europe jjjjjjj what is emergency medicine? …cja.upol.cz/svoc/zlate_hory/2009-01/jakubaszko.pdf ·...

EDUCATIONEDUCATIONEDUCATIONEDUCATION

ININININ EMERGENCY EMERGENCY EMERGENCY EMERGENCY MEDICINEMEDICINEMEDICINEMEDICINE

IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE

EDUCATIONEDUCATIONEDUCATIONEDUCATIONEDUCATIONEDUCATIONEDUCATIONEDUCATION

ININININININININ EMERGENCY EMERGENCY EMERGENCY EMERGENCY EMERGENCY EMERGENCY EMERGENCY EMERGENCY MEDICINEMEDICINEMEDICINEMEDICINEMEDICINEMEDICINEMEDICINEMEDICINE

IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE IN EUROPEAN PERSPECTIVE

JJJJULIUSZULIUSZULIUSZULIUSZ JJJJAKUBASZKOAKUBASZKOAKUBASZKOAKUBASZKOJJJJJJJJULIUSZULIUSZULIUSZULIUSZULIUSZULIUSZULIUSZULIUSZ JJJJJJJJAKUBASZKOAKUBASZKOAKUBASZKOAKUBASZKOAKUBASZKOAKUBASZKOAKUBASZKOAKUBASZKO

WHAT IS EMERGENCY MEDICINE?WHAT IS EMERGENCY MEDICINE?WHAT IS EMERGENCY MEDICINE?

Emergency Medicine is a specialty based on the knowledge and skills required for the prevention, diagnosis and management of urgent and emergency aspects of illness and injury … in which time is critical. The practice of Emergency Medicine encompasses the pre-hospital and in-hospital triage, resuscitation, initial assessment and management of undifferentiated urgent and emergency cases. It also includes involvement in the development of pre-hospital and in-hospital emergency medical systems.

Emergency Medicine is a specialty based on the Emergency Medicine is a specialty based on the

knowledge and skills required for the prevention, knowledge and skills required for the prevention,

diagnosis and management of urgent and diagnosis and management of urgent and

emergency aspects of illness and injury emergency aspects of illness and injury …… in in

which time is critical. which time is critical. The practice of Emergency The practice of Emergency

Medicine encompasses the preMedicine encompasses the pre--hospital and inhospital and in--

hospital triage, resuscitation, initial assessment hospital triage, resuscitation, initial assessment

and management of undifferentiated urgent and and management of undifferentiated urgent and

emergency casesemergency cases.. It also includes involvement in It also includes involvement in

the development of prethe development of pre--hospital and inhospital and in--hospital hospital

emergency medical systems.emergency medical systems.

EUROPEEUROPEEUROPE

WHAT IS THE CURRENT STATUS OF EMERGENCY MEDICINE IN EUROPE?WHAT IS THE CURRENT STATUS OF WHAT IS THE CURRENT STATUS OF EMERGENCY MEDICINE IN EUROPE?EMERGENCY MEDICINE IN EUROPE?

Emergency Medicine is currently recognised as an independent specialty in nine member states of the European Union (EU Directive 2005/36/EC) …high quality emergency care requires physicians with specialised training in Emergency Medicine because this is the most effective way (in both clinical and financial terms) to provide high quality care during the critical initial stages of emergency treatment. All European countries should thus work towards the establishment of Emergency Medicine as a primary medical specialty.

Emergency Medicine is currently recognised as an Emergency Medicine is currently recognised as an

independent specialty independent specialty in nine member states of in nine member states of

the European Union the European Union (EU Directive 2005/36/EC) (EU Directive 2005/36/EC) ……

high quality emergency care requires physicians high quality emergency care requires physicians

with specialised training in Emergency Medicine with specialised training in Emergency Medicine

because this is the most effective way (in both because this is the most effective way (in both

clinical and financial terms) to provide high quality clinical and financial terms) to provide high quality

care during the critical initial stages of emergency care during the critical initial stages of emergency

treatment. treatment. All European countries should thus All European countries should thus

work towards the establishment of Emergency work towards the establishment of Emergency

Medicine as a primary medical specialty.Medicine as a primary medical specialty.

WHAT ARE THE PRINCIPLES OF EuSEM POLICY?

WHAT ARE THE PRINCIPLES OF WHAT ARE THE PRINCIPLES OF EuSEM POLICY?EuSEM POLICY?

The European Society for Emergency Medicine The European Society for Emergency Medicine The European Society for Emergency Medicine The European Society for Emergency Medicine seeks to ensure: seeks to ensure: seeks to ensure: seeks to ensure:

� The highest quality of emergency care for all patients

� The delivery of such care by specialists

trained in Emergency Medicine

� A comparable standard of clinical care in Emergency Departments across Europe

The European Society for Emergency Medicine The European Society for Emergency Medicine The European Society for Emergency Medicine The European Society for Emergency Medicine The European Society for Emergency Medicine The European Society for Emergency Medicine The European Society for Emergency Medicine The European Society for Emergency Medicine

seeks to ensure: seeks to ensure: seeks to ensure: seeks to ensure: seeks to ensure: seeks to ensure: seeks to ensure: seeks to ensure:

�� The highest quality of emergency care The highest quality of emergency care

for all patients for all patients

�� The delivery of such care by specialists The delivery of such care by specialists

trained in Emergency Medicinetrained in Emergency Medicine

�� A comparable standard of clinical care A comparable standard of clinical care

in Emergency Departments across in Emergency Departments across

EuropeEurope

EMERGENCY MEDICINE BASIC DEFINITIONS

EMERGENCY MEDICINE EMERGENCY MEDICINE BASIC DEFINITIONSBASIC DEFINITIONS

Medical discipline dedicated to the patient in health emergency with principal mission of evaluating, managing, treating and preventing to:

� minimize physical and emotional impact

� reduce preventable disability

� reduce preventable death

Medical Medical discipline discipline dedicated to the patient dedicated to the patient in in healthhealth emergencyemergency with principal mission with principal mission of evaluating, managing, treating and of evaluating, managing, treating and preventing to:preventing to:

�� minimize physical and emotional impactminimize physical and emotional impact

�� reduce preventable disabilityreduce preventable disability

�� reduce preventable deathreduce preventable death

EMERGENCY MEDICINEBASIC COMPONENTS

EMERGENCY MEDICINEEMERGENCY MEDICINEBASIC COMPONENTSBASIC COMPONENTS

Independent Medical Specialty

Academic Education Curriculum

Hospital Emergency Departments

Postgraduate education and training programs

Dedicated scientific society

Integrated EMS Infrastructures

Independent Medical Independent Medical SpecialtySpecialty

Academic Education CurriculumAcademic Education Curriculum

Hospital Emergency DepartmentsHospital Emergency Departments

Postgraduate education and training programPostgraduate education and training programss

Dedicated scientific societyDedicated scientific society

Integrated EMS InfrastructuresIntegrated EMS Infrastructures

Education and training in EMEducation and training in EMEducation and training in EM

Emergency medicine specialization is Emergency medicine specialization is Emergency medicine specialization is Emergency medicine specialization is recognizedrecognizedrecognizedrecognized by lawby lawby lawby law worldwide in 54 worldwide in 54 worldwide in 54 worldwide in 54 countries, in Europe countries, in Europe countries, in Europe countries, in Europe –––– 19 countries.19 countries.19 countries.19 countries.

Emergency medicine courses are part of Emergency medicine courses are part of Emergency medicine courses are part of Emergency medicine courses are part of

the curriculum at medical schoolthe curriculum at medical schoolthe curriculum at medical schoolthe curriculum at medical school in in in in

16 16 16 16 european countrieseuropean countrieseuropean countrieseuropean countries....

Emergency medicine specialization is Emergency medicine specialization is Emergency medicine specialization is Emergency medicine specialization is Emergency medicine specialization is Emergency medicine specialization is Emergency medicine specialization is Emergency medicine specialization is

recognizedrecognizedrecognizedrecognizedrecognizedrecognizedrecognizedrecognized by lawby lawby lawby lawby lawby lawby lawby law worldwide in 54 worldwide in 54 worldwide in 54 worldwide in 54 worldwide in 54 worldwide in 54 worldwide in 54 worldwide in 54

countries, in Europe countries, in Europe countries, in Europe countries, in Europe countries, in Europe countries, in Europe countries, in Europe countries, in Europe –––––––– 19 countries.19 countries.19 countries.19 countries.19 countries.19 countries.19 countries.19 countries.

Emergency medicine courses are part of Emergency medicine courses are part of Emergency medicine courses are part of Emergency medicine courses are part of Emergency medicine courses are part of Emergency medicine courses are part of Emergency medicine courses are part of Emergency medicine courses are part of

the curriculum at medical schoolthe curriculum at medical schoolthe curriculum at medical schoolthe curriculum at medical schoolthe curriculum at medical schoolthe curriculum at medical schoolthe curriculum at medical schoolthe curriculum at medical school in in in in in in in in

16 16 16 16 16 16 16 16 european countrieseuropean countrieseuropean countrieseuropean countrieseuropean countrieseuropean countrieseuropean countrieseuropean countries........

