Emergency Medicine

Emergency Medicine Overview Liu Baochi Emergency Department First Affiliated Hospital Zhengzhou University

Concept of Emergency Medicine • A discipline of medicine that deals with the acute and life threatening aspect of medical care. It emphasizes the recognition, evaluation, care and disposition of patient. • A new field related to multisystem disease. • It benefits from almost any advance in medical science. • The characteristic is providing fast, effective and better management for the patient.

Role of Emergency Medicine • To provide emergency life support for the

critical ill patients. • To direct patients to appropriate sources of continuing care. • To provide disaster management when there are massive casualties in the community. • To participate in pre-hospital care of critical ill patients before they can be transferred to emergency department. • To provide continuously accessible emergency services for the general public.

History of Emergency Medicine • Emergency medicine as a independent

discipline only 30 years. • In 1984,Emergency Department set up in some of large hospital in China. • In 1986,China stipulated “120” for emergency medicine. • In May,1987, Emergency Medicine Association was set up in China. • It develops fast in recent 10 years.

Field of Emergency Medicine 1.Pre-Hospital Care 2.Resuscitation 3.Critical Medicine 4.Disaster Medicine 5.Trauma 6.Piosion 7.Administration of EMSS

1.Prehospital EMSS refers to an organized Care

approach to the care of the acutely ill patient during the period of time between the occurrence of the disease and the arrival of the patient at the hospital.

2.Resuscitation Clinical diagnosis of cardiac arrest ① loss of consciousness ② observation of no respiration ③ absent major pulses

Timing Brain cell death occurs 4 to 10 minutes after the circulation stopped.

Basic life support Chain of survival

Early access

Early CPR

Airwar breath circulatio n

Early defibrilation

Early Advanced care

Cardiac arrest by thunder

Resuscitation In time Complete recovery

uccessfully Resuscitation after Hart beat stopped for 20 minutes

3.Critical Care Medicine Critical care is a important part of emergency medicine .special trained doctors and nurses with advanced facility in Intensive Care Unit (ICU ） treat severe ill patients.

Severe acute pancreatitis

recovery

4.Disaster Medicine An incident whereby the demand for life saving and emergency services exceed the normal capacity of a single receiving hospital. Triage Treatment Transport

Important principle Do the most for the most Get the right patient to the right place at the right time Communication Co-ordination Control command

Zhengzhou chengzai disaster

Daping coal mine gas explosion 148 died

32 32 injury injury

Xinan coal mine Disaster 42 died

nzhou city 2005.1.29 firecraker Explosio

36 died. 48 injury

5.traumatology trauma constitute the third leading cause of death over all ages and the leading cause of death among children, adolescents, and young adults aged 1 to 44.

Timing synthetical

Carotid artery injury

Emergency operation

Damage control in trauma surgery

6.Acute Poisoning study difference kind of acute poison. It resolves in occupational disease, toxicant, medico-legal . It is a new discipline.

Poisonous snake bit

7.Administration of emergency medical system emergency information net. transformation equipment and emergency care installation. training research

Emergency Medicine Service System

Pre-hospital

Emergency department

Emergency ICU

Zambia Medical Deliverance

依托综合医院 整体优势

Emergency Department the First Affiliated Hospital Zhengzhou University

Emergency doctor to be

• Emergency medicine encompasses the immediate

decision making and action necessary to prevent death or any further disability for patient in health crisis.

• Very often emergency doctor need to start

treatment before establishing a diagnosis.

task of emergency medicine Good interpersonal communication skill. Clinical acumen for a focussed approach to clinical evaluation.

Medicine is an art as well as a science Never say: “there is nothing wrong with you”. If you don’t know what to do—do nothing. Consult you senior. Abnormal vital signs must be repeated and explained. Trust no one, believe nothing(not even yourself) Learn from your mistakes

Challenges of emergency medicine All sorts of patients could come in at any time Any combination of case may present together

Emergency doctor’s ability The sharp eagles’s eyes The brave lion’s heart The tender lady’s hands

救人一命胜造七级浮 屠 Saving man one life, better than building seven-floor tower