The emergency department (ED), sometimes termed the emergency room (ER), emergency ward (EW), accident & emergency (A&E) department or casualty department is a hospital or primary care department that provides initial treatment to patients with a broad spectrum of illnesses and injuries, some of which may be life-threatening and requiring immediate attention. A hospital is an institution for Health care providing treatment by specialised staff and equipment and often but not always providing for Primary care is a term used for the activity of a Health care provider who acts as a first point of consultation for all patients A patient is any person who receives medical attention care or treatment. Illness (sometimes referred to as ill-health or ail) can be defined as a state of poor Health. Injury or bodily injury is Damage or Harm caused to the Structure or function of the Body caused by an outside agent or A medical emergency is an Injury or Illness that is acute and poses an immediate risk to a person's life or long term health Emergency departments developed during the 20th century in response to an increased need for rapid assessment and management of critical illnesses. The twentieth century of the Common Era began on In some countries, emergency departments have become important entry points for those without other means of access to medical care.

Upon arrival in the ED, people typically undergo a brief triage, or sorting, interview to help determine the nature and severity of their illness. Triage (ˈtriːɑːʒ is a process of prioritizing patients based on the severity of their condition so as to treat as many as possible when resources are insufficient for all Individuals with serious illnesses are then seen by a physician more rapidly than those with less severe symptoms or injuries. After initial assessment and treatment, patients are either admitted to the hospital, stabilized and transferred to another hospital for various reasons, or discharged. The staff in emergency departments not only includes doctors, but physician assistants (PAs) and nurses with specialized training in emergency medicine and in house Paramedics and/or emergency medical technicians, respiratory therapists, radiology technicians, Healthcare Assistants (HCAs), volunteers, and other support staff who all work as a team to treat emergency patients and provide support to anxious family members. In the United States, a physician assistant (PA is an advanced practice clinician licensed to practice Medicine with the supervision of a licensed A nurse is responsible—along with other Health care Professionals —for the treatment safety and recovery of acutely or chronically Emergency Medicine is a speciality of Medicine that focuses on the Diagnosis and treatment of acute illnesses and injuries that require immediate medical attention A paramedic is a medical professional usually a member of the emergency medical service, who primarily provides Pre-hospital advanced medical and The emergency departments of most hospitals operate around the clock, although staffing levels are usually much lower at night. Since a diagnosis must be made by an attending physician, the patient is initially assigned a chief complaint rather than a diagnosis. This is usually a symptom: headache, nausea, loss of consciousness. The chief complaint remains a primary fact until the attending physician makes a diagnosis.

Contents 1 Department layout 2 Signage 3 Nomenclature 3.1 Commonwealth nations and Ireland 3.2 United States 3.3 United Kingdom 4 Patient experience 5 Critical conditions handled 5.1 Cardiac arrest 5.2 Heart attack 5.3 Trauma 5.4 Mental Illness 5.5 Asthma and COPD 6 Special facilities, training, and equipment 7 Non-emergency use 8 Resident physicians 9 Academic resources 10 Citations 11 References 12 See also 13 External links

Department layout

A typical emergency department has several different areas, each specialized for patients with particular severities or types of illness.

In the triage area, patients are seen by a triage nurse who completes a preliminary evaluation, before transferring care to another area of the ED or a different department in the hospital. Triage (ˈtriːɑːʒ is a process of prioritizing patients based on the severity of their condition so as to treat as many as possible when resources are insufficient for all Patients with life or limb-threatening conditions may bypass triage and be seen directly by a physician.

