Emergency Medicine Physicians can Manage all Emergent Procedures in the Emergency Department

Hassan AMIRI; Samad SHAMS VAHDATI; Niloofar GHODRAT; Azin SOHRABI; Leila RASI MARZABADI; Arezoo Garadaghı

Hassan AMIRI¹, Samad SHAMS VAHDATI¹, Niloofar GHODRAT², Azin SOHRABI³, Leila RASI MARZABADI², Arezoo Garadaghı²

¹Emergency Medicine, Imam Reza Hospital Of Tabriz University Of Medicine, Iran
²Tabriz University Of Medicine, Iran
³Pedodontics, Shahid Beheshti University Of Medical Sciences, Iran.

Keywords: Resident of emergency medicine, resident of surgery; procedures

Abstract

Objective: Emergent procedures are one of the cornerstones of emergency departments and are performed in order to save a life of a patient, increase survival or to decrease complications and discomfort. To improve survival and quality of service, all emergency medicine residents and specialist should be able to make decisions and perform these procedures as soon as possible whenever an indication exists. The purpose of this study was to compare the quality and quantity of completing procedures among residents of emergency medicine and surgery.
Methods: Patients who were admitted in the emergency department of Imam Reza hospital between Feb 19th and Jun 21st 2007 and had one of these procedures were included in the study. The procedures which were included in our study were chest tube placement, diagnostic peritoneal lavage (DPL), cut down, jugular, subclavian and femoral catheter and CV line placement, local wound exploration and jaw reduction.
Results: 161 patients were included in the study. Mean age of the patients was 32.4±16.3. All jugular, subclavian and femoral catheter and CV line placement were performed only by emergency medicine residents. 3.1% and 7.8% of patients had chest tube placement, 2.5% and 7.5% of patients had DPL, 3.1% and 8.7% had cut down, 12.4% and 41.0% had local wound exploration by emergency medicine and surgery residents respectively. 2.5% and 0.6% of patients had jaw reduction by emergency and oral and maxillofacial surgery residents respectively.
Conclusion: Emergency medicine residents’ skills are equal to that of residents of surgery in completing these procedures. In all patients who had indication of catheter and CV line placement there was no need for surgical consult and all were performed by emergency medicine residents. Although residents of surgery were interested in performing procedures such as DPL, chest tube placement, in traumatized patients, the emergency medicine residents show their mastery and expertise in successfully completing these procedures too. It was concluded that the emergency medicine residents had necessary skills and knowledge needed to manage all patients.