Location of postgraduate training in emergency medicine in EuropeLocation of postgraduate training Location of postgraduate training in emergency medicinein emergency medicine in Europein Europe

PhysiciansPhysiciansPhysiciansPhysicians NursesNursesNursesNurses ParamedicsParamedicsParamedicsParamedics

UniversityUniversityUniversityUniversity----basedbasedbasedbased 10 6 3

GovernmentGovernmentGovernmentGovernment----basedbasedbasedbased 6 6 9

PrivatePrivatePrivatePrivate 3 4 2

EMERGENCY MEDICINE CURRICULUM FOR MEDICAL STUDENTS

EMERGENCY MEDICINE CURRICULUM EMERGENCY MEDICINE CURRICULUM FOR MEDICAL STUDENTSFOR MEDICAL STUDENTS

BLOCKBLOCK SUBJECTSUBJECT HOURSHOURS

II Cardiopulmunary resuscitationCardiopulmunary resuscitation 1010

IIII Internal emergenciesInternal emergencies 2626

IIIIII Trauma emergenciesTrauma emergencies 1616

IVIV Envinromental emergenciesEnvinromental emergencies 88

VV Diagnostic and clinical procedures Diagnostic and clinical procedures

in EMin EM88

VIVI Disaster medicineDisaster medicine 1212

VIIVII LecutresLecutres 2020

TOTAL EDUCATIONAL HOURSTOTAL EDUCATIONAL HOURS 100100



I. Resuscytacja krI. Resuscytacja krI. Resuscytacja krI. Resuscytacja krąŜeniowoeniowoeniowoeniowo----oddechowaoddechowaoddechowaoddechowa

Podstawy resuscytacji krąŜeniowo-oddechowej

4

Zaawansowana resuscytacja krąŜeniowo-oddechowa

4

Zaawansowana resuscytacja krąŜeniowo-oddechowa u dzieci

2



II. NagII. NagII. NagII. Nagłe zagroe zagroe zagroe zagroŜenia pochodzenia wewnenia pochodzenia wewnenia pochodzenia wewnenia pochodzenia wewnętrznegotrznegotrznegotrznego

Nagłe zagroŜenia sercowo-naczyniowe 2Ostre zagroŜenia oddechowe 2Ostre schorzenia neurologiczneOstre schorzenia psychiczne

22

Ostre zagroŜenia:•Ŝołądkowo-jelitowe•nefrologiczne•infekcyjne•metaboliczne•endokrynne•alergiczne

4



ZagroŜenia wynikające z patologii w połoŜnictwie

2

Wstępna terapia ostrych zatruć 4

Patofizjologia, diagnostyka i leczenie wstrząsu 2

Postępowanie ratunkowe w stanach zagroŜenia u dzieci

4

Postępowanie w ostrych chorobach skóry 1

Postępowanie w ostrych schorzeniach okulistycznych

1

Postępowanie w ostrych schorzeniach laryngologicznych

1

Postępowanie w ostrych stanach hematologicznych

1



III. NagIII. NagIII. NagIII. Nagłe zagroe zagroe zagroe zagroŜenia okoenia okoenia okoenia okołourazoweourazoweourazoweourazoweMnogie obraŜenia ciała:•Priorytety postępowania we wstępnej fazie•Ocena wstępna i wtórna•Strategia leczenia w oddziale ratunkowym

4

Urazy klatki piersiowejUrazy jamy brzusznejUrazy czaszkowo-mózgowe

6

Zasady leczenia ran; rany postrzałowe, zmiaŜdŜenia rany kąsane, itp.

2

Postępowania w obraŜeniach u dzieci 2Postępowanie w obraŜeniach narządu ruchu 2



IV. NagIV. NagIV. NagIV. Nagłe zagroe zagroe zagroe zagroŜenia enia enia enia środowiskowerodowiskowerodowiskowerodowiskowe

PoraŜenie prądem elektrycznym i piorunemChoroba wysokościowaPodtopieniaWypadek nurkowy

4

Uraz termiczny•Hipotermia, odmroŜenia •Hipertermia, oparzenia

4



V. Techniki diagnostyczne i procedury kliniczne V. Techniki diagnostyczne i procedury kliniczne V. Techniki diagnostyczne i procedury kliniczne V. Techniki diagnostyczne i procedury kliniczne w medycynie ratunkowejw medycynie ratunkowejw medycynie ratunkowejw medycynie ratunkowej

Diagnostyka obrazowa ( Rtg, TK, USG, Endoskopia)

4

Nowe technologie w medycynie ratunkowej;Tlenoterapia hiperbarycznaOstra terapia nerkozastępczaHipotermia kontrolowana, itp

2



VI. Medycyna katastrofVI. Medycyna katastrofVI. Medycyna katastrofVI. Medycyna katastrof

Organizacja i postępowanie medyczne w zdarzeniach masowych i katastrofachTRIAGE – segregacja medyczna Regionalne plany zabezpieczenia katastrofy

4

Psychologia akcji ratunkowejPomoc humanitarnaStres zawodowy a zdrowie psychiczne

4

SkaŜenia chemiczne i radioaktywneBioterroryzm

4

WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE

IN EUROPE?IN EUROPE?IN EUROPE?IN EUROPE?

WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO WHAT TRAINING SHOULD BE REQUIRED TO PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE PRACTISE EMERGENCY MEDICINE

IN EUROPE?IN EUROPE?IN EUROPE?IN EUROPE?IN EUROPE?IN EUROPE?IN EUROPE?IN EUROPE?

The EU Doctors’ Directive requires that training in Emergency Medicine should be for a minimum of five years. EuSEM has already published a European core curriculum for the specialty and is now working with a Multidisciplinary Joint Committee of the Union Europeenne des Medecins Specialistes (UEMS). This Committee is overseeing a revision of the core curriculum and is considering the principles involved in the establishment and organisation of training programmes of comparable standard in recognised departments across Europe.

The EU DoctorsThe EU Doctors’’ Directive requires that training in Directive requires that training in

Emergency Medicine should be for a minimum of five Emergency Medicine should be for a minimum of five

years. EuSEM has already published a years. EuSEM has already published a European core European core

curriculum for the specialty curriculum for the specialty and is now working with a and is now working with a

Multidisciplinary Joint Committee of the Union Multidisciplinary Joint Committee of the Union

Europeenne des Medecins Specialistes Europeenne des Medecins Specialistes (UEMS(UEMS). This ). This

Committee is overseeing a revision of the core Committee is overseeing a revision of the core

curriculum and is considering the principles involved in curriculum and is considering the principles involved in

the establishment and organisation of training the establishment and organisation of training

programmes of programmes of comparable standard in recognised comparable standard in recognised

departments across Europe.departments across Europe.

PURPOSE PURPOSE PURPOSE PURPOSE OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM

FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE

PURPOSE PURPOSE PURPOSE PURPOSE PURPOSE PURPOSE PURPOSE PURPOSE OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM OF THE EUROPEAN CURRICULUM

FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE FOR EMERGENCY MEDICINE

The main function and purpose of the European Curriculum for Emergency Medicine is the establishment and organisation of training programmes of comparable standard in recognised departments across Europe. EuSEM has already published a European core curriculum for the specialty. The present curriculum was developed by the Curriculum Task Force of EuSEM and the Multidisciplinary Joint Committee of the Union Européenne des Médecins Spécialistes (UEMS). The curriculum was agreed by the National Societies for Emergency Medicine of 15 European countries

The main function and purpose of the European The main function and purpose of the European

Curriculum for Emergency Medicine is the Curriculum for Emergency Medicine is the

establishment and organisation of training establishment and organisation of training

programmes of comparable standard in recognised programmes of comparable standard in recognised

departments across Europe.departments across Europe. EuSEM has already EuSEM has already

published a European core curriculum for the published a European core curriculum for the

specialty. The present curriculum was developed by specialty. The present curriculum was developed by

the Curriculum Task Force of EuSEM and the the Curriculum Task Force of EuSEM and the

Multidisciplinary Joint Committee of the Union Multidisciplinary Joint Committee of the Union

EuropEuropééenne des Menne des Méédecins Spdecins Spéécialistes (UEMS). cialistes (UEMS). The The

curriculum was agreed by the National Societies for curriculum was agreed by the National Societies for

Emergency Medicine of 15 European countries Emergency Medicine of 15 European countries

EuSEM Core Curriculum for Emergency Medicine in EuropeEuSEM Core Curriculum for EuSEM Core Curriculum for

Emergency Medicine in EuropeEmergency Medicine in Europe

The The The The specialty of emergency medicinespecialty of emergency medicinespecialty of emergency medicinespecialty of emergency medicinemeets themeets themeets themeets the scientific, clinical and scientific, clinical and scientific, clinical and scientific, clinical and organisational need for aorganisational need for aorganisational need for aorganisational need for a medical medical medical medical discipline that has a primary concern discipline that has a primary concern discipline that has a primary concern discipline that has a primary concern withwithwithwith emergencies. It requires a physical emergencies. It requires a physical emergencies. It requires a physical emergencies. It requires a physical and/or conceptualand/or conceptualand/or conceptualand/or conceptual presence in the prepresence in the prepresence in the prepresence in the pre----hospital, inhospital, inhospital, inhospital, in----hospital andhospital andhospital andhospital and interinterinterinter----hospital hospital hospital hospital care of emergency patients.care of emergency patients.care of emergency patients.care of emergency patients.

The The The The The The The The specialty of emergency medicinespecialty of emergency medicinespecialty of emergency medicinespecialty of emergency medicinespecialty of emergency medicinespecialty of emergency medicinespecialty of emergency medicinespecialty of emergency medicinemeets themeets themeets themeets themeets themeets themeets themeets the scientific, clinical and scientific, clinical and scientific, clinical and scientific, clinical and scientific, clinical and scientific, clinical and scientific, clinical and scientific, clinical and organisational need for aorganisational need for aorganisational need for aorganisational need for aorganisational need for aorganisational need for aorganisational need for aorganisational need for a medical medical medical medical medical medical medical medical discipline that has a primary concern discipline that has a primary concern discipline that has a primary concern discipline that has a primary concern discipline that has a primary concern discipline that has a primary concern discipline that has a primary concern discipline that has a primary concern withwithwithwithwithwithwithwith emergencies. It requires a physical emergencies. It requires a physical emergencies. It requires a physical emergencies. It requires a physical emergencies. It requires a physical emergencies. It requires a physical emergencies. It requires a physical emergencies. It requires a physical and/or conceptualand/or conceptualand/or conceptualand/or conceptualand/or conceptualand/or conceptualand/or conceptualand/or conceptual presence in the prepresence in the prepresence in the prepresence in the prepresence in the prepresence in the prepresence in the prepresence in the pre--------hospital, inhospital, inhospital, inhospital, inhospital, inhospital, inhospital, inhospital, in--------hospital andhospital andhospital andhospital andhospital andhospital andhospital andhospital and interinterinterinterinterinterinterinter--------hospital hospital hospital hospital hospital hospital hospital hospital care of emergency patients.care of emergency patients.care of emergency patients.care of emergency patients.care of emergency patients.care of emergency patients.care of emergency patients.care of emergency patients.



