The Evolution of Emergency Medicine

Chung, CH

doi:10.1177/102490790100800204

Cited by 10 publications

(16 citation statements)

References 24 publications

(32 reference statements)

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“…Reports identifying and describing violence and aggression in EDs have been produced for as long as EDs have existed. Emergency Medicine as a specialty typically dates from the 1960s in the UK9 and USA,10 and from the 1980s–1990s in parts of Asia and Europe 11,12. In other regions it is even more recently recognized as a specialty (India, parts of the Middle East and Africa)13–15 and so remains a relatively new field.…”

Section: Introductionmentioning

confidence: 99%

<p>Management of the aggressive emergency department patient: non-pharmacological perspectives and evidence base</p>

Richardson¹,

Ardagh²,

Morrison³

et al. 2019

OAEM

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IntroductionAggression in the Emergency Department (ED) remains an ongoing issue, described as reaching epidemic proportions, with an impact on staff recruitment, retention, and ability to provide quality care. Most literature has focused on the definition (or lack of) core concepts, efforts to quantify the phenomenon or provide an epidemiological profile. Relatively little offers evidence-based interventions or evaluations of the same.AimTo identify the range of suggested practices and the evidence base for currently recommended actions relating to the management of the aggressive Emergency Department patient.MethodsA meta-synthesis of existing reviews of violence and aggression in the acute health-care setting, including management of the aggressive patient, was undertaken. This provided the context for critical consideration of the management of this patient group in the ED and implications for clinical practice.ResultsAn initial outline of issues was followed by a systematic search and 15 reviews were further assessed. Commonly identified interventions are grouped around educational, interpersonal, environmental, and physical responses. These actions can be focused in terms of overall responses to the wider issues of violence and aggression, targeted at the pre-event, event, or post-event phase in terms of strategies; however, there is a very limited evidence base to show the effectiveness of strategies suggested.Clinical ImplicationsThe lack of evidence-based intervention strategies leaves clinicians in a difficult situation, often enacting practices based on anecdote rather than evidence. Local solutions to local problems are occurring in a pragmatic manner, but there needs to be clarification and integration of workable processes for evaluating and disseminating best practice.ConclusionThere is limited evidence reporting on interventional studies, in addition to identification of the need for high quality longitudinal and evaluation studies to determine the efficacy of those responses that have been identified.

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Section: Introductionmentioning

confidence: 99%

<p>Management of the aggressive emergency department patient: non-pharmacological perspectives and evidence base</p>

Richardson¹,

Ardagh²,

Morrison³

et al. 2019

OAEM

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“…Chung states, "Disaster preparedness and response are part and parcel of the basic curriculum of modern Emergency Medicine training." 3 Dr. C.C. Lau says, "In the United States, emergency physicians have sub-specialised in areas such as ... prehospital care."…”

Section: Introductionmentioning

confidence: 99%

Hazmat Emergency Preparedness in Hong Kong: What are the Dangerous Goods in Kowloon?

Walter¹,

Chan

Winegard³

et al. 2008

Hong Kong j. emerg. med.

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Hazmat emergency preparedness is critical, especially as Hong Kong prepares for major international events, such as the 2008 Olympic Equestrian Games. No published medical study has described the identities and quantities of dangerous goods (DG) in the Kowloon area and listed what antidotes are needed for these DG. This study describes what hazardous materials are most common in Kowloon to prioritise emergency preparedness and training. Materials & methods: Design: A descriptive, cross-sectional study. Setting: The Hong Kong Special Administrative Region, specifically Kowloon. Sample: The Hong Kong Fire Services Department (HKFSD) Dangerous Goods Database (DGD). Interventions: Descriptive statistical analyses with Stata 9.2. Chief outcome: Identifying and quantifying dangerous goods in the HKFSD DGD. Results: Most DG do not have antidotes. The most common DG with recognised antidotes are carbon monoxide, methylene chloride, fluorine, fluorides, fluoroboric acid, cyanides, nitriles, methanol, nitrobenzene, nitrites, and nitrates. The most common categories of DG are substances giving off inflammable vapours, compressed gases, and corrosive and poisonous substances. Conclusions: Hazmat emergency preparedness and training should emphasize these most common categories of DG. Disaster planning should ensure adequate antidotes for DG with recognised antidotes, i.e., oxygen for carbon monoxide and methylene chloride; calcium gluconate or calcium chloride for fluorine, fluorides, and fluoroboric acid; hydroxocobalamin for cyanides and nitriles; ethanol for methanol; and methylene blue for methaemoglobinaemia produced by nitrobenzene, nitrites, and nitrates. Supportive care is essential for patients exposed to hazardous materials because most dangerous goods do not have antidotes.