The resuscitation area is a key area of an emergency department. It usually contains several individual resuscitation bays, usually with one specially equipped for paediatric resuscitation. Pediatrics (also spelled paediatrics) is the branch of Medicine that deals with the medical care of Infants Children and Adolescents Each bay is equipped with a defibrillator, airway equipment, oxygen, intravenous lines and fluids, and emergency drugs. Defibrillation is the definitive treatment for the life-threatening Cardiac arrhythmias Ventricular fibrillation and Ventricular tachycardia. Oxygen therapy is the administration of Oxygen as a therapeutic modality Intravenous therapy or IV therapy is the giving of Liquid substances directly into a Vein. Resuscitation areas also have ECG machines, and often limited X-ray facilities to perform chest and pelvis films. X-radiation (composed of X-rays) is a form of Electromagnetic radiation. Other equipment may include non-invasive ventilation (NIV) and portable ultrasound devices. In Medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing when patients cannot do so on their own

The majors, or general medical, area is for stable patients who still need to be confined to bed (note that a "bed" in the ED context is almost always a gurney or trolley rather than a full hospital bed). A gurney, known as a trolley in British medical context is the U This area is often very busy, filled with many patients with a wide range of medical and surgical problems. Many will require further investigation and possible admission. Patients who are not in need of immediate treatment are sent to the minors area. Such patients may still have been found to have significant problems, including fractures, dislocations, and lacerations requiring suturing. A bone fracture (sometimes abbreviated # or Fx or Fx) is a medical condition in which a Bone is cracked or broken Joint dislocation (Latin luxatio) occurs when bones in a Joint become displaced or misaligned In Medicine, a wound is a type of Injury in which the Skin is torn cut or punctured (an open wound or where blunt force trauma

A paediatric area for the treatment of children has recently become standard, to dedicate separate waiting areas and facilities for children. Pediatrics (also spelled paediatrics) is the branch of Medicine that deals with the medical care of Infants Children and Adolescents Some departments employ a play therapist whose job is to put children at ease to reduce the anxiety caused by visiting the emergency department, as well as provide distraction therapy for simple procedures. Anxiety is a physiological and psychological state characterized by Cognitive, Somatic, Emotional and Behavioral components

Very few EDs have a dedicated area for obstetrics nowadays. Obstetrics (from the Latin obstare, "to stand by" is the surgical speciality dealing with the care of a woman and her offspring during Pregnancy In most cases, a pregnant woman who presents to the ED is sent immediately to the obstetrics/maternity ward or the Labour and Delivery suite, unless she has another medical condition that requires treatment first.

Many hospitals have a separate area for evaluation of psychiatric problems. Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as These are often staffed by psychiatrists and mental health nurses and social workers. A psychiatrist (also archaically called an alienist) is a Physician who specializes in Psychiatry and is certified in treating Mental disorders Social work is a discipline involving the application of Social theory and research methods to study and improve the lives of people groups and societies There is typically at least one room for people who are actively a risk to themselves or others (e. g. suicidal).

Emergency departments may also have a separately streamed service for minor and rapidly treatable conditions, such as minor injuries. The fast track may be staffed by emergency nurse practitioners, Physician Assistants and/or physicians, and special consultation rooms are specifically designated for this purpose. In the United States, a physician assistant (PA is an advanced practice clinician licensed to practice Medicine with the supervision of a licensed This system allows for quicker treatment of patients who may otherwise be forced to wait for more pressing cases to resolve. This part of the department may be called by several names e. g. Urgent Care Centre, Fast Track Unit or Primary Care Suite depending on the local emphasis. Where this type of service is provided on a separate site from the local ED it is called a Minor Injuries Unit or an Urgent Care Clinic. A Minor Injuries Unit, in the United Kingdom is a department largely staffed by Emergency Nurse practitioners (ENPs working autonomously who look after

Signage

A hospital with an emergency department usually has prominent signage reading Emergency or Accident and Emergency (often in white text on a red background) and an arrow to indicate where patients should proceed. Some American states closely regulate the design and content of such signs, and require wording such as "Comprehensive Emergency Medical Service" and "Physician On Duty"^[1], to prevent persons in need of critical care from presenting to facilities that are not fully equipped and staffed. A US state is any one of the fifty subnational entities of the United States of America that share Sovereignty with the federal government

