Emergency medicine for 25 Years in Iceland – history of the specialty in a nutshell

Abstract

After the early implementation of Emergency Medicine (EM) 25 years ago, Iceland became the first Nordic country to nationally realize the benefits of this specialty. However, the road has been rocky as in many other countries. The early years of EM in Iceland were characterized by a significant shortage of resources, particularly a lack of medical staff dedicated to EM and properly trained for the services required. The main task for the first couple of decades was to build the infrastructure of an operational emergency department based primarily on the model of EM. Although these efforts eventually led to a critical number of specialists becoming certified in EM, recruiting more people remains a priority in order to fully meet the need for specialty trained emergency physicians in Iceland. A key step towards achieving this goal was the initiation of a two-year residency program for specialty training in EM in year 2002. The program was based on a curriculum produced by the Icelandic Society for Emergency Medicine, which had been founded in year 2000. This training program is currently being redeveloped and the curriculum of the Royal College of Emergency Medicine in the UK will be adopted for use in Iceland. Another important milestone was the appointment of the first faculty member dedicated to EM at the University of Iceland. This created an opportunity to teach medical students EM and advance training at the graduate level. Also, conditions for scientific research in EM have been improved, following the establishment of an EM research institute in 2010.Other Nordic countries may be able to benefit from lessons learned and experiences gained from the development of emergency medicine in Iceland during the past quarter of a century.

Non-conveyance in the ambulance service: a population-based cohort study in Stockholm, Sweden

“… 23 Patients with psychiatric symptoms have generally been more common among the non-conveyance group 1 3 26 ; however, in our study, they were represented to a greater extent. Both patients with non-specific problems and patients with psychiatric symptoms were more common among non-conveyance compared with conveyance have; these two patient groups have previously been described as vulnerable 26 and patients with non-specific problems have been shown to have a greater risk of mortality once presented at the ED. 27 Furthermore, older patients are most often over-represented among this group of patients, and specialist nurse training curricula have been found to lack training in non-conveyance assessments, 17 raising questions regarding clinicians’ knowledge base for conducting non-conveyance assessments involving vulnerable patients.…”

Bioactive Nanofiber-Based Conduits in a Peripheral Nerve Gap Management—An Animal Model Study

“…Peripheral nerve injuries (PNI) are one of the most disabling components of traumatic injuries of extremities, especially traumatic hand injuries, and they may accompany 2.8–6.1% of cases [ 1 , 2 , 3 ]. Sequels of PNI concern sensory or motor malfunction of an injured limb, causing a severe decrease in quality of life.…”

Nerve Ultrasound in Traumatic and Iatrogenic Peripheral Nerve Injury

“…Peripheral nervous system (PNS) trauma is an infrequent but potentially debilitating disorder, that can have a profound impact on a patient’s wellbeing and functional abilities [ 1 ]. The overall incidence is estimated to occur in around 2–3% in patients presenting to major trauma centers globally [ 2 , 3 , 4 , 5 , 6 ], and amounts to about 13–23 per 100,000 persons per year [ 7 ]. Specific trauma mechanisms have a higher chance of injury to specific nerves, an example being the radial nerve that is affected to some degree in about 10% of the patients with a traumatic humeral shaft fracture.…”