Emergency medicineBMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7343.958 (Published 20 April 2002) Cite this as: BMJ 2002;324:958
- Daniel M Fatovich (Daniel.Fatovich@health.wa.gov.au), specialist in emergency medicine
- Royal Perth Hospital, Wellington Street, Perth WA 6000, Australia
Most people believe that the emergency department is always available to help provide non-elective acute hospital care. Daniel Fatovich explains why this is not necessarily so
Emergency medicine is a field of practice based on the knowledge and skills required for the prevention, diagnosis, and management of the acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders.1 It is a specialty in which time is critical. Anyone who has been to an emergency department will appreciate that it is a complex and often turbulent environment. The emergency department is like the fire brigade—you hope you won't need it, but if you do, you expect a timely response.
Emergency medicine is a fairly new specialty. Resuscitation, toxicology, and clinical criteria for imaging represent some of the core topics of the practice of emergency medicine. This review focuses on these key areas and underlines the major problem that the specialty faces—namely, overcrowding.
Overcrowding is the most serious issue confronting emergency departments in the developed world, with quality and timeliness of emergency care being compromised
Amiodarone is the antiarrhythmic drug of choice for cardiac arrest due to shock refractory ventricular fibrillation and ventricular tachycardia
For calcium channel blocker toxicity, the induction of hyperinsulinaemia and euglycaemia has striking bemefits
Octreotide prevents the rebound hypoglycaemia of sulphonylurea overdose
Validated clinical criteria for requesting imaging have been developed for cervical spine injury and are being developed for minor head injury
Many advances have been made in emergency medicine recently. I surveyed colleagues both locally and internationally to nominate suitable topics. The topics I have chosen were considered to be clinically useful and educational. They reflect subjects of change or advancement. Once the topics were chosen, I performed a directed review …