Nomenclature

Commonwealth nations and Ireland

In Australia the department is usually referred to as the emergency department or the ED. For a topic outline on this subject see List of basic Australia topics. In New Zealand, it is always referred to as "A & E" in speech (ie Accident and Emergency. New Zealand is an Island country in the south-western Pacific Ocean comprising two main landmasses (the North Island and the South Island (A & E In the United Kingdom, Hong Kong, Singapore and Ireland it is usually called the accident and emergency department (A&E). The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located Hong Kong ( officially the Hong Kong Special Administrative Region, is a territory located on China 's south coast on the Pearl River Delta, and borders Singapore Ireland ( Irish: Éire, ˈeːrʲə is a country in north-western Europe. The popular term casualty is no longer considered appropriate by emergency physicians in Australia, the United Kingdom and Ireland. A casualty is a person who is the victim of an accident injury or trauma. Leading journals including the Annals of Emergency Medicine, published by the American College of Emergency Physicians and the Emergency Medicine Journal (emj), journal of the British Association for Emergency Medicine (BAEM), consistently use the term Emergency department. The Annals of Emergency Medicine is a Peer-reviewed Medical journal. The American College of Emergency Physicians (ACEP is the largest organization of emergency physicians in the United States. Emergency Medicine Journal ( EMJ) formerly the Journal of Accident and Emergency Medicine is a Peer-reviewed Medical journal The British Association for Emergency Medicine (BAEM is the representative body for emergency physicians in the United Kingdom.

In Canada, a slang word for the emergency department is "emerge". Country to "Dominion of Canada" or "Canadian Federation" or anything else please read the Talk Page

United States

In the United States an emergency department is often referred to by laypeople as an emergency room (ER). The United States of America —commonly referred to as the Medical professionals typically call it whatever its name is within their specific hospitals, or simply "Emergency. " The term "emergency room" is a misnomer, as a modern hospital's emergency facilities consist of dozens of rooms. The ED interacts with every other department in the hospital and often represents a significant percentage of the hospital's work load and finances. It is common for emergency department doctors to work for a company hired by the hospital to provide emergency services.

During the 1990s, an effort was made to change to the more accurate term emergency department (ED), which is a term increasingly used by members of the specialty internationally. The 1990s collectively refers to the years between and including 1990 and 1999 The effort failed and ED never caught on among the U. S. public, perhaps because of the popularity of the TV show ER, and the heavy marketing of the euphemism "ED" for erectile dysfunction by pharmaceutical companies. ER is an Emmy Award -winning American Medical drama series created by Novelist Michael Crichton and airing on However, the term does have some circulation among emergency medicine staff. Individual hospitals may also refer to the department by different names, such as emergency ward, emergency center, emergency unit, etc.

A smaller facility that may provide assistance in medical emergencies is known as a clinic. A clinic (or an outpatient clinic) is a small private or public health facility that is devoted to the care of Outpatients, often in a community in contrast Larger communities often have walk-in clinics where people with medical problems that would not be considered serious enough to warrant an emergency department visit can be seen. These clinics often do not operate on a 24 hour basis, and visiting them is sometimes less expensive than going to the ED.

In 1986 congress passed a law commonly referred to as EMTALA (Federal Emergency Medical Treatment and Active Labor Act, also known as the Patient Anti-Dumping Law) to address a growing concern that EDs were refusing to treat patients based on their inability to pay. The Emergency Medical Treatment and Active Labor Act ( EMTALA) is a United States Act of Congress passed in 1986 as part of the Consolidated Omnibus This law requires every ED to provide a minimal level of care to all comers regardless of their ability to pay.

The EMTALA act was passed by congress in 1986. Under this law, any person presenting to an Emergency Department is entitled by law to a Medical Screening Exam. The purpose of that exam is to determine if any illness or injury is present that without immediate intervention, could have serious consequences if treatment is delayed more than 24 hours. In practice, doing so often requires a full evaluation of all patients presenting to an Emergency Department. Only after that exam is fully complete may patients be referred to an outpatient clinic or their primary care physician if their condition and/or diagnosis allows it. According to a May 2003 American Medical Association (AMA) study, emergency physicians annually provide, on average, $138,300 of uncompensated care under the aegis of EMTALA.

