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Emergency Medicine

Nature of the work

Emergency Medicine (EM) is a young and rapidly evolving specialty in the UK.

The Emergency Department (ED) is at the centre of the acute work of all Trusts. EM specialists are responsible for assessing and resuscitating patients with serious illness and injuries before their transfer to hospital wards or operating theatres. Other patients are assessed, treated and sent home for follow up and ongoing care with their General Practitioner. Many EM specialists also have an interest in observation medicine and have developed clinical decisions units (CDU) where high risk presentation can be managed before discharge.

Most departments now have separate facilities for the care of children, including the presence of Registered Children’s Nurses and play specialists. A particular challenge is the assessment and care of patients with psychiatric illness and liaison with community mental health teams is central to quality care for these patients.

Recent focus on the emergency patient pathway has resulted in the provision of additional resources for EDs and has resulted in improved ways of working for Consultants and other staff.

Working in Emergency Medicine

If you specialise in EM you will need to become expert in rapidly establishing the diagnosis, especially in life threatening situations. You will need to develop both the practical and team leadership skills of adult and paediatric resuscitation.

You will learn to effectively differentiate which patients may appropriately be discharged with follow up when needed, or admitted to an ED-based observation unit (CDU) or hospital ward.

You will need to enjoy working in a team, in the sometimes difficult and challenging environment of the ED and be able to prioritise and respond to new and urgent situations. You will work as part of a multi-disciplinary team where good communication and inter-personal skills are essential. You will work closely with a wide variety of in-patient teams and with primary care and pre-hospital clinicians as well.

Associated sub specialties

Emergency Medicine has two sub-specialties: Paediatric Emergency Medicine and Pre-Hospital Emergency Medicine

August 2012 saw the first intake of trainees in the new sub-specialty Pre-Hospital Emergency Medicine. Details are available at:

http://www.ibtphem.org.uk/

There are opportunities to develop a special interest within the field of Emergency Medicine, concentrating on the provision of care and ongoing care to a group of emergency patients. For example, Consultants may undertake additional training in Acute Medicine, Intensive Care Medicine, observation medicine or sports medicine. This results in some Consultant Emergency Physicians spending a proportion of their working week within other departments.