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Rapid assessment of chest pain

BMJ 2002; 324 doi: (Published 16 February 2002) Cite this as: BMJ 2002;324:422

“Casualty” is outdated term for “emergency medicine”

  1. John M Ryan (, chairman of publications committee,
  2. John Heyworth, president
  1. British Association for Accident and Emergency Medicine, Royal College of Surgeons of England, London WC2A 3PN
  2. Gastroenterological Society of Australia biomedical scholar, department of medicine, University of Sydney
  3. Nepean Hospital, PO Box 63, Penrith, NSW 2751, Australia

    EDITOR—Rapid assessment of chest pain continues to attract the attention of healthcare planners and providers involved in the management of this common emergency. Wood et al's editorial on this subject makes cogent arguments for a clinical trial to assess the impact of rapid medical and surgical management of exertional angina.1

    We are concerned at the terminology used by Wood et al. The term that they use—“casualty”—is outdated and has long been replaced by the term “accident and emergency medicine” or, increasingly, “emergency medicine.” It reflects ignorance of the role that trained specialists in emergency medicine have in the assessment of suspected chest pain.

    Modern emergency departments, under the supervision of senior doctors trained in emergency medicine, use a wide variety of diagnostic tools not mentioned by Wood et al, including cardiac markers and continuous ST segment monitoring, to stratify …

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