refer to a Primary Care Provider, and Prescribe Naloxone
Patient Appropriate for MAT
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.
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 Agrees to MAT
Connect to treatment and support:
- Initiate MAT in ED or refer to MAT provider in South Dakota.
- Provide education on harm reduction, resources, and encourage treatment.
- Prescribe or co-prescribe naloxone.
Patient Declines MAT
Provide Education, Encourage Care Coordination, Refer to a Primary Care Provider, and Prescribe Naloxone
Thank you for using the Emergency Department Provider Toolkit!
As we work together to share ideas and information geared to improve patient outcomes and support transitions to recovery, we welcome your feedback.
We also encourage you to reference the Education and Clinical Resources, MAT information and providers and contact the South Dakota Association of Healthcare Organizations (SDAHO) for technical assistance.
Additional Detail & Resources
Is this an opiate drug-seeking patient?
Clinical Opiate Withdrawl Scale (COWS) is used to determine opiate withdrawal.
Can you get a brief patient self-assessment?
The Current Opioid Misuse Measure (COMM) can be used to determine if a patient is misusing an opioid prescription.
What can be used to predict aberrant medication behavior in adults with chronic pain?
The Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) is a 24-item self-report instrument
How can I assess patient risk?
The National Institute on Drug Abuse offers a Quick Screen that can be used to identify risk behavior/risky substance use for patients 18 and older
Thank you for using the Emergency Department Provider Toolkit!
As we work together to share ideas and information geared to improve patient outcomes and support transitions to recovery, we welcome your feedback.
We also encourage you to reference the Education and Clinical Resources, MAT information and providers and contact the South Dakota Association of Healthcare Organizations (SDAHO) for technical assistance.
Additional Detail & Resources
- Read this case study for MAT in action in rural South Dakota!
Thank you for using the Emergency Department Provider Toolkit!
As we work together to share ideas and information geared to improve patient outcomes and support transitions to recovery, we welcome your feedback.
We also encourage you to reference the Education and Clinical Resources, MAT information and providers and contact the South Dakota Association of Healthcare Organizations (SDAHO) for technical assistance.
Thank you for using the Emergency Department Provider Toolkit!
As we work together to share ideas and information geared to improve patient outcomes and support transitions to recovery, we welcome your feedback.
We also encourage you to reference the Education and Clinical Resources, MAT information and providers and contact the South Dakota Association of Healthcare Organizations (SDAHO) for technical assistance.
Additional Detail & Resources
- Read this case study for MAT in action in rural South Dakota!
- CDP Case Study—in the works!
Thank you for using the Emergency Department Provider Toolkit!
As we work together to share ideas and information geared to improve patient outcomes and support transitions to recovery, we welcome your feedback.
We also encourage you to reference the Education and Clinical Resources, MAT information and providers and contact the South Dakota Association of Healthcare Organizations (SDAHO) for technical assistance.
OUD is a life-threatening disease. In South Dakota, opioid related deaths have increased since 2012. For every death due to opioid overdose in South Dakota, there were two hospital admissions for opioid overdoses and related disorders. Additionally, people who overdose are at a higher risk of future overdoses. For more on opioid-related statistics, please visit the key data page.