A & E

Recently I was lucky enough to attend a lecture on A & E (accident and emergency) at my college and have written this article on this particular side of medicine.

The emergency departement (or accident and emergency department) is a typical mecial treatment facility specializing in the care of patients without prior appointments or those requiring urgent attention due to accidents or injuries. Due to this fact the department must provide initial treatment for a broad range of illnesses and injuries some which may be life threatening and require immediate medical attention, such as loss of consciousness, acute confused state and fits, persistent, severe chest pain, breathing difficulties and severe bleeding that cannot be stopped.

Upon admittance into the hospital the patients undertake triage, which is typically the first stage the patient is passed through and conisists of a set of vital signs and the assessment of the chief complaint. In both cases of an unconscious or conscious patient the doctor or nurse follows a simple code of ABCDE whereby vital signs of the patient are checked to ensure their safety. The letters stand for airway, breathing, circulation, disability and environment with decreasing urgency as you move down (i.e. constricted airways are more dangerous that circulation or disability). Airways being a priority are checked first and can be checked by simply tilting the head backwards to check the air passage is open. This is followed by a check on the breathing of a patient, primarily to find out if the patient is making normal respiratory efforts. After checking oxygen can be delivered to the lungs by a clear airway and efficient breathing, circulation is checked by simply taking the pulse rate of the patient to ensure that blood is being effectively pumped around the body. Disbality is checked next to check if it has been cause by the injury or if the patient has any pre existing conditions. E the finally check is to ensure the environment is safe for the patient.

After the first check the patient can then be passed onto other departments of areas with their waiting time being determined by the seriousness of the injury and their clinical need. Fast decisions on life and death cases are often critical in hospital emergency rooms as a result doctors face great pressure in treating and caring for the over 21 million attendances at accident and emergency departments each year, across the UK.