Background & Scope
Emergency medicine is a medical specialty that deals with the immediate and urgent care of patients with acute illnesses or injuries. The goal of emergency medicine is to stabilize patients and provide the necessary treatment to prevent further deterioration of their condition.
The scope of emergency medicine is broad, covering a wide range of medical conditions and injuries. This includes, but is not limited to:
Trauma, such as injuries from car accidents, falls, and sports-related injuries
Cardiovascular emergencies, such as heart attacks, strokes, and arrhythmias
Respiratory emergencies, such as asthma, pneumonia, and chronic obstructive pulmonary disease (COPD)
Gastrointestinal/abdominal emergencies, such as appendicitis, stomach ulcers, and diverticulitis
Neurological emergencies, such as seizures, head injuries, and spinal cord injuries
Poisoning and overdose
Infectious diseases, such as sepsis and meningitis
Environmental emergencies, such as heat stroke and hypothermia
In addition to providing immediate medical care, emergency medicine physicians coordinate the care of patients with other medical specialists and responsible for the safe transfer patients to other practitioners and facilities for further treatment. They also have an important role in public health and disaster preparedness.
Overall, emergency medicine is a challenging and rewarding field that plays a vital role in saving lives and improving the health of patients. It is a field that requires a high level of medical knowledge and expertise, as well as the ability to think quickly and make decisions under pressure.
Qualifications, Training, and Certifications
Qualifications:
To qualify for a career in emergency medicine, a medical school graduate must complete a three-year residency in emergency medicine. During residency, trainees work in the emergency department under the supervision of experienced emergency medicine physicians learning to diagnose, stabilize, and manage a wide range of medical conditions and injuries, and gain experience in the use of advanced diagnostic and therapeutic techniques. The training covers topics including trauma, cardiology, pediatrics, toxicology, surgery, ophthalmology, and critical care.
After completing the residency, an individual can sit for the certification exam offered by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM).
Conditions, Diseases, Treatments, and Procedures
Emergency medicine physicians are trained to diagnose and treat a wide range of medical conditions and injuries to stabilize patients and prevent further deterioration of their condition. They use a variety of diagnostic techniques, including physical examination, laboratory tests, imaging studies, and other diagnostic procedures to make a diagnosis.
Diagnoses include:
sinusitis
variceal hemorrhage
thrombotic thrombocytopenic purpura (TTP)
aortic regurgitation
bacterial meningitis
cholecystitis
cholangitis
diverticulitis
asthma
migraine
HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets)
hyperkalemia
hyponatremia
intestinal ischemia
streptococcal infections
toxic shock syndrome
pancreatitis
gastroenteritis
adrenal insufficiency
(COPD)
hyponatremia
otitis media
hemophilia
gangrene
cognitive impairment
dementia
peripheral ischemia
rhinitis
thrombolysis
gastrointestinal infections
cardiogenic shock
cirrhosis
gastroesophageal reflux disease (GERD)
pericarditis
pharyngitis
peptic ulcers
cardiac arrest
pericarditis
metabolic alkalosis
mitral valve prolapse
hypertensive encephalopathy
QRS-complex tachycardias
neuropathies
atrial fibrillation
pulmonary embolism
respiratory distress syndrome
myocardial infarction
cellulitis
skin abscess
osteonecrosis (avascular necrosis of bone)
pelvic inflammatory disease
perianal and perirectal abscess
peripheral nerve disease
acute tubular necrosis
pulmonary infections
necrolysis
Streptococcal pharyngitis
supraventricular arrhythmias
acute coronary syndrome
kidney stones
gall stones
unstable angina
retinal detachment
pneumothorax
diverticulosis
anal fissure
angioedema
meningitis
ventricular tachycardia
mesenteric ischemia
non-ST elevation (non-STEMI) myocardial infarction
ST elevation (STEMI) myocardial infarction
upper gastrointestinal bleeding
Lyme disease
hemoptysis
pregnancy and its complications
sinus bradycardia
syncope
thoracic aortic aneurysm
thyroiditis
Transient ischemic attack (TIA)
thrombocytopenia
ventricular arrhythmias
chronic obstructive pulmonary disease
spinal epidural abscess
bacterial peritonitis
toxic shock syndrome
osteomyelitis
aortic stenosis
lactic acidosis
lower gastrointestinal bleeding
metabolic acidosis
diabetic ketoacidosis
small-bowel obstruction
mesenteric venous thrombosis
pneumothorax
atrioventricular blocks
vertigo
viral encephalitis
tachycardia
corneal abrasions
Crohn's disease
hypovolemia or hypovolemic shock
ulcerative colitis
sickle cell disease
hyperosmolar hyperglycemia
dysphagia
Treatments:
Once a diagnosis is made, emergency medicine physicians provide the necessary treatment to stabilize the patient, provide medication, perform some procedures and refer for others, and coordinate the timely care transfer to specialists.