The The The The province of emergency medicineprovince of emergency medicineprovince of emergency medicineprovince of emergency medicine is is is is early diagnosis and treatment of all life, early diagnosis and treatment of all life, early diagnosis and treatment of all life, early diagnosis and treatment of all life, organ or limborgan or limborgan or limborgan or limb----threatening conditions. threatening conditions. threatening conditions. threatening conditions. Timely and wellTimely and wellTimely and wellTimely and well----coordinated care limits coordinated care limits coordinated care limits coordinated care limits both immediate and late mortality and both immediate and late mortality and both immediate and late mortality and both immediate and late mortality and reduces the duration and severity of reduces the duration and severity of reduces the duration and severity of reduces the duration and severity of morbidity from sudden illness and injury. morbidity from sudden illness and injury. morbidity from sudden illness and injury. morbidity from sudden illness and injury. The relief of suffering is also of The relief of suffering is also of The relief of suffering is also of The relief of suffering is also of paramount importance.paramount importance.paramount importance.paramount importance.

The The The The The The The The province of emergency medicineprovince of emergency medicineprovince of emergency medicineprovince of emergency medicineprovince of emergency medicineprovince of emergency medicineprovince of emergency medicineprovince of emergency medicine is is is is is is is is early diagnosis and treatment of all life, early diagnosis and treatment of all life, early diagnosis and treatment of all life, early diagnosis and treatment of all life, early diagnosis and treatment of all life, early diagnosis and treatment of all life, early diagnosis and treatment of all life, early diagnosis and treatment of all life, organ or limborgan or limborgan or limborgan or limborgan or limborgan or limborgan or limborgan or limb--------threatening conditions. threatening conditions. threatening conditions. threatening conditions. threatening conditions. threatening conditions. threatening conditions. threatening conditions. Timely and wellTimely and wellTimely and wellTimely and wellTimely and wellTimely and wellTimely and wellTimely and well--------coordinated care limits coordinated care limits coordinated care limits coordinated care limits coordinated care limits coordinated care limits coordinated care limits coordinated care limits both immediate and late mortality and both immediate and late mortality and both immediate and late mortality and both immediate and late mortality and both immediate and late mortality and both immediate and late mortality and both immediate and late mortality and both immediate and late mortality and reduces the duration and severity of reduces the duration and severity of reduces the duration and severity of reduces the duration and severity of reduces the duration and severity of reduces the duration and severity of reduces the duration and severity of reduces the duration and severity of morbidity from sudden illness and injury. morbidity from sudden illness and injury. morbidity from sudden illness and injury. morbidity from sudden illness and injury. morbidity from sudden illness and injury. morbidity from sudden illness and injury. morbidity from sudden illness and injury. morbidity from sudden illness and injury. The relief of suffering is also of The relief of suffering is also of The relief of suffering is also of The relief of suffering is also of The relief of suffering is also of The relief of suffering is also of The relief of suffering is also of The relief of suffering is also of paramount importance.paramount importance.paramount importance.paramount importance.paramount importance.paramount importance.paramount importance.paramount importance.



The The The The emergency health care systememergency health care systememergency health care systememergency health care system must must must must

bebebebe clinically, organisationally and clinically, organisationally and clinically, organisationally and clinically, organisationally and financially independent.financially independent.financially independent.financially independent. Certain features Certain features Certain features Certain features such as triage, resuscitationsuch as triage, resuscitationsuch as triage, resuscitationsuch as triage, resuscitation and and and and facilities for shortfacilities for shortfacilities for shortfacilities for short----term observation and term observation and term observation and term observation and

therapytherapytherapytherapy should be incorporated into the should be incorporated into the should be incorporated into the should be incorporated into the system.system.system.system.

The The The The The The The The emergency health care systememergency health care systememergency health care systememergency health care systememergency health care systememergency health care systememergency health care systememergency health care system must must must must must must must must

bebebebebebebebe clinically, organisationally and clinically, organisationally and clinically, organisationally and clinically, organisationally and clinically, organisationally and clinically, organisationally and clinically, organisationally and clinically, organisationally and

financially independent.financially independent.financially independent.financially independent.financially independent.financially independent.financially independent.financially independent. Certain features Certain features Certain features Certain features Certain features Certain features Certain features Certain features

such as triage, resuscitationsuch as triage, resuscitationsuch as triage, resuscitationsuch as triage, resuscitationsuch as triage, resuscitationsuch as triage, resuscitationsuch as triage, resuscitationsuch as triage, resuscitation and and and and and and and and

facilities for shortfacilities for shortfacilities for shortfacilities for shortfacilities for shortfacilities for shortfacilities for shortfacilities for short--------term observation and term observation and term observation and term observation and term observation and term observation and term observation and term observation and

therapytherapytherapytherapytherapytherapytherapytherapy should be incorporated into the should be incorporated into the should be incorporated into the should be incorporated into the should be incorporated into the should be incorporated into the should be incorporated into the should be incorporated into the

system.system.system.system.system.system.system.system.



Good practice in emergency medicineGood practice in emergency medicineGood practice in emergency medicineGood practice in emergency medicine will will will will maximise the likelihood of a favourable maximise the likelihood of a favourable maximise the likelihood of a favourable maximise the likelihood of a favourable outcome for the patient. Therapy should outcome for the patient. Therapy should outcome for the patient. Therapy should outcome for the patient. Therapy should be consistent with current knowledge and be consistent with current knowledge and be consistent with current knowledge and be consistent with current knowledge and care must be provided in a humane and care must be provided in a humane and care must be provided in a humane and care must be provided in a humane and respectful manner with psychosocial respectful manner with psychosocial respectful manner with psychosocial respectful manner with psychosocial support available as required. support available as required. support available as required. support available as required. There is no There is no There is no There is no defined time limit to the duration of defined time limit to the duration of defined time limit to the duration of defined time limit to the duration of emergency care.emergency care.emergency care.emergency care.

Good practice in emergency medicineGood practice in emergency medicineGood practice in emergency medicineGood practice in emergency medicineGood practice in emergency medicineGood practice in emergency medicineGood practice in emergency medicineGood practice in emergency medicine will will will will will will will will maximise the likelihood of a favourable maximise the likelihood of a favourable maximise the likelihood of a favourable maximise the likelihood of a favourable maximise the likelihood of a favourable maximise the likelihood of a favourable maximise the likelihood of a favourable maximise the likelihood of a favourable outcome for the patient. Therapy should outcome for the patient. Therapy should outcome for the patient. Therapy should outcome for the patient. Therapy should outcome for the patient. Therapy should outcome for the patient. Therapy should outcome for the patient. Therapy should outcome for the patient. Therapy should be consistent with current knowledge and be consistent with current knowledge and be consistent with current knowledge and be consistent with current knowledge and be consistent with current knowledge and be consistent with current knowledge and be consistent with current knowledge and be consistent with current knowledge and care must be provided in a humane and care must be provided in a humane and care must be provided in a humane and care must be provided in a humane and care must be provided in a humane and care must be provided in a humane and care must be provided in a humane and care must be provided in a humane and respectful manner with psychosocial respectful manner with psychosocial respectful manner with psychosocial respectful manner with psychosocial respectful manner with psychosocial respectful manner with psychosocial respectful manner with psychosocial respectful manner with psychosocial support available as required. support available as required. support available as required. support available as required. support available as required. support available as required. support available as required. support available as required. There is no There is no There is no There is no There is no There is no There is no There is no defined time limit to the duration of defined time limit to the duration of defined time limit to the duration of defined time limit to the duration of defined time limit to the duration of defined time limit to the duration of defined time limit to the duration of defined time limit to the duration of emergency care.emergency care.emergency care.emergency care.emergency care.emergency care.emergency care.emergency care.



� Emergency medicine encourages Emergency medicine encourages Emergency medicine encourages Emergency medicine encourages collaborationcollaborationcollaborationcollaboration between all members of the between all members of the between all members of the between all members of the health care teamhealth care teamhealth care teamhealth care team. . . .

� Team workTeam workTeam workTeam work isisisis essential and must involve essential and must involve essential and must involve essential and must involve close cooperation andclose cooperation andclose cooperation andclose cooperation and integrated facilities integrated facilities integrated facilities integrated facilities for protocol development andfor protocol development andfor protocol development andfor protocol development andimplementation, teaching andimplementation, teaching andimplementation, teaching andimplementation, teaching and researchresearchresearchresearch....

�� Emergency medicine encourages Emergency medicine encourages Emergency medicine encourages Emergency medicine encourages Emergency medicine encourages Emergency medicine encourages Emergency medicine encourages Emergency medicine encourages collaborationcollaborationcollaborationcollaborationcollaborationcollaborationcollaborationcollaboration between all members of the between all members of the between all members of the between all members of the between all members of the between all members of the between all members of the between all members of the health care teamhealth care teamhealth care teamhealth care teamhealth care teamhealth care teamhealth care teamhealth care team. . . . . . . .

�� Team workTeam workTeam workTeam workTeam workTeam workTeam workTeam work isisisisisisisis essential and must involve essential and must involve essential and must involve essential and must involve essential and must involve essential and must involve essential and must involve essential and must involve close cooperation andclose cooperation andclose cooperation andclose cooperation andclose cooperation andclose cooperation andclose cooperation andclose cooperation and integrated facilities integrated facilities integrated facilities integrated facilities integrated facilities integrated facilities integrated facilities integrated facilities for protocol development andfor protocol development andfor protocol development andfor protocol development andfor protocol development andfor protocol development andfor protocol development andfor protocol development andimplementation, teaching andimplementation, teaching andimplementation, teaching andimplementation, teaching andimplementation, teaching andimplementation, teaching andimplementation, teaching andimplementation, teaching and researchresearchresearchresearchresearchresearchresearchresearch........