United Kingdom

Throughout the UK, the department is known as "A&E" - Accident & Emergency. Some hospitals choose to use the term "ED" - Emergency Deparment, and drop the "Accident" from the title. This is considered appropriate by some hospitals due to people turning up with minor injuries after an accident, rather than a real emergency. Although some hospitals use the term "ED", all road signs to the department still read "A&E". Most teaching hospitals and district general hospitals (DGHs) have an A&E department. The largest such department in the UK is in St Thomas' Hospital. St Thomas' Hospital is a large NHS Hospital in Lambeth, London, England.

Traditionally, waits for assessment in A&E were very long in some areas of the UK. In October 2002, the Department of Health introduced the Four Hour Emergency Target that required departments to assess and treat patients within four hours of arrival, with referral and assessment by other departments if deemed necessary. See also 2002 (disambiguation Year 2002 ( MMII) was a Common year starting on Tuesday of the Gregorian calendar. The Four Hour Emergency Target was introduced by the Department of Health for National Health Service Acute Hospitals in England Present policy is that 98% of all patients do not "breach" this four-hour wait.

This triggered the introduction of the Acute Assessment Unit (also known as the Medical Assessment Unit), which works alongside the Emergency Department but is outside it for statistical purposes. An Acute Assessment Unit, or Acute Admissions Unit, ( AAU) is a short-stay department in a UK Hospital which is sometimes part of the Emergency Department It is claimed that though A&E targets have resulted in significant improvements in completion times, the current target would not have been possible without some form of patient re-designation or re-labelling taking place, so true improvements are somewhat less than headline figures might suggest and it is doubtful that a single target target (fitting all A&E and related services) is sustainable. ^[2]

In other countries without this policy (such as Ireland and Australia), patients may be faced with prolonged waits of hours or even days on trolleys for hospital beds.

Patient experience

Patients arrive at emergency departments in two main ways: by ambulance or independently. The ambulance crew notifies the hospital beforehand of the patient's condition and begins Basic Life Support measures as needed. Basic Life Support (BLS is a specific level of prehospital medical care provided by trained responders including Emergency medical technicians in the absence of advanced medical Depending on the patient's condition, the emergency department physician may direct the ambulance crew to begin specific interventions while still en route. These patients are taken to the emergency department's resuscitation area, where they are met by a team with the expertise to deal with the patients' conditions. For example, patients with major trauma are seen by a trauma team consisting of emergency physicians, nurses, paramedics, a surgeon, and an anestheologist. Treatment of physical trauma is described here and in First aid. A Trauma team is a group of healthcare workers who attend to seriously ill or injured casualties who arrive at a Hospital Emergency department. Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental An anaesthetist ( English) or anesthesiologist ( US English) also "anaesthesiologist" is a medical doctor trained to administer

Patients arriving independently or by ambulance are typically triaged by a nurse with training in emergency medicine. Patients are seen in order of medical urgency, not in order of arrival. Patients are triaged to the resuscitation area, majors area, or minors area. Emergency/Accident and Emergency departments usually have one entrance with a lobby and a waiting room for patients with less-urgent conditions, and another entrance reserved for ambulances. A lobby is a Room in a Building which is used for entry from the outside A waiting room is a building or more commonly a part of a building where people sit or stand until the event they are waiting for occurs

Critical conditions handled

Cardiac arrest

Cardiac arrest may occur in the ED/A&E or a patient may be transported by ambulance to the emergency department already in this state. A cardiac arrest, also known as cardiorespiratory arrest, cardiopulmonary arrest or circulatory arrest, is the abrupt cessation of normal circulation of Treatment is basic and advanced life support as taught in the Advanced Life Support and Advanced Cardiac Life Support courses. Basic Life Support (BLS is a specific level of prehospital medical care provided by trained responders including Emergency medical technicians in the absence of advanced medical Advanced Life Support (ALS- Implies that a EMT is capable of performing advanced life support skills as either an EMT-I (Intermediate or an EMT-P (Paramedic commonly referred Advanced cardiac life support or ( ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies as This is an immediately life-threatening condition which requires immediate action in salvageable cases.

