Emergency medicine, as a branch of medicine, deals with the recognition and treatment of medical emergencies. It is closely related to the subfields of internal medicine, surgery, anesthesiology and neurology. In Germany, emergency medicine is a specialty that requires additional continuing medical education.
What is emergency medicine?
As a branch of medicine, emergency medicine deals with the recognition and treatment of medical emergencies. Emergency medicine encompasses an entire professional rescue chain involving several medical subspecialties. These include internal medicine, anesthesiology, neurology and surgery. Closely related to emergency medicine are also rescue medicine and disaster medicine. Rescue medicine deals with emergency medical measures carried out outside medical facilities. It cannot be separated from emergency medicine in hospitals in terms of content or subject matter. Disaster medicine describes the aspect of emergency medicine that occurs in disaster situations. Whereas in disaster situations, mass care must be organized for people who have suffered an accident, in emergency medicine, individual measures are taken to save lives. Emergency medicine is therefore a very complex specialty and requires extensive medical training. This includes specialist knowledge of the procedures to be followed in the event of a mass casualty incident, psychiatric emergencies and appropriate measures for the treatment and diagnosis of sudden medical emergencies. Furthermore, this also includes knowledge of the organizational and legal principles of emergency medical services. The personnel working in emergency medicine are referred to as rescue specialists. It is composed of emergency physicians, paramedics, rescue assistants, paramedics, paramedics, medical assistants, as well as first responders.
Treatments and therapies
Emergency medicine is used when there is an acute disturbance in the vital function of the body. The severe health impairments can be caused by illnesses, accidents or catastrophic events. First, life-saving measures must be performed. It depends on which life-threatening condition is involved. In case of cardiac arrest, cardio-pulmonary resuscitation must be performed immediately. In the case of injuries, professional immobilization of the body, its repositioning (repositioning) and, if necessary, the application of a pressure bandage to stop bleeding are required. Therapeutic measures also include professional positioning and rescue of emergency patients. Cardiac pressure massage may be necessary. Emergency medicine covers a wide range of disorders to be treated. These include heart attacks, strokes, sudden pain conditions, and other life-threatening medical conditions that occur suddenly as part of an underlying medical condition. Sometimes the causes are known because the patient has been suffering from a serious illness for a long time. In that case, emergency medical measures can be initiated quickly, which are necessary with respect to the underlying condition. The challenge for emergency treatment, however, is in the case of sudden crises without the cause being known. Here, too, however, there are initial emergency measures that are life-saving. Accidents and disasters are a major area of emergency medicine. In accidents with few people involved, first aid measures must be initiated immediately. These include stable lateral position and, if necessary, manual ventilation and cardiac massage. In disasters with a mass casualty incident, individual medical aspects often cannot be considered. As a matter of principle, triage of the affected persons must take place. Triage is the prioritization of medical assistance when there is a very high number of injured people. This is unavoidable in this case in order to be able to save as many people as possible. During prehospital treatment, only the most necessary life-saving measures can be undertaken. Further treatment takes place in the clinical area. Here, emergency medicine is closely intertwined with various other medical fields such as intensive care, trauma surgery, internal medicine, psychiatry or neurosurgery. In the case of children, pediatrics also plays a role. In the clinical field, diagnostic examinations within emergency medicine are gaining great importance.
Diagnosis and examination methods
Within emergency medicine, the reliable recognition of threatening disorders is the basis for the successful treatment of the patient. During initial contact with the life-threatening patient, there is little time for extensive examination. Life-saving immediate measures must be taken. This is where easy-to-use equipment is used for the quick check. In the case of life-threatening injuries, for example, the initial trauma check is performed, which is necessary for transport and further treatment. Basically, all parts of the body are examined in adaptation to the situation. During this check, special attention is paid to pain reactions, abnormal joint and bone positions, and other special features. In prehospital emergency medicine, the examination is limited to the most vulnerable body regions of the chest, abdomen, pelvis and thigh. In the hospital emergency department, the examination is then performed more intensively. Another quick examination is the neurocheck. This tests the functioning of the nervous system, examining pain sensation, motor function and blood flow. This is especially important if a spinal injury is suspected. Emergency medicine has a number of other equipment options at its disposal. For example, continuous monitoring of the heart is possible by means of ECG monitoring. Dangerous cardiac arrhythmias can be diagnosed during this examination. Pulse oximetry is used to examine the arterial oxygen saturation of the blood. This measure is used to monitor patients during patient transport, after artificial respiration or after oxygen deficiency states. Another examination method is the so-called capnometry by means of a capnograph. This determines the carbon dioxide content of the exhaled air. Capnometry is used to optimize ventilation during respiration. It can also be used to estimate the metabolic rate during resuscitation treatment. Furthermore, blood glucose measurements are performed to detect any hypo- or hyperglycemic states. Examinations for troponin can provide an indication of myocardial infarction. Finally, testing for toxic substances also takes place in emergency medicine.
