Emergency Medicine is a speciality of medicine that focuses on diagnosis and treatment of acute illnesses and injuries that require immediate medical attention. Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the Diagnosis is the identification by Process of elimination, of the nature of anything While not usually providing long-term or continuous care, emergency medicine physicians diagnose a wide array of pathology and undertake acute interventions to stabilize the patient. These professionals practice in hospital emergency departments, in the prehospital setting via emergency medical service and other locations where initial medical treatment of illness takes place. A hospital is an institution for Health care providing treatment by specialised staff and equipment and often but not always providing for Emergency medical services (abbreviated to the initialism "EMS" in many countries are a branch of Emergency services dedicated to providing out-of-hospital Just as clinicians operate by immediacy rules under large emergency systems, emergency practioniers aim to diagnose emergent conditions and stabilize the patient for definitive care.

Urgent Care Centers are often staffed by physicians, physician assistants, nurses and nurse practitioners who may or may not be formally trained in emergency medicine. They offer primary care treatment to patients who desire or require immediate care, but who do not reach the acuity that requires care in an emergency department or admission to a hospital.

Emergency Medicine encompasses a large amount of general medicine but involves virtually all fields of medicine and surgery including the surgical sub-specialties. Emergency physicians are tasked with seeing a large number of patients, treating their illnesses and arranging for disposition - either admitting them to the hospital or releasing them after treatment as necessary. The emergency physician requires a broad field of knowledge and advanced procedural skills often including surgical procedures, trauma resuscitation, advanced cardiac life support and advanced airway management. Emergency physicians ideally have the skills of many specialists - the ability to manage a difficult airway (anesthesia), suture a complex laceration (plastic surgery), reduce (set) a fractured bone or dislocated joint (orthopedic surgery), treat a heart attack (internist), work-up a pregnant patient with vaginal bleeding (Obstetrics and Gynecology), and stop a bad nosebleed (ENT). Anesthesia, or anaesthesia (see spelling differences; from Greek grc αν- an-, "without" and grc αἲσθησις Plastic surgery is a medical specialty interested in the correction of form and function Orthopedic surgery or orthopedics (also spelled orthopaedics) is the branch of Surgery concerned with injuries to or conditions involving the Internal medicine is the medical specialty concerned with the diagnosis management and nonsurgical treatment of unusual or serious diseases As per the discussion in the Talk page there has been no consensus as to using the American (gynecology or British (gynaecology spelling for this article BUT Otolaryngology is the branch of Medicine that specializes in the diagnosis and treatment of Ear, Nose, Throat, and head and neck disorders

Contents 1 Definition 2 History 3 Organizations around the world 4 Education 5 Working 6 References 7 See also 8 External links

Definition

"Emergency medicine is a medical specialty -- a field of practice based on the knowledge and skills required for the prevention, diagnosis and management of acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioral disorders. It further encompasses an understanding of the development of pre-hospital and in-hospital emergency medical systems and the skills necessary for this development. "

International Federation for Emergency Medicine 1991

History

During the French Revolution, after seeing the speed with which the carriages of the French flying artillery maneuvered across the battlefields, French military surgeon Dominique Jean Larrey applied the idea of Ambulances, or "Flying Carriages", for rapid transport of wounded soldiers to a central place where medical care was more accessible and effective. The French Revolution (1789–1799 was a period of political and social upheaval in the History of France, during which the French governmental structure previously an Dominique Jean Larrey ( 8 July, 1766 &ndash 25 July, 1842) was a French surgeon in Napoleon 's army and an important Larrey manned Ambulances with trained crews of drivers, corpsmen and litter-bearers and had them bring the wounded to centralized field hospitals, effectively creating a forerunner of the modern MASH units. Due to the popularity of the series M*A*S*H, colloquial use might refer to any mobile military Field hospital. Dominique Jean Larrey is sometimes called the father of Emergency Medicine for his strategies during the French wars. Dominique Jean Larrey ( 8 July, 1766 &ndash 25 July, 1842) was a French surgeon in Napoleon 's army and an important

Emergency Medicine (EM) as a medical specialty is relatively young. Prior to the 1960's and 70's, hospital "emergency rooms" were generally staffed by physicians on staff at the hospital on a rotating basis, among them general surgeons, internists, psychiatrists, and dermatologists. Dermatology (from Greek grc δέρμα derma, "skin" and grc -λογία -logia) is a branch of Medicine dealing with Physicians in training (interns and residents), foreign medical graduates and sometimes nurses also staffed the ED. EM was born as a specialty in order to fill the time commitment required by physicians on staff to work in the increasingly chaotic emergency departments (EDs) of the time. During this period, groups of physicians began to emerge who had left their respective practices in order to devote their work completely to the ED. The first of such groups was headed by Dr. James DeWitt Mills who, along with four associate physicians at Alexandria Hospital, VA established 24/7 year round emergency care which became known as the "Alexandria Plan". Soon, the problem of the "ER", propagated by published reports and media coverage of the poor state of affairs for emergency medical care had culminated with the establishment of the first emergency medicine training program at Cincinnati General Hospital, with Bruce Janiak, M. D. being the first emergency medicine resident in 1970. During the 1970's, several other residency programs developed throughout the country. At this time, EM was not yet a recognized specialty and hence had no primary board certification exam. It was not until the establishment of ACEP, the recognition of emergency medicine training programs by the AMA and the AOA, and in 1979 a historical vote by the American Board of Medical Specialties that EM became a recognized medical specialty. The American College of Emergency Physicians (ACEP is the largest organization of emergency physicians in the United States. The American Board of Medical Specialties ( ABMS) is a non-profit Physician -led Umbrella organization for 24 of the 26 approved medical specialty