Heart attack

See main article: Myocardial infarction

Patients arriving to the emergency department with a myocardial infarction (heart attack) are likely to be triaged to the resuscitation area. Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply They will receive oxygen and monitoring and have an early ECG; aspirin will be given if not contraindicated or not already administered by the ambulance team; morphine or diamorphine will be given for pain; sublingual (under the tongue) or buccal (between cheek and upper gum) glyceryl trinitrate (nitroglycerin) (GTN or NTG) will be given, unless contraindicated by the presence of other drugs, such as drugs that treat erectile disfunction. Aspirin, or acetylsalicylic acid (ASA (əˌsɛtɨlsælɨˌsɪlɨk ˈæsɨd is a Salicylate drug, often used as an Analgesic to relieve In Medicine, a contraindication (pronounced as contra-indication is a condition or factor that increases the Risks involved in using a particular drug, Medical uses Morphine can be used as an analgesic in hospital settings to relieve pain in Myocardial infarction pain in Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative Pain, in the sense of physical pain, is a typical sensory experience that may be described as the unpleasant awareness of a noxious stimulus or bodily harm Nitroglycerin ( NG) ( US spelling also known as nitroglycerine, ( UK Spelling trinitroglycerin, trinitroglycerine

An ECG that reveals ST segment elevation or new left bundle branch block suggests complete blockage of one of the main coronary arteries. A bundle branch block refers to a defect of the Heart 's electrical conduction system. These patients require immediate reperfusion (re-opening) of the occluded vessel. This can be achieved in two ways: thrombolysis (clot-busting medication) or percutaneous transluminal coronary angioplasty (PTCA). Thrombolysis is the breakdown ( lysis) of blood clots by pharmacological means Angioplasty is the technique of mechanically widening a narrowed or totally obstructed Blood vessel; typically as a result of Atherosclerosis. Both of these are effective in reducing significantly the mortality of myocardial infarction. Many centers are now moving to the use of PTCA as it is somewhat more effective than thrombolysis if it can be administered early. This may involve transfer to a nearby facility with facilities for angioplasty.

Trauma

Main article: Physical trauma

Major trauma, the term for patients with multiple injuries, often from a road traffic accident or a fall, is treated by a trauma team who have been trained using the principles taught in the internationally recognized Advanced Trauma Life Support (ATLS) course of the American College of Surgeons. Treatment of physical trauma is described here and in First aid. A Trauma team is a group of healthcare workers who attend to seriously ill or injured casualties who arrive at a Hospital Emergency department. Advanced Trauma Life Support (ATLS is a training program for doctors in the management of acute trauma cases developed by the American College of Surgeons. The American College of Surgeons is an educational association of Surgeons created in 1913 Some other international training bodies have started to run similar courses based on the same principles.

The services that are provided in an emergency department can range from simple x-rays and the setting of broken bones to those of a full-scale trauma center. A trauma center is a Hospital equipped to provide comprehensive Emergency medical services to patients suffering traumatic injuries A patient's chance of survival is greatly improved if the patient receives definitive treatment (i. e. surgery or reperfusion)within one hour of an accident (such as a car accident) or onset of acute illness (such as a heart attack). This critical time frame is commonly known as the "golden hour. In Emergency medicine, the golden hour is the first sixty minutes after the occurrence of multi-system trauma "

Some emergency departments in smaller hospitals are located near a helipad which is used by helicopters to transport a patient to a trauma center. The word helipad is a portmanteau meaning helicopter landing pad, a landing area for Helicopters Though helicopters can usually land anywhere flat a fabricated This inter-hospital transfer is often done when a patient requires advanced medical care unavailable at the local facility. In such cases the emergency department can only stabilize the patient for transport. Stabilizer (spelt stabiliser in UK English may mean Stabilizer (aircraft, surfaces to help keep aircraft under control Stabilizer

Mental Illness

Some patients arrive at an emergency department for a complaint of mental illness. In many jurisdictions (including many U. S. states), patients who appear to be mentally ill and to present a danger to themselves or others may be brought against their will to an emergency department by law enforcement officers for psychiatric examination. From the emergency department, patients thought to be mentally ill may be transferred to a psychiatric unit (in many cases involuntarily).

