What is emergency Medicine?

Emergency Medicine was defined by the International Federation for Emergency Medicine in 1991 as:

"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 behavioural 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."

Practically speaking, the emergency physician (EP) evaluates and treats patients who present with an acute illness or injury at any time. Patients often have “undifferentiated” presentations (i.e. they don’t come in with a known diagnosis), with little initial information available apart from that obtained by talking to the patient; the history, examination and bedside investigations. There is a great challenge in providing rapid and appropriate treatment in the first hours, but effective early diagnosis and treatment has been shown to make big differences for short and longer term outcome in many conditions.

For example, if a patient presents with vomiting, the EP must determine whether there is a potentially life threatening condition associated such as an acute bowel obstruction or whether the patient will be able to be discharged after treatment as would be the case in a viral illness. The EP must also determine if a specialist needs to be involved and if so from which specialty; a surgeon for an obstruction, an internist for pancreatitis, or an obstetrician in the case of hyperemesis gravidarum.

Emergency medicine has often been criticised for not being a specialty as it borrows from many of the established specialty however that would be inaccurate. Emergency Medicine is the specialty of the acute undifferentiated patient. We specialise in rapidly and efficiently establishing a working diagnosis and mitigating life threatening presentations. We are resuscitation specialists: whether from trauma, cardiac arrest, sepsis or anaphylaxis we specialise in obtaining difficult airways, IV's when none are evident, and stabilizing a patient so that patients can survive to admission where specialty care can continue.

Furthermore, the EP manages these numerous patients keeping in mind the resources available, the volume of the waiting room and the number of beds available on the inpatient wards. Thus emergency medicine is a complete specialty with a heavy emphasis on concomitant diagnosis and treatment.

Emergency physicians can be involved in numerous posts after residency including a consultant teaching new residents, specialising in prehospital care, disaster medicine, pediatric emergency medicine, research or administration.