This is a very interesting question, though very difficult to answer. A few
years ago a US physician from Florida was asked what the biggest problem of
doing EM in the states was; he replied "that the biggest problem of being an
Emergency Physician was that noone else understands what we really did".
The outcomes study for A+E conducted by Elinor Beattie produced few robust
outcome measures for our speciality. They were mostly process based.
Some would say that we should be defined in terms of urgency and need rather
than diagnosis or therapy.
Others would (and do) say that we are merely in place to fill the void left
by the lack of "true" specialists (if there were enough specialists around,
patients could go directly to them, A+E would be unnecessary). Not a view I
subscribe to as unrealistic.
Still others (and there a few on this list) would define us as specialists
in initial assessment, diagnosis and management.
Perhaps we are just what we do.
Simon
----- Original Message -----
From: "LAMBERT MIKE [RM1] Norfolk & Norwich University Hospital"
<[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, January 02, 2003 10:18 AM
Subject: What is A&E?
> Recent postings have raised questions about the role of our specialty-
>
> Between 11.30 and 0200, 31/12 - 01/03 our department dealt with a
> respiratory arrest due to asthma ( pH 6.6 pCO2 25), a collapsed pregnant
> woman who underwent immediate section to deliver the baby, an axillary
stab
> wound with shock and an ischaemic arm, and an anterior MI who received
> thrombolysis in A&E - later on there was an acute subdural transferred to
> the neurosurgical unit. All except the ~30/52 baby have survived so far. I
> haven't include the numerous drunks +/- HI etc.
>
> I don't claim this is "normal for Norfolk" or wish to start a "if you
think
> that was bad, we saw..." thread. My point is that while some colleagues
> will claim to be better at treating asthma, obstreticians can perform
neater
> c-sections, anaesthetists can resuscitate, surgeons can manage the stab
> wounds etc., it is the unique combination of skills, knowledge and
> attributes of those who practice A&E medicine (medical and nursing staff)
> that allow us to move seamlessly between these cases and deal with them as
> they come through the door. Of course we are grateful for the support we
can
> call upon from the other specialties, but those first few minutes and the
> breadth of our abilities ( if not always the depth of our knowledge) are,
> for me, what defines the core of our specialty.
>
> It was a hell of a night and it is helpful, to me, to be able to share it
> with you - thanks.
>
> Happy New Year!
>
> Mike Lambert
> A&E Consultant
> Norfolk & Norwich University Hospital
>
> Tel 01603 287316
>
>
>
> --------------------------------------------------------------------------
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