Introduction to Emergency Medicine

In the “good old days” there used to be two rotations per year in UK Emergency Departments (ED) – August and February. Now we almost seem to have one continuous induction, with new doctors arriving every few months and new nurses starting all the time. 

Every time a new team of enthusiastic, bright eyed, ambitious medics is descend on our departments we have to see this as a chance to welcome this happy band into our beautiful world, where we heal the sick, laugh like the cast of Scrubs and all look like the cast of ER.

OK, so, I admit,  it’s not quite like that. In fact for doctors about to start work in the ED it can be a nervous and fearful time. Our esteemed British Press has been full of stories of the “Crisis in A&E” but we at St Emlyn’s want to reassure you that rather than being worried you can be excited as you enter what we believe is one of the most fulfilling jobs a medic can ever do. After all, working in an Emergency Department is the very embodiment of what being a doctor is all about.

We want to do all we can to help guide you through those first few days and weeks and so have devised an educational programme that you can use in conjunction with those provided by your own departments. We have recorded a series of podcasts on some of the more common “presenting complaints” and linked these to other resources. We are big (very big!) fans of online education and “FOAMed” (Free Open Access Medical Education). All of the sites we will recommend share this philosophy and each post will have links to some of the great resources available worldwide.

In this first post we are focusing on the approach to the patient in the ED, as this may differ somewhat from what you were taught at medical school.

To start have a listen to this podcast where Simon and I discuss the approach to the patient in the ED.

Hopefully, after listening you’ll have thoughts about the structure you might want to use when you approach a patient in the ED.

Top Ten Tips

Emergency Physicians generally have very short attention spans and love a list of “take home points” where others would prefer reams of prose. These are our top ten tips for success and happiness in the ED.

  1. Respect those around you and value their opinion
  2. The History is everything
  3. There are 4 key treatments we give in the ED – think whether every patient you see needs any of these and you will save lives and relieve pain
    1. Oxygen
    2. Fluids
    3. Analgesia
    4. Antibiotics
  4. Think ‘What difference have I made to this patient?’. Always try to make a difference, however small (it may “just” be getting them an extra blanket)
  5. No patient (almost) wants to be in the ED. They really don’t. It wasn’t what they planned for their day.
  6. Spend twice as long with patients you don’t like or don’t get on with.
  7. Look the part. Be smart. Behave in the way you would expect anyone to behave towards you.
  8. Be on time. Always. Ansd leave on time if at all possible.
  9. Take your breaks – eat when you can and drink water when you can’t.
  10. Enjoy yourself…

So lots to think about (and we’ve barely got started!) Please post any tips or comments you might have in the section below – we would love to hear from you. And welcome again to the most exciting specialty in medicine. It’s going to be a blast.

All best and good luck,


Other great resources

This is a fabulous e-book from the team at RCEM learning.

Cite this article as: Iain Beardsell, "Introduction to Emergency Medicine," in St.Emlyn's, July 23, 2014,

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Thanks so much for following. Viva la #FOAMed

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