Asthma and COPD

Acute exacerbations of chronic respiratory diseases, mainly asthma and chronic obstructive pulmonary disease (COPD) are assessed as emergencies and treated with oxygen therapy, bronchodilators, steroids or theophylline, have an urgent chest X-ray and arterial blood gases and are referred for intensive care if necessary. Asthma is a chronic Condition involving the Respiratory system in which the airways occasionally constrict become inflamed, and are Chronic obstructive pulmonary disease ( COPD) is a Disease of the lungs in which the Airways become narrowed Oxygen therapy is the administration of Oxygen as a therapeutic modality A bronchodilator is a substance that dilates the bronchi and Bronchioles decreasing airway resistance and thereby facilitating airflow Glucocorticoids (GC are a class of Steroid hormones characterised by an ability to bind with the glucocorticoid receptor ( GR) and trigger similar effects Theophylline, also known as dimethylxanthine, is a Methylxanthine drug used in therapy for Respiratory diseases such as COPD or Asthma A chest X-ray, commonly abbreviated CXR, is a projection radiograph ( X-ray) taken by a Radiographer, of the Thorax which is used An arterial blood gas ( ABG) is a Blood test that is performed specifically on Blood from an Artery. Intensive Care Medicine or critical care medicine is a branch of medicine concerned with the provision of Life support or organ support systems in patients Non invasive ventilation in the ED has reduced the requirement for intubation in many cases of severe exacerbations of COPD. In Medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing when patients cannot do so on their own In Medicine, intubation refers to the placement of a tube into an external or internal orifice of the body

Special facilities, training, and equipment

An ED requires different equipment and different approaches than most other hospital divisions. Patients frequently arrive with unstable conditions, and so must be treated quickly. They may be unconscious, and information such as their medical history, allergies, and blood type may be unavailable. ED staff are trained to work quickly and effectively even with minimal information.

ED staff must also interact efficiently with pre-hospital care providers such as EMTs, paramedics, and others who are occasionally based in an ED. The Emergency Medical Technician ( EMT) exists in many countries and is a health care provider trained to provide prehospital emergency medical care A paramedic is a medical professional usually a member of the emergency medical service, who primarily provides Pre-hospital advanced medical and The pre-hospital providers may use equipment unfamiliar to the average physician, but ED physicians must be expert in using (and safely removing) specialized equipment, since devices such as Military Anti-Shock Trousers ("MAST") and traction splints require special procedures. Military Anti-Shock Trousers are medical devices used to treat severe blood loss A traction splint is used to treat severe bone fractures of the Femuror Tib Fib area Among other reasons, given that they must be able to handle specialized equipment, physicians can now specialize in emergency medicine, and EDs employ many such specialists.

ED staff have much in common with ambulance and fire crews, combat medics, search and rescue teams, and disaster response teams. An ambulance is a Vehicle for transporting sick or injured people to from or between places of treatment for an Illness or Injury. Firefighters are rescuers extensively trained primarily to put out hazardous Fires that threaten civilian populations and property to rescue people from car accidents collapsed A combat medic is a trained Soldier or sailor who is responsible for providing First aid and frontline trauma care on the battlefield For the TV series of this title see Search and Rescue (TV series. Disaster response is a phase of the Disaster management cycle Often, joint training and practice drills are organized to improve the coordination of this complex response system. Busy EDs exchange a great deal of equipment with ambulance crews, and both must provide for replacing, returning, or reimbursing for costly items.

