| What is Emergency Medicine and Emergency Care? |
| Emergency Medicine is the evolving speciality that defines the practice of medicine in Emergency Departments (previously known as Casualty or Accident and Emergency). It developed when it became apparent that people coming to Emergency Departments (potentially the most unwell and complex patients) needed the attention of experts and not unsupervised junior doctors. Emergency Medicine requires an ability to manage people with a wide variety of conditions while also possessing a high level of skill in both resuscitation and initial diagnosis. While the term Emergency Care covers the practice of Emergency Medicine it also includes other aspects of the management of unwell or injured persons such as first aid, rescue and pre-hospital care and covers Emergency Care Foundation’s future research into all aspects of emergency care. |
| Why have a foundation? |
| Supposing you, or a loved one, suffered from a sudden illness or injury and found yourself in the Emergency Department, would you want quick access to well trained doctors and nurses, a rapid and accurate diagnosis with prompt delivery of the right treatment without unnecessary tests and intrusive exploration? To date there has been limited research into the many facets of emergency care. Unfortunately neither hospitals nor health boards are equipped to fund this. Whilst hospitals in particular adopt standards highlighted through research findings they have a limited capacity to explore new ideas. Their role is to ‘manage’ an Emergency Department. The Emergency Care Foundation’s focus is instead on ‘leadership’ in Emergency Care and answering unsolved questions to benefit all practitioners. To this end Emergency Care Research Foundation will seek funding from such bodies as the Health Research Council and the Canterbury Medical Research Foundation. However these organizations approve approximately only 10% of applications based mainly on laboratory based research. Emergency Care competes with many well-established research disciplines with decades of well-resourced research. The Emergency Care Foundation has done research to date which has taken enormous effort within a difficult environment. This is due to the provision of appropriate service to patients in Emergency Departments overriding almost every other peripheral activity. Appropriate fundingl allows a capacity (on the floor, 24 hours a day, 7 days a week) so that research can occur without impacting on the demands of the service. |
| Emergency Care Foundation's Core Goals |
| Our research will be published and presented in a variety of forums to ensure that emergency care is the best it possibly can be. It will focus upon five important goals. • Establish solutions to the problems of people accessing appropriate Emergency Care. This research will specifically examine methods of reducing waiting times and overcrowding in Emergency Departments. • Undertake research leading to improvements in diagnostic accuracy and decision making in emergency care, particularly in relation to conditions which can be difficult to diagnose (heart disease, blood clots in the legs and lungs and infections like meningitis). • Improve knowledge about the best way to manage a variety of emergency conditions. • Initiate research leading to advancements in relation to ethical decision-making in emergency care. • Improve access to emergency care for all those who might need it and improve the diagnostic and decision-making accuracy of doctors and nurses working in emergency care. |
| What has Emergency Care Foundation achieved so far? |
| Members of Emergency Care Foundation have contributed more than 50 publications to world-renowned medical journals, plus many other more general publications, as well as numerous presentations to various medical and non-medical groups. A direct consequence of this activity has been the improvement of access to, and accuracy of, emergency care in New Zealand. One example of this was the New Zealand Medical Journal publication (and feature at conferences) of findings from research into the potentially dangerous and often-unnecessary interventions such as stomach ’wash-outs’ for patients poisoned by drugs. This resulted in a change in practice in Emergency Departments throughout the country. Similarly patients with possible deep venous thrombosis (blood clot in the leg) or pulmonary embolus (blood clot in the lung) now have a diagnostic algorithm in Christchurch to ensure the most pertinent signs and symptoms are given due weight in decision making. The algorithms are a direct consequence of ongoing research by Emergency Care Foundation in this area. Ethical decision making in emergency care is another area to benefit from research. People suffering an emergency illness or injury often find themselves in a position where it is difficult to exercise their right to determine which medical interventions they receive. Providers of emergency care have found the application of medical ethics in this area to be particularly difficult. The presentation of an ‘Ethics Toolkit for Emergency Care’ by Professor Ardagh has offered great assistance and has featured at conferences in New Zealand, Australia and the United Kingdom. |
What does Emergency Care do?