Diseases and conditions:
The scope of emergency medicine is broad, covering a wide range of medical conditions and injuries. This includes, but is not limited to:
Trauma, such as injuries from car accidents, falls, and sports-related injuries
Cardiovascular emergencies, such as heart attacks, strokes, and arrhythmias
Respiratory emergencies, such as asthma, pneumonia, and chronic obstructive pulmonary disease (COPD)
Gastrointestinal emergencies, such as appendicitis, stomach ulcers, and diverticulitis
Neurological emergencies, such as seizures, head injuries, and spinal cord injuries
Poisoning and overdose
Infectious diseases, such as sepsis and meningitis
Environmental emergencies, such as heat stroke and hypothermia
Injuries:
Emergency medicine physicians also manage a wide range of injuries, from simple lacerations and fractures to complex traumatic injuries such as head injuries and multiple fractures. They are also trained to manage injuries related to burns, drowning, and electrical injuries.
Procedures:
Emergency medicine physicians may be trained in or to perform a wide range of procedures, including but not limited to:
Cardiac Life Support (ACLS)
Trauma Life Support (ATLS)
Advanced Trauma Life Support (ATLS)
Basic Life Support (BLS)
Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Advanced Trauma Operative Management (ATOM)
Ultrasound-guided procedures
Intubation, cricothyrotomy, and tracheostomy
Lumbar puncture
Thoracentesis
Paracentesis
Arthrocentesis
Incision and drainage of abscesses
Removal of foreign bodies
Wound suturing and wound care
Related Medical Specialties
Emergency medicine is a medical specialty that deals with the immediate and urgent care of patients with acute illnesses or injuries. While emergency medicine physicians are trained to handle a wide range of medical conditions, there are several other medical specialties that are closely related to emergency medicine and that work closely with emergency medicine physicians to provide comprehensive care to patients.
One of the most closely related specialties to emergency medicine is critical care medicine. Critical care medicine focuses on the management of critically ill or injured patients. Beyond the immediate goals of emergency medicine, these patients often require close monitoring, invasive procedures, and life support to survive. Critical care medicine specialists are trained to manage patients in an intensive care unit (ICU), including those with respiratory failure, sepsis, organ failure, and traumatic injuries.
Anesthesiology is another closely related specialty to emergency medicine. Anesthesiologists are responsible for managing pain and providing sedation during surgical and other procedures. They also provide critical care services, such as managing patients on ventilators and other life support systems. In the emergency department, anesthesiologists are responsible for providing pain management, procedural sedation, and airway management.
Surgery is also closely related to emergency medicine, as emergency medicine physicians often manage patients with surgical emergencies, such as appendicitis, diverticulitis, and traumatic injuries. Surgeons are responsible for performing surgical procedures to treat these conditions and injuries.
Other closely related specialties include pediatrics, radiology, OB/GYN, burn medicine/surgery, and ophthalmology.
Medical-Legal Cases Involving Emergency Medicine
Due to the high-stress and high-stakes nature of emergency medicine, medical-legal cases involving emergency medicine are not uncommon. Some involve a claim of failing to consult, e.g., with surgery, ophthalmology, or OB/GYN.
Medical-legal cases involving emergency medicine can include allegations of diagnostic failures/misdiagnoses, treatment errors/failure to treat, and failure to obtain informed consent.
Examples include alleged failures to diagnose a heart attack in a patient who presents with chest pain, to refer abdominal pain for surgical consult, to diagnose testicular torsion, or to diagnose ectopic pregnancy.
Emergency medicine physicians may need to perform procedures or administer treatment without the patient's consent. However, there may be a claim that the physician failed to obtain required informed consent.