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Disease Knowledge Centres

Emergency Medicine - Disease Topic Overview

Emergency medicine, also called oxiology, combines medical and surgical techniques to deal with a life-threatening emergency, in other words, a situation where, in the absence of treatment, the patient risks dying or having irreversible after-effects within a short time.

In addition to general medicine, the specific skills used in the context of emergency medicine are anaesthesiology, traumatology and toxicology.

Anaesthesiology plays an important role in both the treatment of pain in emergency medicine, and in the sedation of seriously ill people. The maintenance of a patient’s airway is a crucial aspect of emergency medicine. This is most commonly achieved either by non-invasive ventilation (face or nasal mask) or rapid sequence induction intubation, the latter of which requires intravenous sedation and a short-acting neuromuscular blocker.^1,2 Sedation is also used to aid procedures such as the reduction of large joint dislocations and long bone fractures.²

Traumatology or trauma care is a major component of emergency medicine; injury kills 16,000 people worldwide everyday.³ The three most common causes of unintentional injury are; road traffic accidents, falls and burns, which result in the annual global deaths of 1.3 million, 283,000 and 238,000 people respectively.^4,5 In addition to those killed, many more people are injured and require emergency hospitalisation.

Poisoning, intentional or unintentional, is the absorption of a hazardous substance which leads to illness or death. Unintentional poisoning caused the death of an estimated 346,000 people globally in 2004,⁶ and caused illness in thousands more people. The role of toxicology in emergency medicine is to determine the poison and determine a suitable antidote.

1. Mitchell E. et al. Introduction to Emergency Medicine. Lippincott Williams and Wilkins. 2005 ; 567-577
2. Fulde G.W.O. Emergency Medicine: The Principles of Practice. Elsevier Australia. 2009 : 12-32
3. World Health Organization. Global Burden of Injuries. WHO Geneva. 1999
4. Department of Injuries and Violence Prevention Noncommunicable Disease and Mental Health Cluster World Health Organization. A Graphical Overview of the Global Burden of Injury. The Injury Chart Book. WHO Geneva. 2002
5. World Health Organization. Facts about Injuries: Burns. WHO Geneva.
6. World Health Organization. Global Burden of Diseases. WHO Geneva

Latest Multi Media

Presentation on Torso Trauma From the Emergency Medicine and Trauma Update 2010

Emergency Medicine Drug Data - A-Z English

Latest Drug News

BTG licence of rights to Voraxaze for Methotrexate Toxicity - 12-12-2011

BTG has agreed to licence Ohara Pharmaceutical the rights in Japan to develop and market Voraxaze (glucarpidase) its treatment for Methotrexate Toxicity due to impaired renal function. The drug is filed in the USA and EU and its PDUFA action date is 17 January 2012.

Latest Social Media

Sobering up a patient rapidly
on doc2doc

... I was aware of a practice by a couple of Consultants in Emergency Care who prescribed IV Dextrose with Insulin with the aim of speeding up ...

Medical slangs anyone??
on doc2doc

... in Woolworths on a Saturday, it's safe to give them a general anaesthetic. Our Woolworths closed down a few years ago, so we have the Primark ...

Is restricting GP referrals the best way of cutting NHS costs?
on doc2doc

... nbsp;I think that a better solution would be ( for the non-emergency cases) ; the GPs after they do a very good examination of the patient ...

Latest Clinical Trials

Effect of Vildagliptin on Left Ventricular Function in Patients With Type 2 Diabetes and Congestive Heart Failure

This study will assess the effect of vildagliptin on left ventricular function in patients with type 2 diabetes and congestive heart failure (NYHA Class I-III). Effect on HbA1c and overall safety and tolerability will also be assessed.

Peritoneal Dialysis in Congestive Heart Failure (PDinCHF)

Objective: To improve symptomatology in severe chronic failure patients. Study design: Open, parallel intervention trial comparing 2 schemes of peritoneal dialysis with icodextrin (Extraneal®) with standard medical therapy..

Latest Journal Publications

Journal of Epidemiology and Community Health

Background: Concern over the adverse effects of heat on human health has led to numerous studies assessing the relationship between heat and mortality. Few studies have quantified the impact of heat on morbidity, including ambulance response calls. This study describes the association between temperature and ambulance response calls for heat-related illness (HRI) in Toronto, Ontario, Canada during the summer of 2005. Methods: Data sources included daily temperature, relative humidity and humidex information from Environment Canada, and Medical Priority Dispatch System data from Toronto Emergency Medical Services. Time series and regression analyses were used to examine the relationship between daily temperature and ambulance response calls for HRI during the summer (1 June to 31 August) of 2005. Results: In 2005, there were 201 ambulance response calls for HRI. On average, for every one degree increase in maximum temperature (°C) there was a 29% increase in ambulance response calls for HRI (p<0.0001). For every one degree increase in mean temperature (°C) there was a 32% increase in ambulance response calls for HRI (p<0.0001). Conclusions: Given these associations, we urge further exploration of ambulance response calls as a source of HRI morbidity data particularly given the increasing health concerns associated with climate change.

Journal of Neurology Neurosurgery and Psychiatry

Objective: To compare the sensitivity and specificity of bedside diagnostic stroke scales in patients with suspected stroke. Design: A cross-sectional observational study of patients with suspected acute stroke in an emergency department in a UK hospital. Diagnostic scales: The results of an assessment with the Recognition of Stroke in the Emergency Room (ROSIER) scale, the Face Arm Speech Test (FAST) scale and the diagnosis of definite or probable stroke by an emergency department. Reference standard: A consensus diagnosis of stroke or transient ischaemic attack (TIA) made after discussion by an expert panel (members included stroke physicians, neurologists and neuroradiologists), who had access to the clinical findings, imaging and subsequent clinical course, but were blinded to the results of the assessments by emergency-department staff. Results: In 356 patients with complete data, the expert panel assigned a diagnosis of acute stroke or TIA in 246 and a diagnosis of mimic in 110. The ROSIER had a sensitivity of 83% (95% CI 78 to 87) and specificity of 44% (95% CI 34 to 53), and the FAST had a sensitivity of 81% (95% CI 76 to 86) and a specificity of 39% (95% CI 30 to 48). There was no detectable difference between the scales in sensitivity (p=0.39) or specificity (p=0.30). Conclusions: The simpler FAST scale could replace the more complex ROSIER for the initial assessment of patients with suspected acute stroke in the emergency department.