Emergency medicine, as a specialtyEmergency medicine, as a specialtyEmergency medicine, as a specialtyEmergency medicine, as a specialty, is thus , is thus , is thus , is thus a disciplinea disciplinea disciplinea discipline that coversthat coversthat coversthat covers emergency and emergency and emergency and emergency and urgent aspects of virtually allurgent aspects of virtually allurgent aspects of virtually allurgent aspects of virtually all facets of facets of facets of facets of

medicine, in contrast to most other medicine, in contrast to most other medicine, in contrast to most other medicine, in contrast to most other specialtiesspecialtiesspecialtiesspecialties that are considerably that are considerably that are considerably that are considerably circumscribed by age, sex, organcircumscribed by age, sex, organcircumscribed by age, sex, organcircumscribed by age, sex, organ system, or system, or system, or system, or other factors.other factors.other factors.other factors.

Emergency medicine, as a specialtyEmergency medicine, as a specialtyEmergency medicine, as a specialtyEmergency medicine, as a specialtyEmergency medicine, as a specialtyEmergency medicine, as a specialtyEmergency medicine, as a specialtyEmergency medicine, as a specialty, is thus , is thus , is thus , is thus , is thus , is thus , is thus , is thus

a disciplinea disciplinea disciplinea disciplinea disciplinea disciplinea disciplinea discipline that coversthat coversthat coversthat coversthat coversthat coversthat coversthat covers emergency and emergency and emergency and emergency and emergency and emergency and emergency and emergency and

urgent aspects of virtually allurgent aspects of virtually allurgent aspects of virtually allurgent aspects of virtually allurgent aspects of virtually allurgent aspects of virtually allurgent aspects of virtually allurgent aspects of virtually all facets of facets of facets of facets of facets of facets of facets of facets of

medicine, in contrast to most other medicine, in contrast to most other medicine, in contrast to most other medicine, in contrast to most other medicine, in contrast to most other medicine, in contrast to most other medicine, in contrast to most other medicine, in contrast to most other

specialtiesspecialtiesspecialtiesspecialtiesspecialtiesspecialtiesspecialtiesspecialties that are considerably that are considerably that are considerably that are considerably that are considerably that are considerably that are considerably that are considerably

circumscribed by age, sex, organcircumscribed by age, sex, organcircumscribed by age, sex, organcircumscribed by age, sex, organcircumscribed by age, sex, organcircumscribed by age, sex, organcircumscribed by age, sex, organcircumscribed by age, sex, organ system, or system, or system, or system, or system, or system, or system, or system, or

other factors.other factors.other factors.other factors.other factors.other factors.other factors.other factors.



The variety of clinical materialThe variety of clinical materialThe variety of clinical materialThe variety of clinical material presenting presenting presenting presenting to the emergency department demands the to the emergency department demands the to the emergency department demands the to the emergency department demands the attention of a medical practitioner with attention of a medical practitioner with attention of a medical practitioner with attention of a medical practitioner with significant breadth and depth of experience significant breadth and depth of experience significant breadth and depth of experience significant breadth and depth of experience and knowledge, ensuring a and knowledge, ensuring a and knowledge, ensuring a and knowledge, ensuring a detailed detailed detailed detailed understanding of the patientunderstanding of the patientunderstanding of the patientunderstanding of the patient’’’’s s s s requirementsrequirementsrequirementsrequirements....

The variety of clinical materialThe variety of clinical materialThe variety of clinical materialThe variety of clinical materialThe variety of clinical materialThe variety of clinical materialThe variety of clinical materialThe variety of clinical material presenting presenting presenting presenting presenting presenting presenting presenting to the emergency department demands the to the emergency department demands the to the emergency department demands the to the emergency department demands the to the emergency department demands the to the emergency department demands the to the emergency department demands the to the emergency department demands the attention of a medical practitioner with attention of a medical practitioner with attention of a medical practitioner with attention of a medical practitioner with attention of a medical practitioner with attention of a medical practitioner with attention of a medical practitioner with attention of a medical practitioner with significant breadth and depth of experience significant breadth and depth of experience significant breadth and depth of experience significant breadth and depth of experience significant breadth and depth of experience significant breadth and depth of experience significant breadth and depth of experience significant breadth and depth of experience and knowledge, ensuring a and knowledge, ensuring a and knowledge, ensuring a and knowledge, ensuring a and knowledge, ensuring a and knowledge, ensuring a and knowledge, ensuring a and knowledge, ensuring a detailed detailed detailed detailed detailed detailed detailed detailed understanding of the patientunderstanding of the patientunderstanding of the patientunderstanding of the patientunderstanding of the patientunderstanding of the patientunderstanding of the patientunderstanding of the patient’’’’’’’’s s s s s s s s requirementsrequirementsrequirementsrequirementsrequirementsrequirementsrequirementsrequirements........



Within the 5 years specialist trainingWithin the 5 years specialist trainingWithin the 5 years specialist trainingWithin the 5 years specialist training, it is , it is , it is , it is our view that aour view that aour view that aour view that a minimum of minimum of minimum of minimum of 3 years be 3 years be 3 years be 3 years be spent purely in emergencyspent purely in emergencyspent purely in emergencyspent purely in emergency departmentdepartmentdepartmentdepartment----

based emergency medicine training, withbased emergency medicine training, withbased emergency medicine training, withbased emergency medicine training, withvarying exposure to other specialties, varying exposure to other specialties, varying exposure to other specialties, varying exposure to other specialties, depending on thedepending on thedepending on thedepending on the needs for training and the needs for training and the needs for training and the needs for training and the scope of practice expected inscope of practice expected inscope of practice expected inscope of practice expected in that countrythat countrythat countrythat country....

Within the 5 years specialist trainingWithin the 5 years specialist trainingWithin the 5 years specialist trainingWithin the 5 years specialist trainingWithin the 5 years specialist trainingWithin the 5 years specialist trainingWithin the 5 years specialist trainingWithin the 5 years specialist training, it is , it is , it is , it is , it is , it is , it is , it is

our view that aour view that aour view that aour view that aour view that aour view that aour view that aour view that a minimum of minimum of minimum of minimum of minimum of minimum of minimum of minimum of 3 years be 3 years be 3 years be 3 years be 3 years be 3 years be 3 years be 3 years be

spent purely in emergencyspent purely in emergencyspent purely in emergencyspent purely in emergencyspent purely in emergencyspent purely in emergencyspent purely in emergencyspent purely in emergency departmentdepartmentdepartmentdepartmentdepartmentdepartmentdepartmentdepartment--------

based emergency medicine training, withbased emergency medicine training, withbased emergency medicine training, withbased emergency medicine training, withbased emergency medicine training, withbased emergency medicine training, withbased emergency medicine training, withbased emergency medicine training, with

varying exposure to other specialties, varying exposure to other specialties, varying exposure to other specialties, varying exposure to other specialties, varying exposure to other specialties, varying exposure to other specialties, varying exposure to other specialties, varying exposure to other specialties,

depending on thedepending on thedepending on thedepending on thedepending on thedepending on thedepending on thedepending on the needs for training and the needs for training and the needs for training and the needs for training and the needs for training and the needs for training and the needs for training and the needs for training and the

scope of practice expected inscope of practice expected inscope of practice expected inscope of practice expected inscope of practice expected inscope of practice expected inscope of practice expected inscope of practice expected in that countrythat countrythat countrythat countrythat countrythat countrythat countrythat country........



Each country will have a National Training Each country will have a National Training Each country will have a National Training Each country will have a National Training Authority to visit and accredit centres to Authority to visit and accredit centres to Authority to visit and accredit centres to Authority to visit and accredit centres to national criteria, which will be basednational criteria, which will be basednational criteria, which will be basednational criteria, which will be based on, on, on, on,

and referenced to, European criteria. There and referenced to, European criteria. There and referenced to, European criteria. There and referenced to, European criteria. There should be ashould be ashould be ashould be a programme of periodic reprogramme of periodic reprogramme of periodic reprogramme of periodic re----visitation and revisitation and revisitation and revisitation and re----accreditation byaccreditation byaccreditation byaccreditation byrepresentatives of the National Training representatives of the National Training representatives of the National Training representatives of the National Training

Authority.Authority.Authority.Authority.

Each country will have a National Training Each country will have a National Training Each country will have a National Training Each country will have a National Training Each country will have a National Training Each country will have a National Training Each country will have a National Training Each country will have a National Training

Authority to visit and accredit centres to Authority to visit and accredit centres to Authority to visit and accredit centres to Authority to visit and accredit centres to Authority to visit and accredit centres to Authority to visit and accredit centres to Authority to visit and accredit centres to Authority to visit and accredit centres to

national criteria, which will be basednational criteria, which will be basednational criteria, which will be basednational criteria, which will be basednational criteria, which will be basednational criteria, which will be basednational criteria, which will be basednational criteria, which will be based on, on, on, on, on, on, on, on,

and referenced to, European criteria. There and referenced to, European criteria. There and referenced to, European criteria. There and referenced to, European criteria. There and referenced to, European criteria. There and referenced to, European criteria. There and referenced to, European criteria. There and referenced to, European criteria. There

should be ashould be ashould be ashould be ashould be ashould be ashould be ashould be a programme of periodic reprogramme of periodic reprogramme of periodic reprogramme of periodic reprogramme of periodic reprogramme of periodic reprogramme of periodic reprogramme of periodic re--------

visitation and revisitation and revisitation and revisitation and revisitation and revisitation and revisitation and revisitation and re--------accreditation byaccreditation byaccreditation byaccreditation byaccreditation byaccreditation byaccreditation byaccreditation by

representatives of the National Training representatives of the National Training representatives of the National Training representatives of the National Training representatives of the National Training representatives of the National Training representatives of the National Training representatives of the National Training

Authority.Authority.Authority.Authority.Authority.Authority.Authority.Authority.



