Emergency Medicine

Dr.Sreekrishnan T.P and Dr.Sabarish B First Batch–MBBS,Amrita School of Medicine Presently the post-graduate students persuing MD in Emergency Medicine, Amrita School of Medicine, Kochi There may be moments in your life when you witness someone’s life fading away in front of you, when life may be crawling out of someone with each tick of the clock , a moment when things cant afford to WAIT ….when time means LIFE …that is where the notion of “timely intervention” attains importance. To intervene when it really matters often decides whether he/she will be there for the next Christmas. And in most situations the people who make the real difference is the “emergency medical team”. The concept of emergency medicine is relatively new to the Indian medical world while it has become the back bone of the healthcare system in most developed countries. What is Emergency Medicine? According to the curriculum of the College of Emergency Medicine (CEM) United Kingdom, 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 behavioral disorders. It is a specialty in which time is critical. Who is an emergency physician? EM now encompasses all fields of medicine, surgery and also many of the so called super/ sub-specialties. Emergency physicians are tasked with seeing a large number of patients, treating their illnesses and arranging for disposition—either admitting them to the hospital or releasing them after treatment as necessary. The emergency physician requires a broad field of knowledge and advanced procedural skills often including surgical procedures, trauma resuscitation, advanced cardiac life support and advanced airway management. Emergency physicians ideally have the skills of many specialists—the ability to manage a difficult airway (Anesthesia), suture a complex laceration (Plastic surgery), reduce a fractured bone or dislocated joint (Orthopedic surgery), treat a heart attack (Cardiology), conduct deliveries (Obstetrics and Gynecology), stop a bad nosebleed (ENT), and place a chest tube (Cardiothoracic Surgery).An emergency medicine physician in India also has the added role of a primary care physician. Emergency medicine has evolved to include added responsibilities in the areas of : 1. Management of medical and administrative aspects of emergency services system. 2. Disaster planning and management for both natural and man made events. 3. Toxicology and Poison center development. 4. Education of medical students and personnel as well as common people. 5. Preventive medicine. 6 .Basic and Clinical research, especially in resuscitation methods and acute interventions. 7. Intensive Care Unit Management All of this requires a quick mind, a decisive nature, a good fund of knowledge and interest in the breadth of medicine, excellent physical diagnostic skills, good manual dexterity, the deductive ability of a detective, and nerves of steel. It is also necessary to have special communication skills as the need frequently arises to establish rapport in a very short time with people under very stressful conditions. The EP must have an attitude of cooperation, as success in practice depends upon working effectively as a team member with members of your department as well as physicians in other specialties. An emergency physician has to deal with crying children; violent patients, abusive by-standers, a bleeding nose, a swallowed dentition; constipation; intoxicated humans, police personal, medico-legal cases; overworked staffs apart from a diagnosis which often like to play hide and seek with you. But then if you love challenges of diagnosing, stabilizing and treating very sick patients in extremely short spans of time and to make the difference when it really matters then this could be the right place for you. Expansion of emergency services to include intensive diagnostics, treatment and observation units, and "fast track" or urgent care centers will soon become reality. This specialty is comprised of one of the youngest and most dedicated groups of physicians who have become accustomed to pioneering new ideas. The future looks bright indeed for this growing specialty and for those who take on the challenge of becoming the next generation of EP's! FOOTNOTE: If you ever expect to be remembered or acknowledged for your contribution or the effort you have put in, from either the patient or from the relatives when they get discharged - am sorry, it never happens!!!! You will always remain the unsung hero.