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Revue E

located in tertiary care hospitals and most local county • N of Doctors/inhabitant: 1.98‰ (Ch), 2.3 (Sing) 52,000
hospitals and operate 24 /7. emphasis was placed on doctors 0.83‰ (VN) + 244% in 40 years
the mobile emergency services (ambulances) and the
pre-hospital EMS provided by these mobile teams. In • Number of emergency workers: 40,000 (Ch) 212 (Sing)
an emergency, dial 112 for police, fire department or • System: “ED of internal Medicine”
ambulance. At the same time, there is a move towards
the use of mobile emergency EMT, made up of different While emergency medicine is developing in most Asian
clinical skills and carrying out home visits, in particular for countries, it can be considered that the development is
people who have greater care needs, such as the elderly developing favorably in China and in particular in large
and people with chronic illnesses. cities such as Shenzhen or Hong Kong.

Overwhelmed ED, shortage of doctors: these constraints have Vietnam has developed private hospital structures for
pushed the goverment to innovate to provide better care. 15 years, allowing foreign capital to be invested and
Cost effective telemedicine with its northern regions sparsely doctors to be recruited based on the wealthy Vietnamese
populated and buried under snow during the long winter population (or tourists) and allowing reinvestment in the
months, Sweden has embarked in particular on telemedicine. development of hospital structures after 10 years of ‘use.
In Gothenburg, the dermatologist John Paoli has developed The large volumes of patients presenting to emergencies,
an application allowing general practitioners to obtain, by particularly in China, are particularly organized and it is
a simple photo taken on a smartphone, the diagnosis of therefore curious to see that the young Chinese population
the hospital dermatologist on the dangerousness of an ugly resorts to safety emergencies and believes more in modern
mole. His invention, which received the Swedish Innovation medicine rather than traditional medicine.
Award in 2013, has already been adopted by 20 regional
health centers. Tested on two groups of some 800 patients, it The waiting rooms had to show original organization to
allowed much faster treatment of melanoma cases (nine days combine a young population in a seated position with its
instead of thirty-five), avoiding 20% of unnecessary visits to magical infusion. Emergency medicine has made great
the hospital. A gain of 10 million euros for the community. strides in Singapore. It is now a recognized medical
Another recipe from which other countries could draw specialty with a growing pool of trained physicians and
inspiration: Person Centered Care, care centered on the staff. established structured training programs. Emergency
medicine in Singapore still faces many challenges, with
The improvement, qualitative and financial, is obvious: a marked improvement in the level of emergency patient
satisfaction rate up sharply and length of stay (LOS) reduced care as Singapore enters the third millennium.
by 25% in six years. With > 25 Million visits/year (3 visits/
year for 1 person), the organization of emergency services in EMIRATES, DUBAI
Sweden varies according to the type of hospital. In general,
in large university hospitals, patients are sorted according to
the nature of their complaint: medical or surgical. Pediatric, • Speciality: 2004
obstetrics and gynecology, ENT, and ophthalmology patients • N of Doctors/inhabitant: 2.53
are all triaged and treated in separate departments that
are not associated with the main emergency department. • Number of emergency physicians 1.93
Emergencies are not always considered and manage the input
of patients to hospitals 24 hours a day, without being able to • High performance system
control admissions and discharges (ouput), inevitably leading • Features: 75% minor pb EMS managed by Police.
to the accumulation of patients in the emergency room,
leading to a lack of security, a bad working environment. Emergency medicine was recognized as a specialty in the
United Arab Emirates (UAE) in 2004. In this short time,
Therefore, Swedish emergency care needs to improve emergency medicine has established itself and grown
collaboration with other actors, both inside and outside rapidly in the UAE. Large, well-equipped emergency
the hospital, such as health care and community care departments are usually located in public hospitals, some
services. Many patients might prefer to seek care at home of which operate as regional trauma centers. Most large
rather than in an UAS. To a greater extent, some patients emergency departments are staffed by physicians trained
could be admitted directly to the services.
in medicine or surgery, with board-certified emergency
physicians serving as consultants overseeing care. Pre-
CHINA, HONG KONG VIET NAM, SINGAPORE hospital care and emergency medical services (EMS)
21
operate under the auspices of the police department .
• Specialty: 1997 (HK), 1984 (Sing) 2010 (Vietnam) Standard protocols have been established for paramedic

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