Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS.
Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thirst. This may be followed by confusion, unconsciousness, or cardiac arrest, as complications worsen.
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of patients who present without prior appointment; either by their own means or by that of an ambulance. The emergency department is usually found in a hospital or other primary care center.
A trauma center, or trauma centre, is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emergency department without the presence of specialized services to care for victims of major trauma.
Internal bleeding is a loss of blood from a blood vessel that collects inside the body, and is not usually visible from the outside. It can be a serious medical emergency but the extent of severity depends on bleeding rate and location of the bleeding. Severe internal bleeding into the chest, abdomen, pelvis, or thighs can cause hemorrhagic shock or death if proper medical treatment is not received quickly. Internal bleeding is a medical emergency and should be treated immediately by medical professionals.
Neurogenic shock is a distributive type of shock resulting in hypotension, often with bradycardia, caused by disruption of autonomic nervous system pathways. It can occur after damage to the central nervous system, such as spinal cord injury and traumatic brain injury. Low blood pressure occurs due to decreased systemic vascular resistance resulting from loss of sympathetic tone, which in turn causes blood pooling within the extremities rather than being available to circulate throughout the body. The slowed heart rate results from a vagal response unopposed by a sympathetic nervous system (SNS) response. Such cardiovascular instability is exacerbated by hypoxia, or treatment with endotracheal or endobronchial suction used to prevent pulmonary aspiration.
A medical director is a physician who provides guidance and leadership on the use of medicine in a healthcare organization. These include the emergency medical services, hospital departments, blood banks, clinical teaching services, and others. A medical director devises the protocols and guidelines for the clinical staff and evaluates them while they are in use.
Advanced trauma life support (ATLS) is a training program for medical providers in the management of acute trauma cases, developed by the American College of Surgeons. Similar programs exist for immediate care providers such as paramedics. The program has been adopted worldwide in over 60 countries, sometimes under the name of Early Management of Severe Trauma, especially outside North America. Its goal is to teach a simplified and standardized approach to trauma patients. Originally designed for emergency situations where only one doctor and one nurse are present, ATLS is now widely accepted as the standard of care for initial assessment and treatment in trauma centers. The premise of the ATLS program is to treat the greatest threat to life first. It also advocates that the lack of a definitive diagnosis and a detailed history should not slow the application of indicated treatment for life-threatening injury, with the most time-critical interventions performed early.
A trauma team is a multidisciplinary group of healthcare workers under the direction of a team leader that works together to assess and treat the severely injured. This team typically meets before the patient reaches the trauma center. Upon arrival, the team does an initial assessment and necessary resuscitation, adhering to a defined protocol.
The University of Maryland Medical System (UMMS) is a private, not-for-profit corporation founded in 1984 and based in Baltimore, Maryland. As of 2023, it owns and operates 11 hospitals in Maryland, 4 free-standing emergency rooms and over 150 care locations, including a network of urgent care centers. The System has more than 2,400 licensed beds, 100,000 annual admissions and gross patient revenues of $4.86 billion annually. University of Maryland Medical System medical staff work with University of Maryland School of Medicine specialists to provide primary and specialty care across the state.
R Adams Cowley Shock Trauma Center is a free-standing trauma hospital in Baltimore, Maryland and is part of the University of Maryland Medical Center. It was the first facility in the world to treat shock. Shock Trauma was founded by R Adams Cowley, considered the father and major innovator of trauma medicine.
A gunshot wound (GSW) is a penetrating injury caused by a projectile from a gun. Damage may include bleeding, bone fractures, organ damage, wound infection, loss of the ability to move part of the body, and in severe cases, death. Damage depends on the part of the body hit, the path the bullet follows through the body, and the type and speed of the bullet. Long-term complications can include bowel obstruction, failure to thrive, neurogenic bladder and paralysis, recurrent cardiorespiratory distress and pneumothorax, hypoxic brain injury leading to early dementia, amputations, chronic pain and pain with light touch (hyperalgesia), deep venous thrombosis with pulmonary embolus, limb swelling and debility, and lead poisoning.
R Adams Cowley was an American surgeon considered a pioneer in emergency medicine and the treatment of shock trauma. Called the "Father of Trauma Medicine", he was the founder of the United States' first trauma center at the University of Maryland in 1958, after the United States Army awarded him $100,000 to study shock in people—the first award of its kind in the United States. The trauma unit at first consisted of two beds, and was later expanded to four beds. Many people called the four-bed unit the "death lab." Cowley was the creator of the "Golden Hour" concept, the period of 60 minutes or less following injury when immediate definitive care is crucial to a trauma patient's survival. He was a leader in the use of helicopters for medical evacuations of civilians, beginning in 1969, and founded the Society of Thoracic Surgeons. He also founded the nation's first statewide EMS system, called MIEMSS by Executive Order of Maryland's Governor Mandel, 1972, as well as the National Study Center for Trauma and EMS, enacted by Congress in 1986 and signed into law by President Ronald Reagan. He is also known for being one of the first surgeons to perform open-heart surgery and invented both a surgical clamp that bears his name and the prototype pacemaker that was used by Dwight D. Eisenhower.
The University of Maryland Medical Center (UMMC) is a teaching hospital with 806 beds based in Baltimore, Maryland, that provides the full range of health care to people throughout Maryland and the Mid-Atlantic region. It gets more than 26,000 inpatient admissions and 284,000 outpatient visits each year. UMMC has approximately 9,050 employees at the UMMC Downtown Campus, as well as 1,300 attending physicians and 950 resident physicians across the Downtown and the Midtown campuses. UMMC provides training for about half of Maryland's physicians and other health care professionals. All members of the medical staff are on the faculty of the University of Maryland School of Medicine.
The following outline is provided as an overview of and topical guide to emergency medicine:
Trauma in children, also known as pediatric trauma, refers to a traumatic injury that happens to an infant, child or adolescent. Because of anatomical and physiological differences between children and adults the care and management of this population differs.
A wilderness medical emergency is a medical emergency that takes place in a wilderness or remote setting affinitive care. Such an emergency can require specialized skills, treatment techniques, and knowledge in order to manage the patient for an extended period of time before and during evacuation.
Todd E. Rasmussen, MD, FACS is an American professor and Vice Chair for Education in the Department of Surgery at Mayo Clinic, Rochester, and a Senior Associate Consultant in the Division of Vascular and Endovascular Surgery. Prior to joining the Mayo Clinic, he had a 28-year career in the military, retiring as an Air Force Colonel in 2021. His most recent military assignment was as Associate Dean or Research at the Uniformed Services University of the Health Sciences and an attending surgeon at the Walter Reed National Military Medical Center.
David R. Boyd was an American surgeon and pioneer in emergency medicine. Boyd is considered to be one of the "fathers of EMS systems." His colleague John Otten noted that Boyd "had been responsible for saving thousands of lives - more than anyone in the medical profession."
Hasan Badre Alam is a trauma surgeon, surgeon-scientist, and a medical professor in the United States. He is the Loyal and Edith Davis Professor of Surgery, the Chairman of Department of Surgery at the Feinberg School of Medicine (FSM)/Northwestern University, and the Surgeon-in-Chief at Northwestern Memorial Hospital (NMH) in Chicago.
