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Emergency medicine (EM) stands in the centre of interest of healthcare systems all over Europe. The society, politicians and healthcare workers recognise this field of medicine as of utmost importance for the community, for obvious reasons. Emergency care is an important cornerstone of medicine because every human can expect professional help in the event of an acute illness or injury. The acuity of disease development explains the need for time-conscious emergency care that secures patients lives, well-being and further independent life. Thus all European state governments have strong interests in offering their society a well-organised, efficient and solid system of emergency care. Patients appreciate emergency departments as a continuously available source for highly professional medical care all over Europe. They expect high safety, immediate and passionate care, timely diagnosis and appropriate treatment.
For this reason, emergency care is centralised in emergency departments in many countries. Emergency nursing and EM are highly developed and professionalised fields. These are conveyed to specifically educated personnel in most, but not all, European countries. While EM is recognised as a full medical specialty in most European nations, some including Spain, Germany or Austria, have a less developed specialisation in EM. The European Society of Emergency Medicine (EUSEM), which is the umbrella organisation of the national EM societies, having more than 40,000 members, believes that EM deserves a European qualification standard: EM should be performed by skilled nurses and doctors who have received a standardised specialist training and are fully recognised specialists in the field of EM, which covers both pre-hospital and hospital emergency care.
In recent years, EM healthcare workers have been facing specific challenges. Obviously, terrorist attacks are potential threats to communities that need specific preparation. This is mainly organised in close cooperation with EM specialists. In the past, disaster medicine (DM) has become a very prominent field in EM, and EUSEM is actively supporting training in DM by specific courses at the annual congress, which is mainly organised by the Section of Disaster Medicine of EUSEM.
Every year, influenza spreads through Europe. In 2017 it caused a severe healthcare crisis in some countries due to the number of affected patients, who entered the hospital severely ill. The hospitals were massively overcrowded and the numbers of medical workers were reduced because they were infected by influenza themselves. These weeks of epidemic influenza were extremely stressful for the emergency department teams, and the departments learned once again that specific strategies against overcrowding need to be developed in every hospital. These organisational tasks, as well as the art to motivate a team in order to maintain high work commitment even under difficult conditions, are key roles of emergency department leaders. Strategies to become a professional leader in EM are also covered extensively at the annual EUSEM conference and are also central topics of the work of the EUSEM professional committee.
New standards, new developments
At the centre of EM is the provision of every immediate life-saving procedure; this needs to be performed professionally to save patients’ lives and to guarantee stabilisation for further diagnostic and therapeutic work-up. Life support is continuously taught to EM team members in every ED both to guarantee patient safety and to ensure that the ED team performs these procedures securely and with confidence. ‘Teach the teacher’ and support of young emergency doctors are additional cornerstones of EUSEM’s work and are also extensively covered in the EUSEM congresses either through the educational committee or the Young EM Doctors section.
Finally, EM is developing quickly all over the world and new standards have been achieved in the recent years. Non-invasive ventilation, point of care ultrasound, point of care laboratory tests have helped to increase the efficiency of emergency care. To interact in the development and the scientific evaluation of new techniques and strategies is another central interest of the physicians who collaborate under the patronage of EUSEM. This is evidenced by the development of the European Journal of Emergency Medicine, which has dynamically improved in quality and impact over the last years. International exchange on new scientific knowledge and new developments is an urgent need for EM physicians. EUSEM congresses and the EUSEM sections offer a vivid platform for a European-wide exchange that is extremely helpful. The European perspective on EM, with its diversity resulting in different answers to similar questions, allows the collection of a wide range of experience in every field of EM.