Emergency Medicine

Overview

Liu Baochi
Emergency Department
First Affiliated Hospital
Zhengzhou University
 Concept of Emergency
Medicine
• A discipline of medicine that deals with the
acute and life threatening aspect of medical
care. It emphasizes the recognition,
evaluation, care and disposition of patient.
• A new field related to multisystem disease.
• It benefits from almost any advance in
medical science.
• The characteristic is providing fast,
effective and better management for the
patient.
 Role of Emergency
Medicine
• To provide emergency life support for the
critical ill patients.
• To direct patients to appropriate sources of
continuing care.
• To provide disaster management when
there are massive casualties in the
community.
• To participate in pre-hospital care of
critical ill patients before they can be
transferred to emergency department.
• To provide continuously accessible
emergency services for the general public.
History of Emergency
Medicine
• Emergency medicine as a independent
discipline only 30 years.
• In 1984,Emergency Department set up in
some of large hospital in China.
• In 1986,China stipulated “120” for
emergency medicine.
• In May,1987, Emergency Medicine
Association was set up in China.
• It develops fast in recent 10 years.
 Field of Emergency
Medicine
1.Pre-Hospital Care
2.Resuscitation
3.Critical Medicine
4.Disaster Medicine
5.Trauma
6.Piosion
7.Administration of EMSS
 1.Prehospital
Care
EMSS refers to an organized
approach to the care of the
acutely ill patient during the
period of time between the
occurrence of the disease and the
arrival of the patient at the
hospital.
 2.Resuscitation
Clinical diagnosis of cardiac arrest
① loss of consciousness
② observation of no respiration
③ absent major pulses

Timing
Brain cell death occurs
4 to 10 minutes
after the circulation
stopped.
 Basic life support
Chain of Early Early Early Early
survival access CPR defibrilation Advanced care

Airwar
breath
circulatio
n
Cardiac arrest by
thunder

Resuscitation
In time
Complete
recovery
uccessfully Resuscitation after Hart beat stopped for 20 minutes
3.Critical Care Medicine
Critical care
is a important
part of emergency
medicine .special
trained doctors
and nurses with
advanced facility
in Intensive Care
Unit (ICU ） treat
severe ill
patients.
Severe acute pancreatitis
recovery
 4.Disaster
Medicine
An incident whereby the demand
for life saving and emergency
services exceed the normal
capacity of a single receiving
hospital.

Triage
Treatment
Transport
Important principle

Do the most for the most

Get the right patient to
the right place at the right
time

Communication
Co-ordination
Control
command
Zhengzhou
chengzai
disaster
Daping coal
mine gas
explosion
148 died
32
32
injury
injury
Xinan coal mine
Disaster
42 died
nzhou city 2005.1.29 firecraker Explosio
36 died. 48 injury
 5.traumatology
trauma constitute the third leading
cause of death over all ages and the
leading cause of death among
children, adolescents, and young
adults aged 1 to 44.

Timing

synthetical
Carotid artery injury Emergency operation
Damage control in trauma surgery
 6.Acute Poisoning

study difference kind of

acute poison. It resolves in
occupational disease,
toxicant, medico-legal . It
is a new discipline.
Poisonous
snake bit
7.Administration of
emergency medical
system
emergency information
net.
transformation equipment
and emergency care
installation.
training
research
Emergency Medicine Service
System

Emergency Emergency
Pre-hospital
department ICU
Zambia Medical
Deliverance
依托综合医院 整体优势

Emergency Department
the First Affiliated Hospital
Zhengzhou University
 Emergency doctor to
be
• Emergency medicine encompasses the immediate
decision making and action necessary to prevent
death or any further disability for patient in
health crisis.

• Very often emergency doctor need to start

treatment before establishing a diagnosis.
task of emergency
medicine

Good interpersonal
communication skill.
Clinical acumen for a focussed
approach to clinical evaluation.
Medicine is an art as well as a
science
Never say: “there is
nothing wrong with
you”.
If you don’t know what
to do—do nothing.
Consult you senior.
Abnormal vital signs
must be repeated and
explained.
Trust no one, believe
nothing(not even
yourself)
Learn from your
mistakes
Challenges of
emergency
medicine
All sorts of patients could
come in at any time
Any combination of case
may present together
Emergency doctor’s ability
The sharp eagles’s eyes
The brave lion’s heart
The tender lady’s hands
 救人一命胜造七级浮
屠
Saving man one life, better than
building seven-floor tower