UMEM Educational Pearls

Title: Tearing down the Tower of Babel

Keywords: International, health systems, acute care, services (PubMed Search)

Posted: 12/31/2013 by Andrea Tenner, MD (Updated: 1/1/2014)
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Background Information: While the concept of Emergency Medicine is fairly well understood in the United States, it is less clear in countries where the concept is not as well established. This has caused quite a bit of confusion and hindered progress and collaboration.

Pertinent Study Design and Conclusions: In a recent consensus conference held at SAEM several definitions were standardized.

Acute Care: all promotional, preventive, curative, rehabilitative, and palliative actions, whether oriented toward individuals or populations, whose primary purpose is to improve health and whose effectiveness depends largely on time-sensitive and frequently rapid intervention.
Emergency Medicine: a named field of specialty practice for which formal training prepares a candidate whose competence is officially standardized and regulated (thus EM is a subset of acute care)
Emergency services: the sum of all efforts to deliver effective health action in response to extreme risk under intense time pressure
Emergency care: the subset of emergency services focused on delivery of curative interventions targeting severe clinical cases

Bottom Line:

It is imperative that the same terminology be used when discussing the delivery of care on a time-sensitive basis.

University of Maryland Section of Global Emergency Health

Author: Andi Tenner, MD, MPH, FACEP

References

Calvello EJB, Broccoli M, Risko N et al. Emergency care and health systems: consensus-based recommendations and future research priorities. Academic Emergency Medicine. 2013. 20(12): 1278-1288.

Hirshon JM, Risko N, Calvello EJ, et al. Health systems and services: the role of acute care. Bull World Health Organ. 2013. 91:386-388.