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Emergency Medicine is the branch of medicine that deals with evaluation and initial treatment of medical conditions caused by trauma or sudden illness. It is the medical specialty that comprises the immediate decision making and action necessary to prevent death or further disability under emergency conditions. It is based primarily in hospital emergency departments, but with extensive responsibilities for supervising emergency medical systems outside the hospital (paramedics). Emergency medicine is 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 behavioral 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.
Prehospital care is professional emergency care delivered before the patient reaches the hospital. Care is provided by paramedics and emergency medical technicians. Paramedics are technicians trained in techniques such as electric shock for defibrillation of the heart, insertion of a tube into the trachea to assist respiration, and the use of intravenous drugs normally administered by physicians. They operate under the supervision of an emergency physician, usually by radio communication. Emergency medical technicians (EMTs) are trained in first aid, give no medication, seldom communicate with a doctor, and often receive very little medical supervision
Emergency medicine is practiced in a hospital emergency department in the field by emergency medical service, such as paramedics, and other locations where initial medical treatment of illness takes place. Just as clinicians operate by immediacy rules under large emergency systems, emergency physicians and other allied health care workers in the emergency department base their practice on a triage system.
Emergency medicine focuses on diagnosis and treatment of acute illnesses and injuries that require immediate medical attention. While not usually providing long-term or continuous care, emergency medicine physicians and paramedics still provide care with the aim of improving long-term patient outcome. In the United States, millions of people do not have health insurance, which means many of them seek care in emergency departments, because they have a federal mandate (Emegency Medical Treatment and Labor Act) to care for everyone regardless of their ability to pay.
Emergency Medicine encompasses a large amount of general medicine but involves virtually all fields of medicine including the surgical 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 (set) a fractured bone or dislocated joint (orthopedic surgery), treat a heart attack (internist), work-up a pregnant patient with vaginal bleeding (Obstetrics and Gynecology), and stop a bad nosebleed (ENT).
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