Introduction to Practicing Emergency Medicine

Introducing the practice of emergency medicine.

1. Introduction to Emergency Medicine Dr. Badar Al Hamrashdi, MD, ArBEM, OMSB-EM, ARDMS Consultant & Head Department of Emergency Medicine, Assistant Director of Medical and Paramedical affairs,Rustaq Hospital, Oman

2. Why it is special? - 24 hrs - All specialties. -Reversed equation in sick patient. - Priorities. - No routine - Shift work - Team based

3. case 24 years old male Car roll over vitals upon arrival:BP: 84/43 mmhg, P:136/m, RR:28/m,SpO2: 78% RA, T:36.8C Unconscious How to proceed?

4. Approach to sick patient Primary Assessment: evaluate and rule out life/limb threatening conditions Secondary Assessment Evaluate - Identify - Intervene

5. Primary Assessment Airway Breathing Circulation Disability Exposure

6. Airway Patent: Patient is verbal Snoring, gurgling or strider agitation may indicate hypoxia obtundation may indicate hypercarpia

7. Airway Manœuvres

8. Breathing Work of breathing RR Spo2 Chest expansion Auscultation

9. Circulation Cold extremities Capillary refill time < 2 sec Peripheral pulses BP Cardiac monitor

10. Circulation 2 large bore canula / Intra-osseus access. Intravenous fluid / blood products stop any bleeding FAST( Focused assessment sonography in trauma) Medications. Definitive treatment

11. Disability Glasgow Coma Scale A.V. P.U Pupils Dextrose(Blood Sugar)

12. Exposure Trauma injection marks rashes

13. Secondary Assessment SAMPLE history: Signs & symptoms, Allergies, Medications, PMH, Last meal, Event head to toe exam

14. Thank you

15. Triage To Sort Patients. ONSET: Oman National System for Emergency Triage ESI: Emergency Severity Index

16. ONSET Oman National System for Emergency Triage It is a 5- level scale Prioritise patients according to severity and resources required.

17. ONSET Oman National System for Emergency Triage

18. Thank you