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REVIEW

BRAZILIAN JOURNAL OF EMERGENCY MEDICINE VOLUME 02 / 34-47

Emergency Medicine in the World

Eric Revue 1
1 Médico especialista em Medicina de Emergência e Toxicologia; Chefe do Departamento de Emergências e Serviço Médico
Pré-hospitalar (SMUR, SAMU de Paris) do Hospital Lariboisiere, APHP, Paris.

To cite this article: Revue E. Emergency Medicine in the World. Brazilian Journal of Emergency Medicine 2022; 2: 34-47.

INTRODUCTION medicine or primary care, emergency medical care focuses
on providing immediate or urgent medical interventions. It
Emergency medicine has long been established as the main includes two main elements: the medical decision-making
medical specialty in Australasia, Canada, Ireland, the United and actions necessary to prevent death or disability due to
Kingdom and the United States. However, emergency urgent medical conditions, regardless of the patient’s age,
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medicine is an interdisciplinary specialty, interdependent sex, location or condition .
of all other clinical disciplines . According to the EuSEM
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(European Society of Emergency Medicine), pre-hospital EMERGENCY MEDICAL CARE AND TRANSPORT
emergency care is an integral part of emergency medicine AROUND THE WORLD
as the first link in the chain of survival and is available to all
European citizens. Pre-hospital emergency care requires a Lack of emergency medical transport is a common
specific set of knowledge and skills from providers, based barrier to emergency care due to several factors,
on knowledge and exceptional experience working in the including the lack of suitable vehicles or the inability
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emergency department . Despite different organizations to pay for transport services. The consequences
within European countries, the pre-hospital EMS wishes to of a lack of transportation can be dangerous for
develop pre-hospital emergency care and ensure the best patients . Rather than attempting to create a de novo
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quality of service throughout Europe (Figure 1).
emergency medical care system, the use of established
Emergency department (ED) overcrowding and in particular primary care centers could serve as on-site casualty
“access block” potentially represent the greatest threats management points for initial assessment.
to the primary mission of emergency care worldwide. When a patient’s condition requires resources that a
The problem is pervasive, large-scale and amounts to primary care center does not have, they can be transferred
a public health emergency with sometimes disastrous to the nearest hospital. The involvement of primary health
consequences. COVID-19 represents a great example of care centers in the provision of emergency medical care
how crowding and blocked access to emergency rooms should reduce the risk of district and regional hospitals
can be dangerous for pandemic infections . The main being overwhelmed with non-emergency cases.
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unifying acts for the management of emergencies within the
European Union were the creation in 1991 of the common According to WHO data, the main causes of emergencies in
emergency phone call number”112”. In the last 20 years, the world are medical causes mora than road trafic injuries
the number of ED visits double all over the world without as in India, China or Turkey (Figure 2).
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explanation with the concept of overcrowding, mainly
linked to a shortage of beds. For the majority of EU countries, 112 is the emergency
phone number.
EMERGENCIES IN DEVELOPED COUNTRIES In Sweden and Portugal, 112 is the single emergency

telephone number. Ambulance dispatch is controlled by
The goal of emergency medicine is to stabilize patients who a regional dispatch center, which can also coordinate fire
have a life-threatening injury or illness. Unlike preventive and rescue calls (Figure 3).

Correspondence to: Eric Revue
E-mail: eric.revue@aphp.fr
34 | REBRAME | REVISTA BRASILEIRA DE MEDICINA DE EMERGÊNCIA