First Aid, Emergency Medicine and the situation we’re in!

Hey guys, Jarred again for another blog post. So as I said last time, I was to attend a first aid cause, and I did! It was an enjoyable night, and very informative for me, covering tons of procedures like: CPR (cardiopulmonary resuscitation), the recovery position, what to do if someone is choking and the signs of a heart attack. The evening used a series of videos followed by examples (from the man who hosted the course, who came from the charity FastAid, which is a valuable and deserving cause) and practicals, which made it extremely interactive and useful. This was so useful for my aspiration, as it is a perfect starting skill set to have and understand for a Doctor. However, this isn’t just some aside about WEX, but it also links in with todays topic; Emergency medicine and fast response to medical problems. Now, there are many aspects to emergency medicine, from fast response ambulance services to emergency Doctors in A&E departments in hospitals; this post will talk about what each aspect deals with, their methods and problems they face…

Firstly, what is the emergency branch of medicine: this is where Doctors or paramedics carry out the immediate assessment and treatment of patients who are critically ill or severely injured. These problems can range from injuries sustained in accidents to sudden illnesses like a heart attack or long-term but priority illnesses like cancer. Firstly, I shall address the process of a first response to a sudden emergency, the ambulatory emergency care service (also known as the ambulance service). So, the ambulance is called out to an emergency after a dial has been made to 999, if the accident or illness is seen as high enough concern. They often deal with problems which can be split into one of either trauma or medical. Trauma problems often include physical injuries, so car crashes, stabbings and brawls are among the main causes of an emergency call. With medical, incidents often include heart attacks, strokes and repercussions from shock. The method for the ambulance service uses a priority, coded, system: Category A Red 1 (no pulse and not breathing) will be responded to in 8 minutes, Category A Red 2 (strokes or fits) will be responded to in 9 minutes and with all other calls being handled in an average of 16.3 minutes. The methods deployed by paramedics at the scene will include CPR (Used when the patient no longer has a pulse in an attempt to prolong time before permanent brain damage), actions including those that stabilize bones (e.g. body boards and braces), administration of Intravenous fluids (IVs) and applying bandages to wounds in an attempt to stop serious bleeding. From this, we can see that emergency first aiders and paramedics provide a very useful first, emergency response to problems. The next step in the emergency treatment of patients are Accident and Emergency Departments at most hospitals, where seriously ill patients are taken by ambulances or even by people themselves. Here, nurses, paramedics and doctors trained especially in emergency care will be put in charge of your welfare, attempting to treat you to the best of their ability (there are often Consultant Doctors who oversee the whole team at the top of organisational chain). At A&E, they often treat a huge variety of illnesses and damage, with many physical problems such as severe bleeding and burns, persistant chest pains and allergic reactions, going hand in hand with problems like a loss of consciousness or acute confused states. These problems are all extreme emergencies, so the methods used are a huge variety, often corresponding with the problem in hand, so are hard to pin down. However, the patient will be assessed, and any treatment needed will follow.

So, what problems face these emergency services? Well, ambulance services face two major problems: 1)Major demand pressure while funding is cut and 2)Problems and violence at scenes of accidents. Problem 1 is a huge problem facing not only the ambulance service, but also the NHS as a whole (which I shall talk about in a later blog), as it means too little ambulances crews for too many emergency situations. There are purely not enough resources to go round, meaning that the ambulance crews often cannot reach incidents on time, or not at all. They are attempting to amend this by reducing the number of high priority calls, changing patient destinations and seeing what differences can be made to on site care, in an attempt to reduce time taken at emergencies and help with the major problem. Problem 2 however is more of a direct problem. Violence and hate towards ambulance crews is on a rise, with stats showing that the risk of non-fatal assault resulting in lost work time among paramedics is 0.6 cases per 100 workers a year; where the national average is about 1.8 per 10,000 workers. This cannot be allowed to happen, as those that are trying to save us are getting abused, putting them off their job and causing animosity. Next, the A&E department also face huge problems, with the main one being, yet again, too much demand and pressure on the service. The College of Emergency Medicine believes that 15%-30% of patients could be treated elsewhere, showing that over demand for A&E is a huge problem. There are not enough places, Doctors and resources to treat the huge number of patients which, according to Health Minister Anna Soubry,”have grown by a million in the last year.” Implications such as redirection of money and addition resources are being made in an attempt to solve the problem.

In conclusion, as you can see, the Emergency care and response that the NHS put out and support use a huge variety of methods, applying them to a massive diversity of problems and tasks. However, they face tons of problems, that, clearly are hard to solve. As you can tell, this is a huge part of a doctors life, and an important part of medicine, which will change greatly in the future.

Thanks for reading, I hope I have opened your eyes to something today, and you have learnt something.
Cheers Jarred.

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