Organizations around the world

In the United Kingdom and Ireland, the College of Emergency Medicine sets the examinations that trainees in Emergency Medicine take in order to become consultants (fully-trained emergency physicians). The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located Ireland (pronounced /ˈaɾlənd/ Éire) is the third largest island in Europe, and the twentieth-largest island in the world The College of Emergency Medicine ( CEM) is an organization of Emergency physicians in the United Kingdom which sets standards of training and administers An emergency physician is a Physician who works at an Emergency department to care for acutely ill patients The British Association for Emergency Medicine is the member organization in the UK. The British Association for Emergency Medicine (BAEM is the representative body for emergency physicians in the United Kingdom. In 2005 , the two organizations initiated steps, and have applied for a royal seal, to merge as the Royal College of Emergency Medicine.

In Australia and New Zealand, advanced training in Emergency Medicine is overseen by the Australasian College for Emergency Medicine (ACEM). For a topic outline on this subject see List of basic Australia topics. New Zealand is an Island country in the south-western Pacific Ocean comprising two main landmasses (the North Island and the South Island The Australasian College for Emergency Medicine is an institution whose prime objective is the training and examination of emergency physicians for Australia

In Canada, there are two routes to practice emergency medicine. Country to "Dominion of Canada" or "Canadian Federation" or anything else please read the Talk Page More than two thirds of physicians currently practicing emergency medicine across the Canadian nation have no specific emergency medicine residency training. Emergency physicians who tend to work in more community-based settings complete a residency specializing in Family Medicine and then proceed to obtain an additional year of training of special competence on Emergency Medicine from the College of Family Physicians of Canada (CCFP-EM). Family medicine differs from the traditional European general practitioner Physicians practicing in major urban/tertiary care hospitals will often pursue a 5 year specialist residency in Emergency Medicine, certified by the Royal College of Physicians and Surgeons of Canada. The Royal College of Physicians and Surgeons of Canada, (RCPSC is a national private nonprofit organization established in 1929 by a special Act of Parliament These members typically spend a great deal of time in academic and leadership roles within emergency medicine, EMS, research, and other avenues. There is no significant difference in remuneration or clinical practice type between physicians certified via either route.

In the United States, there are many member organizations for emergency physicians:

• The American College of Emergency Physicians (ACEP) is presently the largest member organization of emergency physicians, and Active membership is open to all physicians that have completed an emergency medicine residency approved by the Accreditation Council on Graduate Medical Education (ACGME) or the American Osteopathic Association (AOA), or are certified by any emergency medicine certifying body recognized by ACEP. The United States of America —commonly referred to as the The American College of Emergency Physicians (ACEP is the largest organization of emergency physicians in the United States. The American Osteopathic Association (AOA is the representative organization for osteopathic medical physicians (D Physicians engaged in the practice of emergency medicine prior to 2000 also qualify for membership under a grandfather clause. A grandfather clause is a term used in US English for an exception that allows an old rule to continue to apply to some existing situations when a new rule will apply to all future situations Originally founded in 1968, ACEP was the first Emergency Medicine society formed in the United States. Fellows use the designation FACEP. As of 2006, ACEP had about 25,000 members. ^[1][2]

• The American Academy of Emergency Medicine (AAEM) was formed in 1993 and has been the subject of some controversy due to its traditional position statements concerning board certification, resident "moonlighting", and the practice of "corporate medicine". Nevertheless, AAEM has worked cooperatively alongside the ACEP and the ACOEP when the interests of emergency medicine have called for a united front. Active membership is open to all physicians who have completed an emergency medicine residency approved by either ACGME or the AOA. Fellows use the designation FAAEM. As of 2007, the AAEM had about 5,000 members.

• The American College of Osteopathic Emergency Physicians (ACOEP) was founded seven years later in 1975. ^[3] Active membership is open only to osteopathic (D. O. ) medical physicians who have practiced emergency medicine for the past three years and/or have completed an emergency medicine residency approved by the AOA or ACGME. Fellows use the designation FACOEP. As of 2006, ACOEP enrolled about 2,300 members

• The Association of Emergency Physicians (AEP), which was founded in 1991, distinguishes itself by offering membership to any practicing emergency physician regardless of training. ^[4] By so doing, the AEP acknowledges that more than half of practicing emergency physicians in the United States, much like their colleagues in other countries, completed residencies in other related specialties that included training in the practice of emergency medicine. Currently, this organization is the only US organization that admits non-specialty trained physicians. AEP has members in 45 states. ^[4]

• The American Board of Emergency Medicine (ABEM) provides board certification to emergency physicians. Although ABEM now requires successful completion of an ACGME-approved residency in emergency medicine followed by completion of an additional year of practice before taking the exam, currently half of the emergency physicians currently holding ABEM certification were "grandfathered" in to certification eligibility via the practice track by training in another specialty, practicing emergency medicine, and then passing the ABEM certification exam.

