Emergency medicine

Treating an emergency patient at home could look like this image (which was made for illustration only)

Emergency Medicine physicians, or EM doctors, are highly skilled in assessing, diagnosing, and treating patients who arrive at the Emergency Department (ED) with urgent health issues. The ED, also known as the Emergency Room (ER) or casualty department, is a specialized area in hospitals equipped to handle emergencies. It is identifiable by symbols such as a red cross or red letters, signaling immediate care services to the public.

CA Medic in Afghan

EM doctors are unique in their comprehensive knowledge across various medical fields, allowing them to manage acute manifestations of diseases and injuries. Their expertise is not limited to any one organ or system, making them proficient in treating patients with diverse healthcare needs. Although their primary focus is on acute care, EM physicians also encounter patients with non-emergent conditions, necessitating a broad understanding of general medicine.

Core Competencies

The practice of Emergency Medicine involves a wide range of competencies and procedures aimed at effectively managing emergency situations:

• Triage: Rapid assessment and prioritization of patients based on the severity of their condition to ensure timely treatment.
• Resuscitation: Life-saving interventions for patients in critical conditions, such as those experiencing cardiac arrest or severe trauma.
• Acute medical conditions: Diagnosis and management of sudden, often severe, medical illnesses.
• Trauma care: Comprehensive care for patients with traumatic injuries, including coordination with surgical teams.
• Procedural skills: Expertise in performing emergency procedures, such as lumbar punctures, intubation, and the management of fractures.
• Collaboration: Working closely with specialists across various fields to ensure holistic patient care.
• Discharge planning: Determining the appropriate care continuum for patients post-emergency treatment, including hospital admission or home-based care.
• Patient education: Informing patients and their families about the management of acute conditions and preventive measures to avoid future emergencies.
• Continuous learning: Keeping abreast of the latest developments in medicine to provide the best care possible.
• Advocacy and public health: Engagement in community health initiatives and promotion of safety measures to prevent emergencies.

Diagnostic Tools and Procedures

Emergency Departments are equipped with a range of diagnostic tools and facilities to support the rapid assessment and treatment of patients:

• Tests: Essential diagnostics include blood tests (e.g., CBC or complete blood count), urine analysis, EKGs (electrocardiograms), X-rays, and CT scans.
• Procedures: Emergency physicians perform various critical procedures, including but not limited to laceration repair, endotracheal intubation, chest tube placement, emergency vascular access, gastric lavage, and incision and drainage of abscesses.

Scholarship and Research

The field of Emergency Medicine is supported by a robust academic and research framework, with several leading journals dedicated to the specialty:

• Shock
• Resuscitation
• Academic Emergency Medicine
• Annals of Emergency Medicine
• American Journal of Emergency Medicine

