Intro to Emergency Medicine

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By: HaroldJoh (11 month(s) ago)

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Presentation Transcript

Introduction to Emergency Medicine : 

1 Introduction to Emergency Medicine American College of Emergency Physicians

Lecture Objectives : 

A-2 Lecture Objectives Convey an understanding of the field of Emergency Medicine Discuss pros and cons of specialty Describe emergency medicine residency training Introduce EMRA and EM interest groups

History of Emergency Medicine : 

A-3 History of Emergency Medicine Emergency Departments Staffed by physicians of various backgrounds No specialty training American College of Emergency Physicians Established 1968 American Board of Emergency Medicine Formed 1979 Independent specialty 1988

Emergency Medicine Residency : 

A-4 Emergency Medicine Residency First “resident” - 1969 First residencies - 1970 University of Cincinnati Emergency Medicine Residents’ Association - 1974

Emergency Medicine Residency : 

A-5 Emergency Medicine Residency Emergency Medicine Residencies 1983 - 66 programs 1990 - 84 programs 2000 - 122 allopathic programs; 25 AOA programs Resident Positions in NRMP 1990 - 440 positions 2000 - 971 positions

Specialty Selection Top Ten Leading Causes of Death in the U.S. : 

A-6 Specialty Selection Top Ten Leading Causes of Death in the U.S. Heart Disease: 726,974 Cancer: 539,577 Stroke: 159,791 Chronic Obstructive Pulmonary Disease: 109,029 Accidents: 95,644 Pneumonia/Influenza: 86,449 Diabetes: 62,636 Suicide: 30,535 Nephritis, Nephrotic Syndrome, and Nephrosis 25,331 Chronic Liver Disease and Cirrhosis: 25,175

Patient Encounters : 

A-7 Patient Encounters Motor vehicle versus pedestrian accident Acute myocardial infarction 24 yo with GSW to chest 66 yo with CPR in progress

What’s Your Diagnosis ? : 

A-8 What’s Your Diagnosis ?

Patient Encounters : 

A-9 Patient Encounters 5 yo with Asthma 75 yo with Emphysema 45 yo alcoholic vomiting blood 3 week old with fever of 104 37 week pregnant female with vaginal bleeding

What’s Your Diagnosis ? : 

A-10 What’s Your Diagnosis ?

Patient Encounters : 

A-11 Patient Encounters 25 yo with a rash Spousal abuse Homeless patient with no other physician Back pain for 3 months Migraine headache

Employment Opportunities : 

A-12 Employment Opportunities Urban, rural, or suburban hospitals Teaching or community hospitals Traveling (Locum tenens) physicians International opportunities Third world opportunities Cruise ship

Appeal of Emergency Medicine : 

A-13 Appeal of Emergency Medicine Make an immediate difference Life threatening injuries and illnesses Undifferentiated patient population Challenge of “anything” coming in Emergency / invasive procedures Safety net of healthcare

Appeal of Emergency Medicine : 

A-14 Appeal of Emergency Medicine Team approach Patient advocacy Open job market Academic opportunities Shift work / set hours Evolving specialty

Downside to Emergency Medicine : 

A-15 Downside to Emergency Medicine Interaction with difficult, intoxicated, or violent patients Finding follow-up or care for uninsured Work in a “fishbowl” without 20/20 hindsight Working as a patient advocate

The Lifestyle:Two Sides of A Coin : 

A-16 The Lifestyle:Two Sides of A Coin Well defined shifts Usually not on call Part time employment possible Evenings and nights Weekends Holidays

Subspecialties in Emergency Medicine : 

A-17 Subspecialties in Emergency Medicine Pediatric Emergency Medicine Toxicology Emergency Medical Services Sports Medicine

Areas of Expertise : 

A-18 Areas of Expertise Toxicology Emergency medical services Mass gatherings Disaster management Wilderness medicine

Upcoming Areas of Emergency Medicine : 

A-19 Upcoming Areas of Emergency Medicine Hyperbaric medicine Observation units ED ultrasound International emergency medicine

Research Opportunities : 

A-20 Research Opportunities Broad range of subjects Limited amount of work published in our relatively new field Limited number of research mentors Limited number of clinical trials

Number of EM Physicians : 

A-21 Number of EM Physicians 4,945 Emergency Departments Need 32,000 - 37,000 ED physicians to staff In 2000, 20,164 ACEP members In 2000, 16,149 EM Board certified physicians

Emergency Medicine Organizations : 

A-22 Emergency Medicine Organizations American College of Emergency Physicians Society for Academic Emergency Medicine American Academy of Emergency Medicine Emergency Medicine Residents’ Association

Emergency Medicine Journals : 

A-23 Emergency Medicine Journals Annals of Emergency Medicine Academic Emergency Medicine Journal of Emergency Medicine American Journal of Emergency Medicine Pediatric Emergency Care

Emergency Medicine Residents’ Association : 

A-24 Emergency Medicine Residents’ Association Represents interests of EM residents and medical students Publishes EM Resident, a bi-monthly newsletter Publishes annual job catalog Publishes handbook for medical students

Emergency Medicine Residents’ Association : 

A-25 Emergency Medicine Residents’ Association Publishes Antibiotic handbook annually Airway management card Approximately 4,484 members

EMRA’s Medical Student Affiliate : 

A-26 EMRA’s Medical Student Affiliate Represents students with interest in EM Promotes awareness of issues facing EM Organizes annual Medical Student Forum Organizes a Residency Fair Aids in organizing EM interest groups

EM Interest Groups : 

A-27 EM Interest Groups Student run organization “Shadow Shifts” Journal club Suture clinic Radiology lab EKG clinic Lectures on EM topics

Emergency MedicineFirst and Second Year Students : 

A-28 Emergency MedicineFirst and Second Year Students Observe in ED Summer research projects with EM staff EM interest group affiliation Be open to any medical specialty

Emergency MedicineThird Year Students : 

A-29 Emergency MedicineThird Year Students See patients in ED on various rotations Obtain EM physician as mentor Start selecting fourth year rotations

Emergency MedicineFourth Year Students : 

A-30 Emergency MedicineFourth Year Students Mandatory/Elective EM rotation Consider extramural rotations Community experience Opportunity at a residency program SAEM maintains list of extramural EM rotations Letters of recommendation

Residency Programs : 

A-31 Residency Programs As of 2000: 122 allopathic programs; 25 AOA programs 1063 starting positions 971 resident positions in NRMP Training programs: PGY 1-3 (72%) PGY 2-4 (15%) PGY 1-4 (12%)

Combined EM Residency Programs : 

A-32 Combined EM Residency Programs Emergency Medicine / Pediatrics Emergency Medicine / Internal Medicine Emergency Medicine / Internal Medicine / Critical Care

Choosing A Specialty : 

A-33 Choosing A Specialty Fit your personality Decide between general or specialized field Look at all areas of interest Ignore gossip and commentary from outside the specialty you are investigating Commit to specialty you choose

American College ofEmergency Physicians : 

A-34 American College ofEmergency Physicians Member Services Department PO Box 619911 Dallas, TX 75261-9911 1-800-798-1822 Touch 5 www.acep.org

Emergency MedicineResidents’ Association : 

A-35 Emergency MedicineResidents’ Association 1125 Executive Circle Irving, TX 75038-2522 1-972-550-0920 www.emra.org