Cardiac arrest and major trauma are relatively common in EDs, so defibrillators, automatic ventilation and CPR machines, and bleeding control dressings are used heavily. Defibrillation is the definitive treatment for the life-threatening Cardiac arrhythmias Ventricular fibrillation and Ventricular tachycardia. Survival in such cases is greatly enhanced by shortening the wait for key interventions, and in recent years some of this specialized equipment has spread to pre-hospital settings. The best-known example is defibrillators, which spread first to ambulances, then in an automatic version to police cars, and most recently to public spaces such as airports, office buildings, hotels, and even shopping malls. An airport is a location where Aircraft such as airplanes, Helicopters and blimps take off and land An office is generally a room or other area in which people work, but may also denote a position within an Organization with specific duties attached A hotel is an establishment that provides paid lodging usually on a short-term basis

Because time is such an essential factor in emergency treatment, EDs typically have their own diagnostic equipment to avoid waiting for equipment installed elsewhere in the hospital. Nearly all have an X-ray room, and many now have full radiology facilities including CT scanners and ultrasonography equipment. Laboratory services may be handled on a priority basis by the hospital lab, or the ED may have its own "STAT Lab" for basic labs (blood counts, blood typing, toxicology screens, etc) that must be returned very rapidly.

Non-emergency use

Emergency departments around the world are increasingly being used for non-emergency care because of overburdened healthcare systems. Many people, afflicted by minor injuries or illnesses late at night or at times when their doctor's office is closed, are forced to resort to attending the ED. This is especially true for conditions with distressing symptoms, such as a child's ear infection. Otitis is a general term for inflammation or infection of the ear in both humans and other animals People in lower socioeconomic classes are more likely to use the ED for primary care services, as they typically find it inconvenient or impossible to miss work for a visit to the General Practitioner (GP). A general practitioner, or GP is a medical practitioner who provides Primary care and specializes in Family medicine.

In the United Kingdom, it has become more popular to visit the A&E since it became mandatory for patients to be fully treated and discharged from the department within four hours of arrival. Also, the introduction of the new contract for primary care doctors in that country decreased the accessibility of GP services. Under this contract GPs can opt out of on-call cover, and patients sometimes present instead to the A&E.

In many Primary Care Trusts there may be out of hours doctor services sometimes known as Keydoc or something similar (varying by area) provided by volunteer General Practitioners. A Primary Care Trust (PCT is a type of NHS Trust, part of the National Health Service in England, that provides some primary and community services or A general practitioner, or GP is a medical practitioner who provides Primary care and specializes in Family medicine.

Resident physicians

Resident physicians, in specialty training for the specialty of Emergency Medicine, provide a large portion of the medical care in university hospital ED's. They are supervised by ABEM board certified attending physicians. The chief resident (chosen by the university faculty) is often the best all-around resident, universally thought of as the most talented resident physician.

Academic resources

• Academic Emergency Medicine, ISSN: 1069-6563, Elsvier

Citations

References

• John B Bache, Carolyn Armitt, Cathy Gadd, Handbook of Emergency Department Procedures, ISBN 0-7234-3322-4
• Swaminatha V Mahadevan, An Introduction To Clinical Emergency Medicine: Guide for Practitioners in the Emergency Department, ISBN 0-521-54259-6

See also

• on call
• Emergency department in France
• Acute Assessment Unit

External links

• Jacobi/Montefiore Emergency Departments affiliated with Albert Einstein Medical School US Emergency Dept Residency
• Stony Brook University Emergency Dept US Emergency Dept
• St. Luke's-Roosevelt Emergency Department Emergency Rooms in New York City
• Narrative of an ED nurse (AUS)
• ED visits (US)
• ED wait times (Canada)
• Group dedicated to improving A&E departments in East Kent (UK)
• Overuse of Emergency Departments Among Insured Californians (US) (California HealthCare Foundation, October 2006)
• emergencyroom at PS1

In France, there are two types of Emergency rooms: the specialized services (called SAU and the proximity units (called Upatou An Acute Assessment Unit, or Acute Admissions Unit, ( AAU) is a short-stay department in a UK Hospital which is sometimes part of the Emergency Department

---

© 2009 citizendia.org; parts available under the terms of GNU Free Documentation License, from http://en.wikipedia.org
Dapyx Software network: MP3 Explorer | Ebook Manager | Zenithic