Glossary

• Advanced Life Support in Obstetrics - A training program for health professionals on managing critical obstetrical emergencies, emphasizing skills necessary for emergency situations in obstetric care.
• Advanced life support (ALS) - A set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation (breathing).
• Aeromedical Biological Containment System - A specialized containment unit designed for transporting highly infectious disease patients by air, ensuring safety and isolation.
• Aeromedical Isolation Team - A group of trained medical personnel equipped to transport and care for patients with highly infectious diseases under airborne isolation conditions.
• Airtraq - A device used for intubation, designed to facilitate a quick and clear view of the vocal cords and trachea, making it easier to insert a tube for artificial ventilation.
• Altered level of consciousness (ALOC) - A state in which a person is not fully alert or aware of their surroundings, ranging from slight confusion to complete unresponsiveness.
• Angor animi - A sensation of intense anxiety or dread, often described by patients experiencing a heart attack or severe cardiac event, feeling as though death is imminent.
• Artificial ventilation - A means of assisting or stimulating respiration, using mechanical ventilators to move breathable air into and out of the lungs in patients unable to breathe adequately on their own.
• Atelectotrauma - Lung injury caused by the repetitive opening and closing of collapsed airways, often associated with mechanical ventilation.
• Biotrauma - Lung injury resulting from the biological response to mechanical ventilation and the release of inflammatory mediators.
• Blast-related ocular trauma - Eye injuries resulting from the force and pressure of explosions, common in military conflicts and terrorist attacks.
• Buddy wrapping - A method of immobilizing an injured finger or toe by taping it to an adjacent finger or toe, providing support and reducing movement to aid in healing.
• Clearing the cervical spine - A clinical evaluation to determine if there is a cervical spine injury present. This process ensures that the spine is safe from potential further injury during patient handling.
• Coma cocktail - A term used to describe the administration of specific medications to a comatose patient, aiming to treat potential reversible causes of coma.
• Coma scale - A system used to assess the severity of a coma, such as the Glasgow Coma Scale, which evaluates eye opening, verbal response, and motor response to determine the depth and duration of coma and impaired consciousness.
• Coma - A deep state of unconsciousness in which an individual cannot be awakened, fails to respond to painful stimuli, light, or sound, and lacks normal wake-sleep cycles.
• Confidential incident reporting - A system within healthcare settings that allows professionals to report accidents, near misses, or dangerous conditions anonymously to improve safety and prevent future incidents.
• Conflict and Catastrophe Medicine - A field of medicine focused on providing care and medical infrastructure support in areas affected by conflicts, disasters, and major incidents.
• Dental emergency - A type of medical emergency involving the teeth or gingiva. Urgent care is required to save a tooth, control severe pain, or stop ongoing tissue bleeding.
• Dental trauma - Injury to the teeth, gums, or mouth, including teeth that are knocked out, fractured, or displaced, often requiring immediate medical attention to prevent long-term damage.
• Door-to-balloon - A measure of the time from when a patient with an acute myocardial infarction enters the emergency department to when a balloon catheter is inflated within the blocked artery, typically during an angioplasty procedure.
• Emergency department (ED) - A specialized department in a hospital where patients with urgent and emergent health conditions are treated. It is equipped to handle a wide range of medical emergencies.
• Emergency medical dispatch - A system that allows dispatchers to provide immediate guidance and assistance over the phone while emergency services are en route to the scene.
• Emergency medicine - A medical specialty focused on the diagnosis and treatment of acute illnesses and injuries that require immediate medical attention.
• Emergency physician - A medical doctor specialized in emergency medicine, trained to manage acute health issues and injuries in patients of all ages.
• Emergency psychiatry - A branch of psychiatry dealing with the immediate assessment and treatment of patients with psychiatric emergencies such as severe depression, psychosis, or suicidal behavior, often requiring intervention in emergency settings.
• Enamel fracture - A type of dental trauma involving a crack or break in the outermost layer of a tooth, which can cause pain and increase the risk of further dental issues if not treated promptly.
• Enamel-dentine fracture - A dental injury that extends through the enamel and into the dentine of the tooth, potentially leading to sensitivity, pain, and an increased risk of tooth decay.
• Golden hour (medicine) - The critical one-hour time period immediately following traumatic injury during which medical treatment to prevent irreversible internal damage and optimize the chance of survival is most effective.
• Head tilt/Chin lift - A simple first aid technique used to open the airway of an unconscious patient to improve breathing. It involves tilting the head back and lifting the chin.
• Heat illness - A spectrum of disorders due to environmental exposure to heat. It includes minor conditions such as heat cramps and heat exhaustion, as well as the more severe condition, heat stroke.
• Heroic measure - An emergency medical intervention that is extreme or drastic, undertaken in an attempt to save a life in a dire situation where the likelihood of success is uncertain.
• Intermediate Life Support - A level of care more advanced than basic life support but not as complex as advanced life support, including the use of airway devices and the administration of certain emergency medications.
• International emergency medicine - A branch of emergency medicine concerned with the development and delivery of emergency care globally, especially in low-resource settings.
• Jaw-thrust maneuver - An emergency procedure to open the airway by displacing the lower jaw forward without moving the head or neck; used in patients at risk for cervical spine injury.
• Laryngeal tube - A device inserted into the throat to keep the airway open for the delivery of oxygen or anesthesia, commonly used in emergency and pre-hospital settings.
• Lazarus syndrome - A rare phenomenon in which a person spontaneously returns to life after resuscitation has been stopped. It is named after Lazarus, who was resurrected in the Bible.
• Mass casualty incident - A situation where the number and severity of casualties overwhelm the local healthcare infrastructure's ability to provide adequate and timely care.
• Mass gathering medicine - The study and practice of providing medical care and public health services during large-scale events where the concentration of people challenges the existing health care infrastructure.