Training programmesTraining programmesTraining programmesTraining programmes in emergency medicine in emergency medicine in emergency medicine in emergency medicine are designed to train physicians for the are designed to train physicians for the are designed to train physicians for the are designed to train physicians for the practice of emergency medicine. Training practice of emergency medicine. Training practice of emergency medicine. Training practice of emergency medicine. Training programmes must teach the fundamental programmes must teach the fundamental programmes must teach the fundamental programmes must teach the fundamental skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities that constitute the foundations of emergency that constitute the foundations of emergency that constitute the foundations of emergency that constitute the foundations of emergency medicine practice and provide progressive medicine practice and provide progressive medicine practice and provide progressive medicine practice and provide progressive responsibility for, and experience in, the responsibility for, and experience in, the responsibility for, and experience in, the responsibility for, and experience in, the application of these principles, to enable the application of these principles, to enable the application of these principles, to enable the application of these principles, to enable the effective management of clinical problems.effective management of clinical problems.effective management of clinical problems.effective management of clinical problems.

Training programmesTraining programmesTraining programmesTraining programmesTraining programmesTraining programmesTraining programmesTraining programmes in emergency medicine in emergency medicine in emergency medicine in emergency medicine in emergency medicine in emergency medicine in emergency medicine in emergency medicine are designed to train physicians for the are designed to train physicians for the are designed to train physicians for the are designed to train physicians for the are designed to train physicians for the are designed to train physicians for the are designed to train physicians for the are designed to train physicians for the practice of emergency medicine. Training practice of emergency medicine. Training practice of emergency medicine. Training practice of emergency medicine. Training practice of emergency medicine. Training practice of emergency medicine. Training practice of emergency medicine. Training practice of emergency medicine. Training programmes must teach the fundamental programmes must teach the fundamental programmes must teach the fundamental programmes must teach the fundamental programmes must teach the fundamental programmes must teach the fundamental programmes must teach the fundamental programmes must teach the fundamental skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities skills, knowledge, and humanistic qualities that constitute the foundations of emergency that constitute the foundations of emergency that constitute the foundations of emergency that constitute the foundations of emergency that constitute the foundations of emergency that constitute the foundations of emergency that constitute the foundations of emergency that constitute the foundations of emergency medicine practice and provide progressive medicine practice and provide progressive medicine practice and provide progressive medicine practice and provide progressive medicine practice and provide progressive medicine practice and provide progressive medicine practice and provide progressive medicine practice and provide progressive responsibility for, and experience in, the responsibility for, and experience in, the responsibility for, and experience in, the responsibility for, and experience in, the responsibility for, and experience in, the responsibility for, and experience in, the responsibility for, and experience in, the responsibility for, and experience in, the application of these principles, to enable the application of these principles, to enable the application of these principles, to enable the application of these principles, to enable the application of these principles, to enable the application of these principles, to enable the application of these principles, to enable the application of these principles, to enable the effective management of clinical problems.effective management of clinical problems.effective management of clinical problems.effective management of clinical problems.effective management of clinical problems.effective management of clinical problems.effective management of clinical problems.effective management of clinical problems.



Training programmes in emergency medicine should Training programmes in emergency medicine should Training programmes in emergency medicine should Training programmes in emergency medicine should produce emergency physicians prepared with the produce emergency physicians prepared with the produce emergency physicians prepared with the produce emergency physicians prepared with the following basic competencies:following basic competencies:following basic competencies:following basic competencies:1.1.1.1. Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization,

evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present to the emergency department;to the emergency department;to the emergency department;to the emergency department;

2.2.2.2. Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department patients with different complaints and needs;patients with different complaints and needs;patients with different complaints and needs;patients with different complaints and needs;

3.3.3.3. Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and oxygen debt;oxygen debt;oxygen debt;oxygen debt;

4.4.4.4. Arrange appropriate followArrange appropriate followArrange appropriate followArrange appropriate follow----up or referral as required;up or referral as required;up or referral as required;up or referral as required;

5.5.5.5. Manage the outManage the outManage the outManage the out----ofofofof----hospital care of the acutely ill or injured hospital care of the acutely ill or injured hospital care of the acutely ill or injured hospital care of the acutely ill or injured patient;patient;patient;patient;

Training programmes in emergency medicine should Training programmes in emergency medicine should Training programmes in emergency medicine should Training programmes in emergency medicine should Training programmes in emergency medicine should Training programmes in emergency medicine should Training programmes in emergency medicine should Training programmes in emergency medicine should produce emergency physicians prepared with the produce emergency physicians prepared with the produce emergency physicians prepared with the produce emergency physicians prepared with the produce emergency physicians prepared with the produce emergency physicians prepared with the produce emergency physicians prepared with the produce emergency physicians prepared with the following basic competencies:following basic competencies:following basic competencies:following basic competencies:following basic competencies:following basic competencies:following basic competencies:following basic competencies:1.1.1.1.1.1.1.1. Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization, Provide for the recognition, resuscitation, stabilization,

evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present evaluation, and care of the full range of patients who present to the emergency department;to the emergency department;to the emergency department;to the emergency department;to the emergency department;to the emergency department;to the emergency department;to the emergency department;

2.2.2.2.2.2.2.2. Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for Apply critical thinking to determine the priorities for evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department evaluation and treatment of multiple emergency department patients with different complaints and needs;patients with different complaints and needs;patients with different complaints and needs;patients with different complaints and needs;patients with different complaints and needs;patients with different complaints and needs;patients with different complaints and needs;patients with different complaints and needs;

3.3.3.3.3.3.3.3. Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and Evaluate oxygen supply, oxygen need, oxygen deficit and oxygen debt;oxygen debt;oxygen debt;oxygen debt;oxygen debt;oxygen debt;oxygen debt;oxygen debt;

4.4.4.4.4.4.4.4. Arrange appropriate followArrange appropriate followArrange appropriate followArrange appropriate followArrange appropriate followArrange appropriate followArrange appropriate followArrange appropriate follow--------up or referral as required;up or referral as required;up or referral as required;up or referral as required;up or referral as required;up or referral as required;up or referral as required;up or referral as required;

5.5.5.5.5.5.5.5. Manage the outManage the outManage the outManage the outManage the outManage the outManage the outManage the out--------ofofofofofofofof--------hospital care of the acutely ill or injured hospital care of the acutely ill or injured hospital care of the acutely ill or injured hospital care of the acutely ill or injured hospital care of the acutely ill or injured hospital care of the acutely ill or injured hospital care of the acutely ill or injured hospital care of the acutely ill or injured patient;patient;patient;patient;patient;patient;patient;patient;

Core competenciesCore competencies



6.6.6.6. Participate in the administration of the emergencyParticipate in the administration of the emergencyParticipate in the administration of the emergencyParticipate in the administration of the emergency medical medical medical medical services system providing outservices system providing outservices system providing outservices system providing out----ofofofof----hospitalhospitalhospitalhospital care;care;care;care;

7.7.7.7. Provide appropriate patient education directedProvide appropriate patient education directedProvide appropriate patient education directedProvide appropriate patient education directed towards the towards the towards the towards the prevention of illness and injury;prevention of illness and injury;prevention of illness and injury;prevention of illness and injury;

8.8.8.8. Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;9.9.9.9. Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;

10.10.10.10. Understand and evaluate research methodologies andUnderstand and evaluate research methodologies andUnderstand and evaluate research methodologies andUnderstand and evaluate research methodologies and their their their their application;application;application;application;

11.11.11.11. Understand and apply the principles and practice ofUnderstand and apply the principles and practice ofUnderstand and apply the principles and practice ofUnderstand and apply the principles and practice of continuous continuous continuous continuous quality improvement;quality improvement;quality improvement;quality improvement;

12.12.12.12. Manage resource utilization effectively;Manage resource utilization effectively;Manage resource utilization effectively;Manage resource utilization effectively;13.13.13.13. Utilize information resources effectively and applyUtilize information resources effectively and applyUtilize information resources effectively and applyUtilize information resources effectively and apply evidenceevidenceevidenceevidence----

based medicine to update their clinicalbased medicine to update their clinicalbased medicine to update their clinicalbased medicine to update their clinical practice;practice;practice;practice;

6.6.6.6.6.6.6.6. Participate in the administration of the emergencyParticipate in the administration of the emergencyParticipate in the administration of the emergencyParticipate in the administration of the emergencyParticipate in the administration of the emergencyParticipate in the administration of the emergencyParticipate in the administration of the emergencyParticipate in the administration of the emergency medical medical medical medical medical medical medical medical services system providing outservices system providing outservices system providing outservices system providing outservices system providing outservices system providing outservices system providing outservices system providing out--------ofofofofofofofof--------hospitalhospitalhospitalhospitalhospitalhospitalhospitalhospital care;care;care;care;care;care;care;care;

7.7.7.7.7.7.7.7. Provide appropriate patient education directedProvide appropriate patient education directedProvide appropriate patient education directedProvide appropriate patient education directedProvide appropriate patient education directedProvide appropriate patient education directedProvide appropriate patient education directedProvide appropriate patient education directed towards the towards the towards the towards the towards the towards the towards the towards the prevention of illness and injury;prevention of illness and injury;prevention of illness and injury;prevention of illness and injury;prevention of illness and injury;prevention of illness and injury;prevention of illness and injury;prevention of illness and injury;

8.8.8.8.8.8.8.8. Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;Engage in the administration of emergency medicine;

9.9.9.9.9.9.9.9. Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;Engage in the teaching of emergency medicine;

