The monopolisation of emergency medicine in Europe: the flipside of the medal.

  title={The monopolisation of emergency medicine in Europe: the flipside of the medal.},
  author={Edoardo De Robertis and Bernd W. B{\"o}ttiger and Eldar S{\o}reide and Jannicke Mellin-Olsen and Lorenz G. Theiler and Kurt Ruetzler and Jochen Hinkelbein and Luca Brazzi and Karl-Christian Thies},
  journal={European Journal of Anaesthesiology},
Over the past 20 years, emergency medicine has evolved as an independent medical speciality in Europe. This development was mainly driven by poor access to primary care for patients with acute conditions and a shortage of medical specialists to look after patients presenting to emergency departments out of hours. The introduction of emergency medicine has certainly improved access to care in countries where both factors hampered timely provision of emergency care. However, for countries in… 

Cooperation in emergency medicine in Europe: the bright side of the medal.

The development of emergency medicine as a specialty occurred in the same manner as any other medical specialty – as a natural and logical result of the changing medical and organizational needs of

Reply to: collaboration in emergency medical care in Europe: the ten principles of CRitical Emergency Medicine (CREM).

Emergency Medicine does not aspire to monopolise emergency medical care and welcomes collaboration with, and the expertise of, colleagues in a range of specialties during those crucial first hours.

Professionalisation rather than monopolisation is the future of emergency medicine in Europe

It is doubted whether emergency medicine as an independent specialty can support the required skills or the necessary pathway continuity, as pointed out by Dr Buscher.

Emergency medicine is about collaboration, not monopolisation.

From the Division of Drug Research, Department of Medical and Health sciences, Faculty of Health Sciences, Linköping University (DW), Department of Emergency Medicine, Local Health Care Services in Central Östergötland (DW) and Department of Anaesthesiology and Intensive Care in Link Öping (MC).

Critical emergency medicine and the resuscitative care unit

It is proposed that implementation of critical care services in the ED can negate this effect of increased ED stay due to intensive care unit (ICU) overcrowding, and establishment of evidence-based protocols and a multidisciplinary approach in patient management are of major importance.

Reply to: emergency medicine is about collaboration, not monopolisation.

This paper supports rotations between specialties and common educational activities, such as high-fidelity simulation and would like to see more productive collaboration between the specialties, in which initiatives such as CREM could serve as a common platform for development.

Reply to: professionalisation rather than monopolisation is the future of emergency medicine in Europe.

From the Department of Anaesthesia and Pain Medicine, Birmingham Children’s Hospital, Birmingham, UK (K-CT), Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of

Collaboration in emergency medical care in Europe: the patient is the winner.

Airway skills that can be learned on a ‘rotation in the operating room’, as Hautz et al. suggest, can be neither acquired nor maintained in the ED or the prehospital environment.

Reply to: who takes the lead in critical illness?

It is not clear to me if the alternative model (coined as a longitudinal system) – in which the primary specialties are taking the lead – does not present similar problems.

Airway management procedures in Swedish emergency department patients - a national retrospective study

The frequency of invasive airway management procedures in Swedish EDs is low, with approximately 1.9 million adult ED visits per year, which gives an estimated incidence of 2.4 invasive airways management procedures per thousand ED visits in 2017.



Core curriculum in emergency medicine integrated in the specialty of anaesthesiology.

Anaesthesiologists, for their knowledge, skills and expertise, have been playing a key role in the development of emergency medicine. In many countries, anaesthesiologists are today fully involved in

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The risk of a too wide or vague emer gency medicine definit ion is that emergen cy situation s, which can abruptly deteriorate and requ ire im mediate (minu tes) intervent ion to avoid death or disa bility and disease areas of medici ne wher e only initial care is needed.

Severe head injury in children: emergency access to neurosurgery in the United Kingdom

The system of care for severely head injured children in the UK does not achieve surgical evacuation of a significant haematoma within four hours, and the recommendation to use specialist regional paediatric transfer teams delays rather than expedites the emergency service.

Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries

Most North, West, and Central European countries used p-PCI for the majority of their STEMI patients, and the lack of organized p- PCI networks was associated with fewer patients overall receiving some form of reperfusion therapy.

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