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WHAT IS ACUTE AND EMERGENCY CARE RESEARCH? Charles B. Cairns, MD, FACEP OVERVIEW OF EMERGENCY CARE RESEARCH Emergency medicine evolved as a medical specialty from a convergence of events stemming from transformations in hospital systems and changing societal perceptions of access to medical care. Increasing patient loads in hospitals resulted in a need for dedicated staffing of emergency departments (EDs). In addition, lessons from combat had highlighted the importance of timely management of traumatic wounds and the potential for out-ofhospital care (1). The integration of these care systems and the development of resuscitation medicine lead to a remarkably expansive specialty that now delivers care to over 120 million patients annually in the nation’s EDs and has resulted in the training and board certification of over 20,000 emergency physician specialists (2). As the specialty grew rapidly, questions arose about the future of emergency medicine research. The Josiah Macy Jr. Foundation convened a meeting to investigate the role of emergency medicine in the future of American medical care (1). The participants at this and subsequent follow-up conferences (1, 2, 6, 8, 9) noted several unique factors to emergency medicine and emergency medicine research: • Emergency medical care is the only medical care resource that offers both immediacy of care and universality of service. • Emergency medicine encompasses and interacts with all medical specialties. • Emergency departments are literally the front door for the sickest and worst injured in America. • The import of immediacy of care has been proven time and again by research performed in the ED setting, including the very time sensitive treatments of heart attacks, stroke, shock states, pneumonia, respiratory illness, and trauma. • Emergency departments function as a safety net for our health care and social systems and are the only institutional providers mandated by federal law to treat anyone who presents for care.