• The American Osteopathic Board of Emergency Medicine (AOBEM) provides board certification to osteopathic (D. O. ) emergency physicians who have successfully completed an AOA-approved residency in emergency medicine, completed two years of practice, passed a written exam, and passed an oral exam. Like ABEM, the AOBEM at one time offered certification eligibility via a practice track, allowing training in another specialty, practicing emergency medicine, and then passing the AOBEM certification exam.

• The Board of Certification in Emergency Medicine (BCEM) provides board certification to both physicians who have completed an emergency medicine or primary care residency and performed five years of emergency medicine practice, followed by a written and oral examination process. Many of the above-mentioned legacy, or "grandfathered," physicians are certified via this pathway.

• Also, EM doctors who do not qualify for ABEM or AOBEM under the grandfather clause can apply and get boarded via AAPS. The board is being accepted more by hospitals, although it does not carry nearly the weight of ABEM. Furthermore, many emergency departments in the US insist on residency-trained ABEM emergency medicine physicians only.

Education

In the US, Emergency Medicine is a moderately competitive specialty for medical graduates to enter, ranking 7 of 16 specialties in terms of percentage of U. S. graduates whose applications are successful. However, over 90% of applicants from US medical schools to US Emergency Medicine residencies are successful. ^[5] Emergency medicine residencies (MD,MBBS,MBChB) can be three or four years in length, depending on the training institution, while all osteopathic (DO) residencies are four years in length, the first being a one-year traditional rotating internship. In addition to the didactic exposure, much of an emergency medicine residency involves rotating through other specialties with a majority of such rotations through the emergency department itself. By the end of their training, emergency physicians are expected to handle a vast field of medical, surgical, and psychiatric emergencies, and are considered specialists in the stabilization and treatment of emergent condition. Emergency psychiatry is the clinical application of Psychiatry in emergency settings Emergency physicians are therefore both clinical generalists and well-rounded diagnosticians.

A number of fellowships are available for emergency medicine graduates including prehospital medicine (emergency medical services), toxicology, sports medicine, ultrasound, and pediatric emergency medicine. Emergency medical services (abbreviated to the initialism "EMS" in many countries are a branch of Emergency services dedicated to providing out-of-hospital

Working

The employment arrangement of emergency physician practices are either private (a democratic group of EPs staff an ED under contract), institutional (EPs with an independent contractor relationship with the hospital), corporate (EPs with an independent contractor relationship with a third party staffing company that services multiple emergency departments) or governmental (employed by the US armed forces, the US public health service, the Veteran's Administration or other government agency).

Most emergency physicians staff hospital emergency departments in shifts, a job structure necessitated by the 24/7 nature of the emergency department.

Patients being served by the emergency medicine unit often proceed to intensive care medicine, which often is closely related to emergency medicine. 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

References

See also

• Medical emergency, conditions that require immediate or very prompt medical attention
• First aid, a style of initial medical care
• Emergency medical service (EMS), which provides first aid and transport to a hospital
• Rescue squad, a specialized part of the EMS
• Emergency medical technician, a healthcare worker who specializes in emergency care
• Paramedic, a healthcare worker who specializes in emergency care
• CPR, a lifesaving treatment for heart attacks
• Golden hour, about the importance of rapid care in medical emergencies
• Toxicology, the study of toxins and their treatment
• Traumatology, the study of physical trauma and its treatment
• Physical trauma, damage to the body such as due to a car wreck or falling down

External links

• Association of Emergency Physicians
• American Academy of Emergency Medicine
• American Board of Emergency Medicine
• American Board of Medical Specialties
• The American Board of Physician Specialties
• American College of Emergency Physicians
• Emergency Medicine Residents’ Association
• Canadian Association of Emergency Physicians
• College of Emergency Medicine (United Kingdom)
• Emergency Medicine
• European Resuscitation Council
• European Society for Emergency Medicine
• National Centre for Emergency Medicine Informatics
• Society for Academic Emergency Medicine
• Hong Kong College of Emergency Medicine

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 First aid is the provision of initial care for an Illness or Injury. Emergency medical services (abbreviated to the initialism "EMS" in many countries are a branch of Emergency services dedicated to providing out-of-hospital A rescue squad is an organization that provides emergency medical care to both trauma and Medical patients at either the Basic life support or 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 Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply In Emergency medicine, the golden hour is the first sixty minutes after the occurrence of multi-system trauma Toxicology (from the Greek words toxicos and logos) is the study of the adverse effects of Chemicals on living organisms Traumatology (from Greek "Trauma" meaning injury or wound is the study of Wounds and injuries caused by Accidents or Violence to a Treatment of physical trauma is described here and in First aid.

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