• Mechanical power (medicine) - A concept in respiratory care that quantifies the energy applied to the lung during mechanical ventilation, relevant in preventing ventilator-induced lung injury.
• Mechanical ventilation - A life-saving intervention used in intensive care and emergency medicine to assist or replace spontaneous breathing in patients who are unable to breathe adequately on their own.
• Medical Priority Dispatch System - A protocol-based system used by emergency dispatchers to prioritize calls based on the severity of the caller's condition, ensuring that the most critical cases receive immediate attention.
• Medical direction - Oversight provided by a qualified physician to guide the clinical practice of pre-hospital and emergency medical services, ensuring that patients receive optimal care.
• Medical emergency - A severe, life-threatening condition requiring immediate medical attention. Examples include heart attack, stroke, severe bleeding, and poisoning.
• Medical surge - A sudden increase in the demand for medical care and public health services that challenges or exceeds a community's capacity to provide care during a disaster or large-scale emergency event.
• Minor injuries unit - A healthcare facility or part of a facility dedicated to treating patients with less severe injuries, aimed at reducing the workload on emergency departments.
• Nocturnist - A physician, typically in hospital medicine, who works overnight shifts, providing care for hospitalized patients during these hours.
• Oropharyngeal airway - A medical device used to keep a patient's airway open, particularly during anesthesia or sedation, to ensure free passage of air into the lungs.
• Ottawa ankle rules - A set of guidelines used in emergency medicine to help determine the need for X-ray imaging in case of ankle and foot injuries, aimed at reducing unnecessary radiation exposure and resource use.
• Ottawa knee rules - Clinical guidelines that assist in deciding whether radiography is necessary for knee injury patients, optimizing the use of resources and reducing patient exposure to radiation.
• Pain stimulus - A method used in emergency medicine to assess the level of consciousness and neurological function in unresponsive patients by applying a stimulus that elicits a response to pain.
• Pediatric emergency medicine - A subspecialty of emergency medicine dedicated to the care of children and adolescents who are acutely ill or injured.
• Percutaneous transtracheal ventilation - An emergency procedure to provide ventilation through a catheter inserted through the skin into the trachea, used when conventional air
• Permissive hypercapnia - A strategy in mechanical ventilation allowing higher levels of carbon dioxide (CO2) in patients to reduce the risk of lung injury, under controlled conditions.
• Pre-hospital emergency medicine - A specialized field of medicine that focuses on the provision of immediate care to patients with acute illnesses or injuries before they reach the hospital, often by paramedics, emergency medical technicians, and other trained emergency responders.
• Procedural sedation and analgesia - A technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function.
• Prolonged field care - Extended medical and surgical care provided in a pre-hospital setting, particularly in remote or austere environments, beyond the expected duration of care, focusing on sustaining the patient's life until they can reach definitive care.
• Public safety answering point - A call center responsible for answering calls to an emergency telephone number for police, firefighting, and ambulance services. Dispatchers from these points dispatch the appropriate emergency services to the scene.
• Ranson criteria - A prognostic tool used in emergency medicine to predict the severity and outcome of acute pancreatitis based on clinical and laboratory findings at presentation and 48 hours after.
• Recovery position - A lateral, stable position used for patients who are unconscious but breathing, helping to maintain an open airway and reduce the risk of aspiration.
• Renee Salas - This might refer to an individual significant within the field of emergency medicine or related disciplines, often cited in discussions or literature on emergency medicine advancements or case studies. [Note: Without specific context, this entry is speculative and would require further clarification to accurately define within a glossary.]
• Resuscitation - The process of correcting physiological disorders (such as lack of heartbeat or breathing) in an acutely unwell patient. It encompasses a range of techniques, including CPR, defibrillation, and advanced life support interventions.
• Resuscitative hysterotomy - An emergency procedure performed to save the life of a pregnant woman and potentially her fetus by delivering the fetus through an incision in the abdomen and uterus, typically conducted in the context of cardiac arrest or profound hypotension.
• Rheotrauma - Injury to body tissues caused by mechanical forces, such as shear, compression, or stretching, often related to traumatic injuries received in accidents or during emergency medical interventions.
• SOFA score - The Sequential Organ Failure Assessment score, a tool used to track a patient's status during their stay in an ICU to determine the extent of a person's organ function or rate of failure.
• Social emergency medicine - A branch of emergency medicine that considers the social determinants of health and their impact on illnesses and injuries treated in the emergency department, emphasizing holistic and socially aware approaches to patient care.
• Surgical emergency - A condition that requires immediate surgical intervention to save life, limb, or functional capacity, such as appendicitis, ectopic pregnancy, or intestinal obstruction.
• Trauma center - A hospital or medical facility equipped and staffed to provide comprehensive emergency medical services to patients suffering traumatic injuries.
• Trauma team - A multidisciplinary group of healthcare professionals including physicians, nurses, and other specialists, who are trained to provide rapid assessment and treatment of trauma patients.
• Utstein Style - A set of guidelines for uniform reporting of cardiac arrest and resuscitation data, facilitating comparison and improvement of resuscitation outcomes across different regions and settings.
• Ventilator-associated lung injury (VALI) - Lung damage that can occur from mechanical ventilation, characterized by increased permeability of the lung capillary membranes and resulting in respiratory distress.
• Walking wounded - Individuals who have sustained injuries but are able to walk and move without assistance. In mass casualty incidents, they are often triaged to receive medical attention after more critically injured patients.
• Window of opportunity - A critical time period following an acute event during which specific interventions can significantly alter the outcome. In emergency medicine, this concept often refers to the timely administration of treatments that can prevent long-term damage or improve survival rates.

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