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“…Descrever e analisar criticamente o processo de trabalho da Central de Regulação conceito moderno de ambulância, que era chamada de "voadora" por ser leve e permitir o transporte ágil para fora do campo de batalha (CHUNG, 2001;POZNER et al, 2004;ROESSLER e ZUZAN, 2006).…”

Section: Objetivounclassified

“…A partir do final da década de 60, o escopo da atuação dos serviços de APH expandiu. A inclusão da assistência a pacientes com agravos clínicos se deu principalmente devido aos avanços tecnológicos na saúde, como a desfibrilação, cardioversão, novas terapias farmacológicas e a importância da ressuscitação cardiopulmonar em pacientes com morte súbita (CHUNG, 2001). É a partir desta década, que a era moderna dos serviços de atendimento pré-hospitalar iniciou, e os países começaram a desenvolver seus serviços como parte integrante de um sistema, criando legislação e regulamentação específicas.…”

Section: Referencial Teóricounclassified

“…Os avanços na Medicina de Urgência ocorridos na década de 60 fizeram com que alguns serviços introduzissem procedimentos avançados de suporte à vida no ambiente pré-hospitalar, com resultados imediatos benéficos. A experiência da Irlanda com a unidade móvel de cuidados cardíacos no tratamento a parada cardiorrespiratória (PCR) por meio de ressuscitação cardiopulmonar, desfibrilação e novos medicamentos, influenciou iniciativas similares nos Estado Unidos (CHUNG, 2001). Além disso, a volta de médicos militares da Guerra do Vietnam fez com que diversas técnicas avançadas utilizadas em soldados feridos fossem aplicadas em paciente civis (SHAH, 2006).…”

Section: O Modelo Anglo-americanounclassified

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O processo de trabalho da Central de Regulação do Serviço de Atendimento Móvel de Urgência - SAMU 192 do município de São Paulo

Fernandes¹

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Ao Prof. Tanaka que me acolheu nesta fase da vida e acreditou em mim. Obrigada, professor! À equipe do SAMU SP que contribuiu nas discussões e esclarecimentos preliminares. À minha família que, mesmo diante de dificuldades, permanece unida em vibração positiva. Rafa, Debs, Psita e Ri, amo vocês! Ao Renato Filev que me acompanha há algum tempo... tem amo e não me canso! À Brêtas que me contagiou e à Passarella que continua a me encher de inspiração. Gratidão, Aninha! À Beatriz, pela amizade eterna. Aos meus amigos que me ajudam a manter minha sanidade mental... Resumo FERNANDES. F.S.L. O processo de trabalho da Central de Regulação do Serviço de Atendimento Móvel de Urgência-SAMU 192 do município de São Paulo.

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The Evolution of Emergency Medicine

Cited by 10 publications

References 24 publications

<p>Management of the aggressive emergency department patient: non-pharmacological perspectives and evidence base</p>

<p>Management of the aggressive emergency department patient: non-pharmacological perspectives and evidence base</p>

Hazmat Emergency Preparedness in Hong Kong: What are the Dangerous Goods in Kowloon?

O processo de trabalho da Central de Regulação do Serviço de Atendimento Móvel de Urgência - SAMU 192 do município de São Paulo

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