International emergency medicine
From this point of view, international emergency medicine is better described as the training required for and the reality of practicing the specialty outside of one's native country.
Their interest is a result of improved healthcare, increasing urbanization, aging populations, the rising number of traffic fatalities, and heightened awareness of emergency medicine among their citizens.
In addition, emergency medicine is useful in dealing with time-sensitive illnesses, as well as improving public health through vaccinations, interventions, training, and data collection.
Included in those nations are some that are otherwise quite developed but lack a complete emergency medical system, such as Armenia, China, Israel, Nicaragua, and the Philippines.
[5] The United Kingdom, Australia, Canada, Hong Kong, and Singapore followed shortly thereafter, developing their respective emergency medicine systems in the 1970s and 1980s.
[8] Anderson et al. argue that, aside from acute care, emergency medicine can also play a significant role in public health.
Vaccinations for many diseases such as diphtheria, tetanus and pertussis can be administered by emergency departments, patients can be targeted for specific interventions such as counseling for substance abuse, and conditions like hypertension can be detected and treated.
Emergency departments are excellent locations to train health care providers and to collect data, because of the high number of patients.
[1] Jeffrey Arnold and James Holliman have criticized the use of these descriptors for emergency medical systems as an oversimplification and a needless source of controversy.
For instance, a cost–benefit analysis found that creating an EMS system in Kuala Lumpur that met U.S. standards for cardiac arrest response (85 percent of patients receive defibrillation within 6 minutes) would cost US$2.5 million and only save four neurologically intact lives per year.
The primary variable responsible for that result is the relatively young demography of Kuala Lumpur, meaning that comparatively few cardiac-related deaths occur.
Elements of both of the major conventional models have been incorporated, with the EMS system following French influences and the ambulances being staffed by physicians, while an American approach to emergency medical residency training is also present.
The process of development usually begins in academia and patient care, followed by administrative and economic concerns, and finally health policy and agendas.
[15] Given the limited resources of many developing nations, funding vitally effects how emergency medicine fits into the health system.
Preventive care is a crucial part of healthcare in developing countries, and it may be difficult to budget for emergency medicine without cutting into those resources.
Kobusingye et al. argue that expanding emergency medicine does not need to be unreasonably expensive, particularly if developing countries focus on low-cost but effective treatments administered by first responders.
[16] Hobgood et al. argue that one key component in equipping nations to develop emergency medical systems is to identify the aspects of training that are essential for health care providers.
[17] This initiative seeks to provide a minimum basic standard that can be tailored to the specific needs of the various nations implementing training in emergency medicine.
An assessment of the present status was performed that identified targets for improvement in physical plant organization and patient flow; staffing, staff education, equipment, medication and supplies; and infection control practices.
[21] Many new members have been accepted since the mid-1990s, when the IFEM decided to open up membership to other nations' emergency medicine organizations; the conference will rotate to them as well.
[23] To deal with this shortage of educational opportunities, Scott Weiner et al. suggest that countries with developed emergency medical systems should focus on training the trainers.
It works by sending developed country health care workers to equip a small group of trainees with the necessary skills to then go on and teach the concepts to others.
As such, it may be able to leverage the insights of developed emergency medical systems while remaining sustainable, as the newly trained trainers continue to spread the knowledge.
[25] In that year, Rescue 1122 was launched as a professional pre-hospital emergency service, and it has managed to achieve an average response time of 7 minutes, comparable to that of developed nations.
[25] The vital nature of coping with the lack of resources available in international emergency medicine may be seen in the proportion of scientific articles that grapple with the topic.
[26] A new dimension of thought is that of the isolated subject of technology for trauma care as published in the World Journal of Surgery by Mihir Shah et al.[27] Topics covered included the use of the Broselow tape as the best estimate for children's weight, green bananas as an effective treatment for diarrhea, and misoprostol as a potential alternative for postpartum hemorrhage when oxytocin is not available.
[26] Despite the thought that increasing availability to emergency medicine will improve patient outcomes, little empirical evidence exists to directly support that claim, even in developed countries.
Between 1985 and 1998 only 54 randomized controlled trials related to emergency medical services were published, implying that much of the current standard of care rests upon meager support.
[10] A similar lack of direct proof exists for the effectiveness of international assistance in promoting emergency medicine in other countries.
Although it may seem that such efforts must improve health, the failure to quantify international emergency medicine's impact renders it more difficult to identify the best practices and target areas in which the most benefit may be achieved.
