----- Original Message -----
From: LAMBERT MIKE
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.
I think I would be speaking for many on this list if I said that Mike has
just described the essence of our specialty in a most captivating way. This
year we had an unusually quiet New Year's Eve, but they're normally a bit
like the foregoing description! I can identify with the US emergency
physician too Simon; my commonest question from non-medics is "so you're a
specialist then?" which I find difficult to answer.
No, I can't adequately describe what I do to non-medics, despite the recent
growth in popular television depicting our "trade", but I don't really care.
I certainly don't have the answer, and it probably doesn't much matter for
dinner-party small talk. However when the folks from the health authority
don't understand what we do, that's when I start to get worried!
Adrian Fogarty
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