Acute Medicine
Nature of the
work
Acute Medicine (or Acute Internal Medicine –
AIM) is the specialty within medicine that is concerned with the
assessment, diagnosis and management of adults presenting to
secondary care with acute medical illness. There is a broad
spectrum of clinical work within the specialty, including the
immediate management of life-threatening medical emergencies, the
initial treatment (first 72 hours) of all acutely presenting
medical ailments, and the provision of ambulatory care. There is
also a strong focus on management and leadership, allowing doctors
who train in Acute Medicine to run successful Acute Medicine Units
(AMUs)
Working in acute medicine
This is a hospital-based specialty, and the
majority of the work involves caring for medical patients around
the time of their admission to hospital. The spectrum of clinical
problems encountered in the AMU is very wide, which gives the work
a great deal of variability and enables trainees to become experts
in assessment, investigation, diagnosis and management across
multiple disciplines.
There is a focus on the recognition and
management of acute medical emergencies, but also on the
development of ambulatory care systems for patients with medical
problems who do not require immediate admission or indeed are
better treated on an out patient basis. Multidisciplinary team
working is key to an effective AMU; input from nursing staff,
physiotherapists, occupational therapists, pharmacists and social
workers is essential for a well-functioning unit.
Associated sub specialties
Acute Medicine was formally recognised as a
specialty in 2009, having previously been a subspecialty of General
Medicine. The development of specialist skills is a mandatory part
of training in the specialty. Some trainees will choose to learn a
practical procedure such as echocardiography, while others will
gain qualifications in management, leadership or education, and
some will become involved in medical research. The
requirement to develop an additional skill or qualification is a
key element of the new curriculum.
Acute Medicine is distinct from Emergency
Medicine (A&E), although specialist acute physicians should
work in close collaboration with specialists in Emergency Medicine.
There is also a close relationship with Critical Care, and some
trainees in this field will choose Acute Medicine as their ‘base’
speciality, before acquiring dual qualification by CCT or
certification with Critical Care Medicine.
Common Procedures / interventions
The breadth of the specialty is such that a
huge range of interventions will be practised. These include:
- airway manoeuvres, including endotracheal
intubation
- insertion of central venous
catheters
- insertion of pleural and peritoneal
drains
- DC cardioversion
Some trainees will also learn how to perform
specialist diagnostic or therapeutic procedures such as
echocardiography, bronchoscopy and upper G-I endoscopy.
Further information
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