10.10.10.10.10.10.10.10. Understand and evaluate research methodologies andUnderstand and evaluate research methodologies andUnderstand and evaluate research methodologies andUnderstand and evaluate research methodologies andUnderstand and evaluate research methodologies andUnderstand and evaluate research methodologies andUnderstand and evaluate research methodologies andUnderstand and evaluate research methodologies and their their their their their their their their application;application;application;application;application;application;application;application;

11.11.11.11.11.11.11.11. Understand and apply the principles and practice ofUnderstand and apply the principles and practice ofUnderstand and apply the principles and practice ofUnderstand and apply the principles and practice ofUnderstand and apply the principles and practice ofUnderstand and apply the principles and practice ofUnderstand and apply the principles and practice ofUnderstand and apply the principles and practice of continuous continuous continuous continuous continuous continuous continuous continuous quality improvement;quality improvement;quality improvement;quality improvement;quality improvement;quality improvement;quality improvement;quality improvement;

12.12.12.12.12.12.12.12. Manage resource utilization effectively;Manage resource utilization effectively;Manage resource utilization effectively;Manage resource utilization effectively;Manage resource utilization effectively;Manage resource utilization effectively;Manage resource utilization effectively;Manage resource utilization effectively;

13.13.13.13.13.13.13.13. Utilize information resources effectively and applyUtilize information resources effectively and applyUtilize information resources effectively and applyUtilize information resources effectively and applyUtilize information resources effectively and applyUtilize information resources effectively and applyUtilize information resources effectively and applyUtilize information resources effectively and apply evidenceevidenceevidenceevidenceevidenceevidenceevidenceevidence--------based medicine to update their clinicalbased medicine to update their clinicalbased medicine to update their clinicalbased medicine to update their clinicalbased medicine to update their clinicalbased medicine to update their clinicalbased medicine to update their clinicalbased medicine to update their clinical practice;practice;practice;practice;practice;practice;practice;practice;




14.14.14.14. Communicate effectively with patients, families andCommunicate effectively with patients, families andCommunicate effectively with patients, families andCommunicate effectively with patients, families andhealthcare professionals;healthcare professionals;healthcare professionals;healthcare professionals;

15.15.15.15. Utilize resources to address domestic violence andUtilize resources to address domestic violence andUtilize resources to address domestic violence andUtilize resources to address domestic violence and other other other other

public health issues, including violence prevention;public health issues, including violence prevention;public health issues, including violence prevention;public health issues, including violence prevention;

16.16.16.16. Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of

professionalism;professionalism;professionalism;professionalism;

17.17.17.17. Demonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided in the the the the context of a larger healthcare delivery system bycontext of a larger healthcare delivery system bycontext of a larger healthcare delivery system bycontext of a larger healthcare delivery system by

effectively using system resources to support the careeffectively using system resources to support the careeffectively using system resources to support the careeffectively using system resources to support the care of of of of patients.patients.patients.patients.

14.14.14.14.14.14.14.14. Communicate effectively with patients, families andCommunicate effectively with patients, families andCommunicate effectively with patients, families andCommunicate effectively with patients, families andCommunicate effectively with patients, families andCommunicate effectively with patients, families andCommunicate effectively with patients, families andCommunicate effectively with patients, families and

healthcare professionals;healthcare professionals;healthcare professionals;healthcare professionals;healthcare professionals;healthcare professionals;healthcare professionals;healthcare professionals;

15.15.15.15.15.15.15.15. Utilize resources to address domestic violence andUtilize resources to address domestic violence andUtilize resources to address domestic violence andUtilize resources to address domestic violence andUtilize resources to address domestic violence andUtilize resources to address domestic violence andUtilize resources to address domestic violence andUtilize resources to address domestic violence and other other other other other other other other

public health issues, including violence prevention;public health issues, including violence prevention;public health issues, including violence prevention;public health issues, including violence prevention;public health issues, including violence prevention;public health issues, including violence prevention;public health issues, including violence prevention;public health issues, including violence prevention;

16.16.16.16.16.16.16.16. Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of Demonstrate the fundamental qualities of

professionalism;professionalism;professionalism;professionalism;professionalism;professionalism;professionalism;professionalism;

17.17.17.17.17.17.17.17. Demonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided inDemonstrate how optimal patient care is provided in the the the the the the the the

context of a larger healthcare delivery system bycontext of a larger healthcare delivery system bycontext of a larger healthcare delivery system bycontext of a larger healthcare delivery system bycontext of a larger healthcare delivery system bycontext of a larger healthcare delivery system bycontext of a larger healthcare delivery system bycontext of a larger healthcare delivery system by

effectively using system resources to support the careeffectively using system resources to support the careeffectively using system resources to support the careeffectively using system resources to support the careeffectively using system resources to support the careeffectively using system resources to support the careeffectively using system resources to support the careeffectively using system resources to support the care of of of of of of of of

patients.patients.patients.patients.patients.patients.patients.patients.


Who is an Emergency Physician ?WhWhoo is an Emergency Physicianis an Emergency Physician ??

� The Emergency Physician (EP)The Emergency Physician (EP)The Emergency Physician (EP)The Emergency Physician (EP) looks after patients looks after patients looks after patients looks after patients with a wide range of pathologies from the life with a wide range of pathologies from the life with a wide range of pathologies from the life with a wide range of pathologies from the life threatening to the self limiting in all age group.threatening to the self limiting in all age group.threatening to the self limiting in all age group.threatening to the self limiting in all age group.

� The EPThe EPThe EPThe EP is expert in establishing the diagnosis and is expert in establishing the diagnosis and is expert in establishing the diagnosis and is expert in establishing the diagnosis and differential diagnosis especially in life threatening differential diagnosis especially in life threatening differential diagnosis especially in life threatening differential diagnosis especially in life threatening situations.situations.situations.situations.

� The EPThe EPThe EPThe EP is able to identify the critically ill and is able to identify the critically ill and is able to identify the critically ill and is able to identify the critically ill and injured, provide safe and effective immediate care injured, provide safe and effective immediate care injured, provide safe and effective immediate care injured, provide safe and effective immediate care and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for definitive care. definitive care. definitive care. definitive care.

� The EPThe EPThe EPThe EP is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the practical procedures needed.practical procedures needed.practical procedures needed.practical procedures needed.

�� The Emergency Physician (EP)The Emergency Physician (EP)The Emergency Physician (EP)The Emergency Physician (EP)The Emergency Physician (EP)The Emergency Physician (EP)The Emergency Physician (EP)The Emergency Physician (EP) looks after patients looks after patients looks after patients looks after patients looks after patients looks after patients looks after patients looks after patients with a wide range of pathologies from the life with a wide range of pathologies from the life with a wide range of pathologies from the life with a wide range of pathologies from the life with a wide range of pathologies from the life with a wide range of pathologies from the life with a wide range of pathologies from the life with a wide range of pathologies from the life threatening to the self limiting in all age group.threatening to the self limiting in all age group.threatening to the self limiting in all age group.threatening to the self limiting in all age group.threatening to the self limiting in all age group.threatening to the self limiting in all age group.threatening to the self limiting in all age group.threatening to the self limiting in all age group.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP is expert in establishing the diagnosis and is expert in establishing the diagnosis and is expert in establishing the diagnosis and is expert in establishing the diagnosis and is expert in establishing the diagnosis and is expert in establishing the diagnosis and is expert in establishing the diagnosis and is expert in establishing the diagnosis and differential diagnosis especially in life threatening differential diagnosis especially in life threatening differential diagnosis especially in life threatening differential diagnosis especially in life threatening differential diagnosis especially in life threatening differential diagnosis especially in life threatening differential diagnosis especially in life threatening differential diagnosis especially in life threatening situations.situations.situations.situations.situations.situations.situations.situations.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP is able to identify the critically ill and is able to identify the critically ill and is able to identify the critically ill and is able to identify the critically ill and is able to identify the critically ill and is able to identify the critically ill and is able to identify the critically ill and is able to identify the critically ill and injured, provide safe and effective immediate care injured, provide safe and effective immediate care injured, provide safe and effective immediate care injured, provide safe and effective immediate care injured, provide safe and effective immediate care injured, provide safe and effective immediate care injured, provide safe and effective immediate care injured, provide safe and effective immediate care and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for and establish the diagnosis and initiate or plan for definitive care. definitive care. definitive care. definitive care. definitive care. definitive care. definitive care. definitive care.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the is an expert in resuscitation, skilled in the practical procedures needed.practical procedures needed.practical procedures needed.practical procedures needed.practical procedures needed.practical procedures needed.practical procedures needed.practical procedures needed.


� The EPThe EPThe EPThe EP safely and effectively differentiates and safely and effectively differentiates and safely and effectively differentiates and safely and effectively differentiates and places patients on care pathways which lead to places patients on care pathways which lead to places patients on care pathways which lead to places patients on care pathways which lead to appropriate discharge with follow up when needed appropriate discharge with follow up when needed appropriate discharge with follow up when needed appropriate discharge with follow up when needed / admission to an ED based observation unit or / admission to an ED based observation unit or / admission to an ED based observation unit or / admission to an ED based observation unit or admission into hospital.admission into hospital.admission into hospital.admission into hospital.

� The EPThe EPThe EPThe EP works in the difficult and challenging works in the difficult and challenging works in the difficult and challenging works in the difficult and challenging environment of the Emergency Department and is environment of the Emergency Department and is environment of the Emergency Department and is environment of the Emergency Department and is able to reable to reable to reable to re----prioritise and respond to new and urgent prioritise and respond to new and urgent prioritise and respond to new and urgent prioritise and respond to new and urgent situations.situations.situations.situations.

� The EPThe EPThe EPThe EP is part of a multiis part of a multiis part of a multiis part of a multi----disciplinary team where disciplinary team where disciplinary team where disciplinary team where good communication and inter personal skills are good communication and inter personal skills are good communication and inter personal skills are good communication and inter personal skills are essential. essential. essential. essential.

