Emergency Medicine

What is emergency medicine? Emergency medicine is defined as medicine revolving around immediate decision making and necessary actions to prevent death or further disability. Doctors that work in emergency medicine (in emergency rooms) are called emergency physicians, and provide their patients with immediate recognition, evaluation, care and stabilization. However, there is more than one type of emergency doctor and more than one specialty. ​ Subspecialties Palliative medicine, also known as palliative care, is medical care that is specialized in providing patients relief from pain and other symptoms of a serious illness, for every diagnosis and stage of disease. Palliative medicine has a team of doctors, nurses, and other specially trained people. Critical care medicine is overseen by critical care specialists, sometimes referred to as “intensivists.” Most critical care specialists and intensive care physicians work in hospital-based settings, or an ICU (intensive care unit). There are many types of critical care medicine, including anesthesiology critical care medicine, internal medicine-critical care medicine, and neurocritical care. Medical Toxicology is a field of medicine with a dedication to the evaluation and treatment of patients who have been envenomated (injected with venom through a bite or sting of some kind) or poisoned. Medical toxicologists are involved in the care and treatment of individuals who come into contact with drugs, substances or other agents causing harmful or toxic health effects. Wilderness Medicine is the practice of emergency medicine or emergency care while not in a hospital, or while out in the wilderness. In order to become specialized in wilderness medicine you need considerable critical thinking skills, applied hands-on training experience and the improvisation skills required to deliver high-quality care in the world's most grim environments with uncertain resources and limited access to health care. Pediatric Emergency Medicine is the subset of emergency medicine that involves caring for children and teens who are acutely ill or injured. A pediatric emergency physician is trained to care for a wide range of problems that require immediate medical help in teens and children. The problems that pediatric emergency physicians face are regularly serious and can be life threatening. Sports Medicine is the treatment of injuries or wounds caused by sports and other physical activities. Medical pathways under sports medicine include becoming an orthopedic surgeon (surgical and nonsurgical treatment of musculoskeletal injuries), sports medicine primary care physician (provide medical evaluations, sports physicals, and evaluation and treatment of nonsurgical injuries), physical medicine and rehabilitation specialist (Develop injury rehabilitation plans and treat nonsurgical musculoskeletal injuries), or a sports physical therapist (develop rehabilitation and performance improvement programs). Emergency Medical Services are easily recognised when emergency vehicles or helicopters are seen responding to emergency incidents. EMS is a system of coordinated response and emergency medical care, and EMS needs to be prepared for every emergency situation. Here is a diagram to demonstrate the complexity of an EMS system, provided by EMS.gov:

According to EMS.gov, “In the diagram, the large circle represents each system element as it is activated in response to an incident. The arrows within the circle represent the specialty care areas within EMS. The list within the circle represents the elements acting behind the scenes to support the system. In order to be "ready every day for every kind of emergency," an EMS system must be as comprehensive as the one pictured above.” (8). Undersea and Hyperbaric Medicine is the prevention of injury and illness from exposure to environments with increased ambient pressure. Ambient pressure on an object is the pressure of the surrounding substance, such as a gas or liquid, in contact with the object or person. ​ An example of environments with increased ambient pressure would be diving or hyperbaric chamber exposure. Undersea and hyperbaric medicine also includes therapeutic use of high-environmental pressure, as well as the delivery of oxygen under high pressure to treat disease. Education Pathway The road to specialties in emergency medicine is long and complicated, but worth it in the end. The first step to working in emergency medicine is to graduate from high-school. Following that, attend a university or college, and obtain a bachelor's degree, while taking a pre-med program as you will need pre-requisites in math and science. You can take any major you want as long as you fulfill the requirements to get into medical school. After getting an undergraduate degree (four years), take the MCAT (Medical College Admission Test). Next, go to medical school for four years, and obtain a medical license. After medical school, complete your residency, which for emergency medicine is an average of 3-4 years. If you are going into a specific subspecialty, earn the required license and certification for that. For more information about the education pathway to become a doctor, visit the article “Education Pathway to Become a Doctor” by Viva Voong on our website. What can you do working in emergency medicine? Emergency doctors/physicians and nurses can work at many different places. A few examples could be an Urgent Care, or a hospital working in places like the ICU or Emergency Department. If you are interested in working for EMS you can do something like working in an ambulance, an emergency medicine helicopter, or any type of emergency response vehicle. Some specialists can work in their own clinics, but generally are part of a larger hospital or Urgent Care system. Things to consider: Working in emergency medicine requires quick thinking, problem solving and the ability to work under intense pressure. In addition, since emergency medicine interacts with the sickest, most critically injured patients, you have to accept you can’t save everyone, while also being able to get back on your feet and do your absolute best to save someone and improve their quality of life. You get the satisfaction of knowing you have saved lives or otherwise given the treatment and evaluation that was necessary. ​ Sources: https://www.aamc.org/cim/explore-options/specialty-profiles/emergency-medicine https://globalpartnersincare.org/2020/09/17/importance-of-education-in-palliative-care/ https://www.mayoclinic.org/tests-procedures/palliative-care/about/pac-20384637 https://www.ems.gov/whatisems.html https://geiselmed.dartmouth.edu/emig/residency/sub/ https://www.acponline.org/about-acp/about-internal-medicine/subspecialties-of-internal-medicine/critical-care-medicine https://www.hopkinsmedicine.org/emergencymedicine/Education/Medical_Students.html https://learn.org/articles/ER_Doctor_What_are_the_Education_Requirements.html https://www.acmt.net/overview.html https://emergencymed.ucsd.edu/education/fellowships/wilderness-medicine/index.html https://www.healthychildren.org/English/family-life/health-management/pediatric-specialists/Pages/What-is-a-Pediatric-Emergency-Physician.aspx https://www.abem.org/public/ https://health.usnews.com/health-care/patient-advice/articles/2018-02-07/emergency-room-urgent-care-or-primary-care-physician