Emergency medical services originated in the funeral industry, then moved to police officers, and finally onto its own specialty with ambulances, emergency rooms, and trained staff.
If you have ever been in an accident, or needed to make a trip to the emergency room, you already have a high regard for emergency medical services. Andrew Nugent, MD, interim head of the Department of Emergency Medicine and of the Emergency Treatment Center at University of Iowa Hospitals and Clinics, talks about emergency medicine:
How many people are seen in the emergency room at University of Iowa Hospitals and Clinics on any given week?
Right now we're seeing about 1,000 patients per week.
What makes the Emergency Treatment Center (ETC) at UI Hospitals and Clinics different from other emergencies rooms in the area?
I think the first major difference is that we're an academic center—we have a residency program. Residents are doctors in training and we're training them to go out and work in emergency rooms across the state.
The second is that we have substantial backup in our facility. We have services that really aren't available at other places. Being a level 1 trauma center, for instance, we have neurosurgical backup that may not be available at other hospitals.
Does the ETC at UI Hospitals and Clinics have a different procedure in place for handling children in the emergency room?
We have a special care area for our children. In fact, our pediatric emergency care was recently ranked at number five in the country by Parents magazine and we're pretty proud about that.
No one plans to visit an emergency room. Typically, what prompts an emergency room visit?
People have a lot of different motivations. Some people choose an ER visit because it's just easier to get into the emergency room than to see their own physician. Others haven't seen a doctor in years and really don't know where else to go. Almost everyone has a personal definition of what is an emergency, and I can tell you as a father of four that that changes when you're talking about someone other than yourself.
How do patients generally arrive at the ETC?
The vast majority of our patients come to the front door on their own power. We get about 25 to 30 percent that come in by ambulance or helicopter.
What prompts the AirCare helicopter to travel rather than a ground ambulance when transporting a patient to the Emergency Treatment Center?
I think you have to note that AirCare really has two missions:
- Rapid transport over long distances. In a state like Iowa, getting from point A to point B very quickly is important.
- Having highly trained nurses at remote locations where they're often the most experienced people to take care of an emergency.
Once a patient arrives in the ETC, what happens?
Again, it depends a little bit how sick they are. People who walk in off the street are evaluated by a triage nurse, who probably has the toughest job in health care. That nurse determines who needs help right now and who can wait a bit.
Most patients are evaluated by a team including a resident and staff member. They're going to do what is necessary to make sure that emergency conditions are taken care of. Trauma patients are handled a bit differently. We have an entire team of physicians, nurses, and support people who meet the patient and emergency conditions can be handled straight away.
How important is 'time' in any emergency?
It depends on the nature of the emergency. Patients with heart attacks, for example, are going to do a lot better if we can get the artery opened within 90 minutes. Trauma patients who are bleeding to death are going to do a lot better if we get to them in what's called the golden hour.
Survival is a lot better if they get treatment within that first 60 minutes. |