� The EPThe EPThe EPThe EP is able to work both within and lead a team is able to work both within and lead a team is able to work both within and lead a team is able to work both within and lead a team to ensure the patientto ensure the patientto ensure the patientto ensure the patient’’’’s needs are met.s needs are met.s needs are met.s needs are met.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP safely and effectively differentiates and safely and effectively differentiates and safely and effectively differentiates and safely and effectively differentiates and safely and effectively differentiates and safely and effectively differentiates and safely and effectively differentiates and safely and effectively differentiates and places patients on care pathways which lead to places patients on care pathways which lead to places patients on care pathways which lead to places patients on care pathways which lead to places patients on care pathways which lead to places patients on care pathways which lead to places patients on care pathways which lead to places patients on care pathways which lead to appropriate discharge with follow up when needed appropriate discharge with follow up when needed appropriate discharge with follow up when needed appropriate discharge with follow up when needed appropriate discharge with follow up when needed appropriate discharge with follow up when needed appropriate discharge with follow up when needed appropriate discharge with follow up when needed / admission to an ED based observation unit or / admission to an ED based observation unit or / admission to an ED based observation unit or / admission to an ED based observation unit or / admission to an ED based observation unit or / admission to an ED based observation unit or / admission to an ED based observation unit or / admission to an ED based observation unit or admission into hospital.admission into hospital.admission into hospital.admission into hospital.admission into hospital.admission into hospital.admission into hospital.admission into hospital.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP works in the difficult and challenging works in the difficult and challenging works in the difficult and challenging works in the difficult and challenging works in the difficult and challenging works in the difficult and challenging works in the difficult and challenging works in the difficult and challenging environment of the Emergency Department and is environment of the Emergency Department and is environment of the Emergency Department and is environment of the Emergency Department and is environment of the Emergency Department and is environment of the Emergency Department and is environment of the Emergency Department and is environment of the Emergency Department and is able to reable to reable to reable to reable to reable to reable to reable to re--------prioritise and respond to new and urgent prioritise and respond to new and urgent prioritise and respond to new and urgent prioritise and respond to new and urgent prioritise and respond to new and urgent prioritise and respond to new and urgent prioritise and respond to new and urgent prioritise and respond to new and urgent situations.situations.situations.situations.situations.situations.situations.situations.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP is part of a multiis part of a multiis part of a multiis part of a multiis part of a multiis part of a multiis part of a multiis part of a multi--------disciplinary team where disciplinary team where disciplinary team where disciplinary team where disciplinary team where disciplinary team where disciplinary team where disciplinary team where good communication and inter personal skills are good communication and inter personal skills are good communication and inter personal skills are good communication and inter personal skills are good communication and inter personal skills are good communication and inter personal skills are good communication and inter personal skills are good communication and inter personal skills are essential. essential. essential. essential. essential. essential. essential. essential.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP is able to work both within and lead a team is able to work both within and lead a team is able to work both within and lead a team is able to work both within and lead a team is able to work both within and lead a team is able to work both within and lead a team is able to work both within and lead a team is able to work both within and lead a team to ensure the patientto ensure the patientto ensure the patientto ensure the patientto ensure the patientto ensure the patientto ensure the patientto ensure the patient’’’’’’’’s needs are met.s needs are met.s needs are met.s needs are met.s needs are met.s needs are met.s needs are met.s needs are met.


� The EPThe EPThe EPThe EP is able to work closely with a wide variety is able to work closely with a wide variety is able to work closely with a wide variety is able to work closely with a wide variety of inof inof inof in----patient teams and with primary care and pre patient teams and with primary care and pre patient teams and with primary care and pre patient teams and with primary care and pre hospital clinicians.hospital clinicians.hospital clinicians.hospital clinicians.

� The EPThe EPThe EPThe EP is committed to the highest standards of is committed to the highest standards of is committed to the highest standards of is committed to the highest standards of care and of ethical and professional behaviour care and of ethical and professional behaviour care and of ethical and professional behaviour care and of ethical and professional behaviour within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the medical profession as a whole.within the medical profession as a whole.within the medical profession as a whole.within the medical profession as a whole.

� The EPThe EPThe EPThe EP is caring, empathetic, conscientious and is caring, empathetic, conscientious and is caring, empathetic, conscientious and is caring, empathetic, conscientious and practices medicine with out prejudice.practices medicine with out prejudice.practices medicine with out prejudice.practices medicine with out prejudice.

� The EPThe EPThe EPThe EP continually seeks to improve care by continually seeks to improve care by continually seeks to improve care by continually seeks to improve care by utilising up to date evidence, being committed to utilising up to date evidence, being committed to utilising up to date evidence, being committed to utilising up to date evidence, being committed to lifelong learning and being innovative. lifelong learning and being innovative. lifelong learning and being innovative. lifelong learning and being innovative.

� The EPThe EPThe EPThe EP’’’’ssss greatest sense of satisfaction comes greatest sense of satisfaction comes greatest sense of satisfaction comes greatest sense of satisfaction comes from ensuring that patients have received the right from ensuring that patients have received the right from ensuring that patients have received the right from ensuring that patients have received the right treatment at the right time and seeing them treatment at the right time and seeing them treatment at the right time and seeing them treatment at the right time and seeing them improve.improve.improve.improve.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP is able to work closely with a wide variety is able to work closely with a wide variety is able to work closely with a wide variety is able to work closely with a wide variety is able to work closely with a wide variety is able to work closely with a wide variety is able to work closely with a wide variety is able to work closely with a wide variety of inof inof inof inof inof inof inof in--------patient teams and with primary care and pre patient teams and with primary care and pre patient teams and with primary care and pre patient teams and with primary care and pre patient teams and with primary care and pre patient teams and with primary care and pre patient teams and with primary care and pre patient teams and with primary care and pre hospital clinicians.hospital clinicians.hospital clinicians.hospital clinicians.hospital clinicians.hospital clinicians.hospital clinicians.hospital clinicians.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP is committed to the highest standards of is committed to the highest standards of is committed to the highest standards of is committed to the highest standards of is committed to the highest standards of is committed to the highest standards of is committed to the highest standards of is committed to the highest standards of care and of ethical and professional behaviour care and of ethical and professional behaviour care and of ethical and professional behaviour care and of ethical and professional behaviour care and of ethical and professional behaviour care and of ethical and professional behaviour care and of ethical and professional behaviour care and of ethical and professional behaviour within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the specialty of Emergency Medicine and within the medical profession as a whole.within the medical profession as a whole.within the medical profession as a whole.within the medical profession as a whole.within the medical profession as a whole.within the medical profession as a whole.within the medical profession as a whole.within the medical profession as a whole.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP is caring, empathetic, conscientious and is caring, empathetic, conscientious and is caring, empathetic, conscientious and is caring, empathetic, conscientious and is caring, empathetic, conscientious and is caring, empathetic, conscientious and is caring, empathetic, conscientious and is caring, empathetic, conscientious and practices medicine with out prejudice.practices medicine with out prejudice.practices medicine with out prejudice.practices medicine with out prejudice.practices medicine with out prejudice.practices medicine with out prejudice.practices medicine with out prejudice.practices medicine with out prejudice.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP continually seeks to improve care by continually seeks to improve care by continually seeks to improve care by continually seeks to improve care by continually seeks to improve care by continually seeks to improve care by continually seeks to improve care by continually seeks to improve care by utilising up to date evidence, being committed to utilising up to date evidence, being committed to utilising up to date evidence, being committed to utilising up to date evidence, being committed to utilising up to date evidence, being committed to utilising up to date evidence, being committed to utilising up to date evidence, being committed to utilising up to date evidence, being committed to lifelong learning and being innovative. lifelong learning and being innovative. lifelong learning and being innovative. lifelong learning and being innovative. lifelong learning and being innovative. lifelong learning and being innovative. lifelong learning and being innovative. lifelong learning and being innovative.

�� The EPThe EPThe EPThe EPThe EPThe EPThe EPThe EP’’’’’’’’ssssssss greatest sense of satisfaction comes greatest sense of satisfaction comes greatest sense of satisfaction comes greatest sense of satisfaction comes greatest sense of satisfaction comes greatest sense of satisfaction comes greatest sense of satisfaction comes greatest sense of satisfaction comes from ensuring that patients have received the right from ensuring that patients have received the right from ensuring that patients have received the right from ensuring that patients have received the right from ensuring that patients have received the right from ensuring that patients have received the right from ensuring that patients have received the right from ensuring that patients have received the right treatment at the right time and seeing them treatment at the right time and seeing them treatment at the right time and seeing them treatment at the right time and seeing them treatment at the right time and seeing them treatment at the right time and seeing them treatment at the right time and seeing them treatment at the right time and seeing them improve.improve.improve.improve.improve.improve.improve.improve.

PATIENT CAREPATIENT CAREPATIENT CARE

� TriageTriageTriageTriage

� Primary assessment and stabilisation of life Primary assessment and stabilisation of life Primary assessment and stabilisation of life Primary assessment and stabilisation of life threatening conditionsthreatening conditionsthreatening conditionsthreatening conditions

� Focused medical history

� Secondary assessment and immediate clinical management

� Clinical decision makingClinical decision makingClinical decision makingClinical decision making

� Clinical documentationClinical documentationClinical documentationClinical documentation

� ReReReRe----evaluation and further management evaluation and further management evaluation and further management evaluation and further management

�� TriageTriageTriageTriageTriageTriageTriageTriage

�� Primary assessment and stabilisation of life Primary assessment and stabilisation of life Primary assessment and stabilisation of life Primary assessment and stabilisation of life Primary assessment and stabilisation of life Primary assessment and stabilisation of life Primary assessment and stabilisation of life Primary assessment and stabilisation of life

threatening conditionsthreatening conditionsthreatening conditionsthreatening conditionsthreatening conditionsthreatening conditionsthreatening conditionsthreatening conditions

�� Focused medical historyFocused medical history

�� Secondary assessment and immediate Secondary assessment and immediate

clinical managementclinical management

�� Clinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision making

�� Clinical documentationClinical documentationClinical documentationClinical documentationClinical documentationClinical documentationClinical documentationClinical documentation

�� ReReReReReReReRe--------evaluation and further management evaluation and further management evaluation and further management evaluation and further management evaluation and further management evaluation and further management evaluation and further management evaluation and further management

Clinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision makingClinical decision making

Clinical decision making includes:

� re-triage

� immediate care initiated in the ED

� definitive care

� planning for admission or discharge.

