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Introduction
Integrated systems of Emergency Medicine (EM) care did not exist prior to the 1960s. Pre‐hospital care meant little more than rapid transportation of patients to hospitals. The emergency room serves as a reception for patients coming to the hospital. There were also no organizations responsible for provision of high quality emergency medical care and to advance the science and art of its delivery. There were no specific training programs for physicians and nurses. Staffing within the emergency departments was distributed among physicians of various specializations and level of training. The end result was erratic emergency departments with dismal patient outcomes and minimal benefit to public health.
Forty years on, EM has evolved into a discipline with a unique set of cognitive, administrative and technical skills for managing all types of patients with acute illness or injury. The Emergency Department has transformed from a receiving room in the hospital to a focal point of clinical care and research on time‐sensitive medical conditions such as myocardial infarction, severe trauma, sepsis and stroke—all of which require early diagnosis and early initiation of definitive treatment. Delivery of EM care today has a structured training curriculum and is largely coordinated through integrated systems to allow continuity of emergency care from the community at the pre‐hospital level, and into emergency departments.
In 2011, Holliman et al. identified publications that supported the efficacy or value of EM as a medical specialty and of the clinical care delivered by trained emergency physicians. The review concluded that EM is a distinct and recognized medical specialty with its own specialist training programs (residencies), and there is supportive literature for the following statements:
- EM is an important key component for all national healthcare systems.
- EM and care rendered in emergency departments offer many efficiencies and cost effectiveness of care delivery within the broader healthcare system.
- EM and emergency departments can provide a number of effective Public Health and Preventive Medicine measures.
- EM residency training results in improved patient care in the ED.
- EM faculty can deliver high‐quality patient care and medical training, and are effective for patient safety.
- Trained emergency physicians can effectively and safely provide critical care and perform selected invasive procedures.
- Trained emergency physicians can safely and effectively manage trauma patients and perform...