International emergency medicine: Past and future

Abstract

Much has been written about the development of emergency medicine (EM) and its impact on the medical system as a whole. It is still described as 'new' and very much seen as a specialty that is evolving, rather than a static domain of knowledge and skills with rigid boundaries. In reality, the fundamentals of emergency treatment in mitigating the effects of acute illness and injury go back to ancient times.1 This is evidenced by descriptions of the urgent management of acute pain with analgesics, splinting of injured limbs, and more sophisticated procedures, such as the removal of kidney stones and craniotomies. The treatments at that time were limited, but the application of these skills brought relief to many people (and a little pain). The practitioners were generalists and did not limit themselves to emergency treatment alone.Over the past half-century, there has been an acceleration of development in emergency medical treatments and a massive explosion in emergency medical system enhancement. This has resulted in a unique body of knowledge and skills, with the evolution of a new medical specialty specific to the delivery of emergency medical care. It is worth reflecting on the drivers for EM specialisation, where the specialty has come from, and what we can expect as the complexity of medical care increases with technological innovation and social changes associated with increasing connectivity.

Emergency Medicine History and Expansion into the Future: A Narrative Review

“…13 Many factors have driven the successful growth of EM: the rise of hospital medicine; medical advances; improved transport; specialization of workforce; effective emergency treatments; efficiency and safety; and evidence-based medicine. 14 Emergency medicine is now practiced in greater than 50 countries using many different models. 15 Where our specialty has strong representation, outcomes improve for many illnesses: cardiac arrest; stroke; early analgesia; geriatric care; substance use treatment; psychiatric emergency care; and overall system efficiency.…”

“…15 Where our specialty has strong representation, outcomes improve for many illnesses: cardiac arrest; stroke; early analgesia; geriatric care; substance use treatment; psychiatric emergency care; and overall system efficiency. 14,16 As Peter Cameron asserts, "EM is a specialty for the 21 st century 14 " because of our strengths in systems thinking and evidence-based medicine.…”