Clinical decision making includes:Clinical decision making includes:

�� rere--triagetriage

�� immediate care initiated in the EDimmediate care initiated in the ED

�� definitive caredefinitive care

�� planning for admission or discharge. planning for admission or discharge.

WHAT IS HOSPITAL EMERGENCY DEPARTMENT ?

WHAT IS WHAT IS HOSPITAL HOSPITAL EMERGENCY DEPARTMENT EMERGENCY DEPARTMENT ??

Organisational and functional unit within Organisational and functional unit within Organisational and functional unit within Organisational and functional unit within

the structure of multiprofile hospitalthe structure of multiprofile hospitalthe structure of multiprofile hospitalthe structure of multiprofile hospital

created for

performing medical treatment in every performing medical treatment in every performing medical treatment in every performing medical treatment in every health or life emergencyhealth or life emergencyhealth or life emergencyhealth or life emergency

Organisational and functional unit within Organisational and functional unit within Organisational and functional unit within Organisational and functional unit within Organisational and functional unit within Organisational and functional unit within Organisational and functional unit within Organisational and functional unit within

the structure of multiprofile hospitalthe structure of multiprofile hospitalthe structure of multiprofile hospitalthe structure of multiprofile hospitalthe structure of multiprofile hospitalthe structure of multiprofile hospitalthe structure of multiprofile hospitalthe structure of multiprofile hospital

created forcreated for

performing medical treatment in every performing medical treatment in every performing medical treatment in every performing medical treatment in every performing medical treatment in every performing medical treatment in every performing medical treatment in every performing medical treatment in every

health or life emergencyhealth or life emergencyhealth or life emergencyhealth or life emergencyhealth or life emergencyhealth or life emergencyhealth or life emergencyhealth or life emergency

HOSPITAL EMERGENCY DEPARTMENT

HOSPITAL EMERGENCY HOSPITAL EMERGENCY DEPARTMENTDEPARTMENT

PATIENTquick access to qualified

emergency care facilities

HOSPITALrational use of resources rational by law hospital

responsibility

PATIENTPATIENT

quick access to qualified quick access to qualified

emergency care facilitiesemergency care facilities

HOSPITALHOSPITAL

rational use of resources rational use of resources

rational by law hospital rational by law hospital

responsibilityresponsibility

INCREASES SAFETY OF:INCREASES SAFETY OF:INCREASES SAFETY OF:

DiagnosticsDiagnosticsDiagnosticsDiagnostics

EMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENTEMERGENCY DEPARTMENT

SegregacjaSegregacjaSegregacjaSegregacja

TRIAGETRIAGETRIAGETRIAGE

SegregacjaSegregacjaSegregacjaSegregacja

TRIAGETRIAGETRIAGETRIAGE

Resuscitation Resuscitation Resuscitation Resuscitation

areaareaareaareaDelayed Care Immediate Immediate Immediate Immediate ----Intensive CareIntensive CareIntensive CareIntensive Care

Hospital` other Departments

POLAND ACT ON NATIONAL MEDICAL RESCUE

( September, 2001

September, 2006 )

POLAND ACT ON NATIONAL MEDICAL RESCUE

( September, 2001

September, 2006 )

••Emergency DepartmentEmergency Department

--new unit in hospital structurenew unit in hospital structure

EMERGENCY DEPARTMENT

Structure and management

based on hospital units:

� department chairman

� head nurse

Basic duties

emergency medical care

Main partners

� hospital units

� hospital administration

� EMS

EMERGENCY DEPARTMENTEMERGENCY DEPARTMENT

Structure and managementStructure and management

based on hospital units:based on hospital units:

�� department chairmandepartment chairman

�� head nursehead nurse

Basic dutiesBasic duties

emergency emergency medical caremedical care

Main Main partnerpartnerss

�� hospital units hospital units

�� hospital hospital administratadministrationion

�� EMS EMS

DEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINE

Structure and management

based on medical school and on hospital

(Chair or Department of Emergency Medicine) :

head of chair,

department chairman,

head nurse

Basic duties

emergency medical care on referential level

education

research

system monitoring

DEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINEDEPARTMENT OF EMERGENCY MEDICINE

StStrructure and managementucture and management

based on medical school and on hospital based on medical school and on hospital

(Chair or Department of Emergency Medicine) :(Chair or Department of Emergency Medicine) :

head of chair, head of chair,

department chairman, department chairman,

head nurse head nurse

Basic dutiesBasic duties

emergency emergency medical care on referential level medical care on referential level

educationeducation

research research

system monitoringsystem monitoring

DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE

Education duties Academic curriculum for Emergency MedicineAcademic curriculum for Emergency MedicineAcademic curriculum for Emergency MedicineAcademic curriculum for Emergency Medicine:

Medical studentsNursesEM technicians

Postgraduate educationPostgraduate educationPostgraduate educationPostgraduate educationResidentsOther disciplines specialists

Health promotion Health promotion Health promotion Health promotion First aid ( lay public, volunteers, …)Qualified First AidersFirst Aid Instructors

DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE DEPARTMENT OF EMERGENCY MEDICINE

Education duties Education duties Academic curriculum for Emergency MedicineAcademic curriculum for Emergency MedicineAcademic curriculum for Emergency MedicineAcademic curriculum for Emergency MedicineAcademic curriculum for Emergency MedicineAcademic curriculum for Emergency MedicineAcademic curriculum for Emergency MedicineAcademic curriculum for Emergency Medicine::

Medical studentsMedical students

NursesNurses

EM technicians EM technicians

Postgraduate educationPostgraduate educationPostgraduate educationPostgraduate educationPostgraduate educationPostgraduate educationPostgraduate educationPostgraduate education

ResidentsResidents

Other disciplines specialistsOther disciplines specialists

Health promotion Health promotion Health promotion Health promotion Health promotion Health promotion Health promotion Health promotion

First aid (First aid ( lay publiclay public,, volunteers, volunteers, ……))

QuaQualilified First Aidersfied First Aiders

First First AAid id IInstrnstruuctors ctors

EM TEACHING DEPARTMENT ACCREDITATIONEM TEACHING DEPARTMENT ACCREDITATIONEM TEACHING DEPARTMENT ACCREDITATION

� Full profile hospital emergency department in: structure, staffing and function

� At least 2 specialists full time employed

� Being part of full profile teaching hospital

�� Full profile hospital emergency department Full profile hospital emergency department

in: structure, staffing and functionin: structure, staffing and function

�� At least 2 specialists full time employedAt least 2 specialists full time employed

�� Being part of full profile teaching hospitalBeing part of full profile teaching hospital

DUAL MISSION OF THE ACADEMIC DEPARTMENT

OF EMERGENCY MEDICINE

DUAL MISSION DUAL MISSION OF THE ACADEMIC DEPARTMENT OF THE ACADEMIC DEPARTMENT

OF OF EEMERGENCY MERGENCY MMEDICINEEDICINE

� The best art and practice of emergency medicine

� Fulfilling expectations in education

� Successful practice for patient satisfaction

�� The best art and practice of emergency The best art and practice of emergency

medicinemedicine

�� Fulfilling expectationFulfilling expectations ins in educationeducation

�� Successful practice for patient satisfaction Successful practice for patient satisfaction

ACADEMIC DEPARTMENT OF EMERGENCY MEDICINE

CHALLENGES FOR EDUCATION

ACADEMIC DEPARTMENT ACADEMIC DEPARTMENT OF OF EEMERGENCY MERGENCY MMEDICINEEDICINE

CHALLENGES FOR EDUCATIONCHALLENGES FOR EDUCATION

� High number of emergencies

� Flexible, problem orientated approach

� Reversible causes of emergencies immediately apparent to the students

� Wide spectrum of diagnoses

� Direct resource for training

�� High number of emergenciesHigh number of emergencies

�� Flexible, problem orientated approachFlexible, problem orientated approach

�� Reversible causes of emergencies immediately Reversible causes of emergencies immediately

apparent to the studentsapparent to the students

�� Wide spectrum of diagnosesWide spectrum of diagnoses

�� Direct resource for trainingDirect resource for training

ACADEMIC DEPARTMENT OF EMERGENCY MEDICINE

CHALLENGES FOR PATIENTS

ACADEMIC DEPARTMENT ACADEMIC DEPARTMENT OF OF EEMERGENCY MERGENCY MMEDICINEEDICINE

CHALLENGES FOR PATIENTSCHALLENGES FOR PATIENTS

� Referential level hospital

� Permanent supervision of consultants

� Higher number of personnel

� High quality of service

� Broaded medical documentation

�� Referential level hospital Referential level hospital

�� Permanent supervision of consultants Permanent supervision of consultants

�� Higher number of personnel Higher number of personnel

�� High quality of service High quality of service

�� Broaded medical documentationBroaded medical documentation

Białystok18.11.2005BiaBiałłystokystok18.11.200518.11.2005

COMPARISON of SOME EM INDICES

COMPARISON COMPARISON ofof SOME SOME EM INDICESEM INDICES

Number of ED

Number of ED

Number of EmergencyPhysicians

Number of EmergencyPhysicians

CountryCountry

USA (1998)USA (1998) 47504750 30 00030 000

UKUK 277277 2 4502 450

Belgium (1998)Belgium (1998) 154154 400400

Poland (2008)Poland (2008) 150150 620620(expected (expected –– 220)220)

http://http://www.medycynaratunkowa.wroc.plwww.medycynaratunkowa.wroc.pl

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