Emergency doctor

The field of emergency medical care is perhaps the most responsible branch of medicine. It is important for an ambulance doctor not only to correctly diagnose a life-threatening condition for the patient, but also to respond very quickly, select the necessary resuscitation measures or emergency therapy in order to remove an acute threat to life, and all this so that the patient can survive or transfer the process of transportation to medical institution – after all, the ambulance team works on the road in the absence of a complete set of necessary medicines and medical devices. The life of the patient directly depends on how fast and correct medical measures the doctor takes.

Paramedic and emergency doctor – what’s the difference

Many inhabitants, without going into the subtleties of differences in medical professions, believe that paramedics work in the ambulance, and it is they who provide medical assistance to the victims. In fact, a paramedic can work in an ambulance, but this is not the only possible job for him.

An ambulance doctor is a medical worker with a higher medical education who provides precisely qualified medical care and advice, has the right to make a decision on emergency resuscitation measures.

A paramedic, like an emergency doctor, can diagnose the patient’s condition, determine the diagnosis and prescribe treatment. However, unlike a doctor, a paramedic has a specialized secondary education – it can be a diploma from a medical college or technical school. Most often, he provides first aid.

This specialist can work not only in an ambulance brigade, but also in military units, at an ambulance substation, on a river or sea vessel, in a medical center at a railway station or at an airport terminal, as well as in towns and villages in a feldsher-obstetric station.

In places where the access of the population to qualified medical care is difficult, the skills and knowledge of a paramedic should be sufficient to perform the functions of a doctor. For example, he participates in the medical examination of patients, in the absence of an obstetrician on staff, observes pregnant women and participates in childbirth, observes children under 2 years old, conducts physiotherapy according to the doctor’s indications, monitors the timeliness of vaccination.

If there is one doctor in the ambulance team, it is called linear. A specialized team is one that specializes in working with a specific pathology, such as cardiology or psychiatry. A team where a doctor is not provided for by the staffing table is called a paramedic.

In the absence of a doctor, the paramedic can, if necessary, carry out:

• defibrillation of the heart;
• tracheotomy;
• cardiopulmonary resuscitation;
• birth attendance.

Thus, the difference between a paramedic and an emergency doctor is mainly a skill level.

What does an emergency doctor do

The competence of the doctor includes the provision of emergency qualified medical care to victims who need it urgently.

The first task that this specialist faces is making a diagnosis, the correct definition of a disease or condition requiring medical intervention. At the same time, it is necessary to take into account, firstly, the limited time, and secondly, the lack of many necessary devices and devices at hand that are in a stationary medical institution.

It depends on the ambulance team whether the victim will reach the hospital, whether he will live to the intensive care unit, whether the doctors will have time to provide him with full assistance. Therefore, to say that emergency doctors are treating diseases will not be entirely correct. Provided that the patient has a condition when his life is in danger, the ambulance doctor is obliged to take all measures aimed at reducing it or completely eliminating it, therefore, in this case, we are talking, rather, about the treatment of dangerous symptoms and manifestations.

Doctors of this specialty are the first to deal with victims of disasters and road accidents, they come to calls if the person’s condition does not leave him the opportunity to get to a medical facility on his own.

In addition, the doctor provides symptomatic therapy, for example, assistance to cancer patients who are tormented by severe pain attacks (special analgesic injections), patients with blood pressure disorders, they are called to children with signs of fever, acute infectious diseases.

The duties of an emergency physician are:

• provision of qualified medical care to patients;
• transportation of victims to a hospital;
• assessment of the general condition of the patient and the choice of the most appropriate method of transportation and transfer of the victim;
• if the patient refuses hospitalization, if necessary, take all possible measures in relation to the patient himself and his relatives in order to convince him;
• while on the road, when meeting with an accident or an accident, inform the dispatcher and begin to provide assistance to the victims.

The doctor must have good physical and mental health, medical logic, observation, speed of reaction and the ability to make decisions quickly, knowledge of the main pathological conditions and the skills of providing pre-hospital care when they occur, the skills and experience of a specialist diagnostician.

Organs, organ systems and mental phenomena with which the emergency doctor works

The doctor on duty working in the ambulance team is obliged to understand such branches of medicine as gynecology, pediatrics, surgery, obstetrics, neurology, general therapy, rheumatology, resuscitation, traumatology, ophthalmology, otolaryngology. In the course of his medical activities, an ambulance doctor encounters violations in his work:

• heart, blood vessels;
• brain;
• organs of the gastrointestinal tract;
• organs of the genitourinary system;
• eye;
• nervous system;
• spine, joints, bones;
• body parts: head, torso, limbs;
• ENT organs.

Calling a specialized psychiatric ambulance team is carried out in the case of:

• psychotic or acute psychomotor agitation (hallucinations, delusions, pathological impulsivity);
• depression, which is accompanied by suicidal behavior;
• socially dangerous behavior of a mentally ill person (aggression, death threats);
• manic states with gross violation of public order and socially dangerous behavior;
• acute affective reactions, accompanied by aggression, arousal;
• acute alcoholic psychoses;
• suicide attempts in persons who were not previously registered with psychiatry.

Diseases and injuries treated by emergency physicians

This specialist provides assistance to patients in any difficult situations that threaten life and health.

According to the nature of the diseases, and, accordingly, the medical measures that the ambulance teams can provide, they are all divided into:

• resuscitation (most often they work with victims of accidents and disasters, they specialize in the most severe cases of damage to the human body);
• pediatric (it employs specialists with specialized education in the field of pediatrics who provide emergency care to the smallest patients, for example, in acute febrile conditions, pain attacks, burn lesions);
• cardiological (these doctors are sent to save people with such dangerous conditions as attacks of acute heart failure or heart attack);
• traumatological (specialize in providing assistance and transporting victims with injuries and polytraumas of any nature);
• psychiatric (engaged in emergency treatment and transportation to appropriate medical institutions of patients with acute mental disorders, people who, due to their illness, can threaten themselves and others with their behavior);
• brigades of general qualification (brigades working with various injuries, burns, diseases, feverish conditions).

When to Call an Emergency Doctor

The reason for calling an ambulance is a patient’s condition in which he needs urgent medical care, otherwise his life and health are in serious danger. There are a number of so-called threatening conditions in which it is necessary to contact the ambulance teams:

• electric shock, significant burn injuries, poisoning with poisons;
• road accidents and catastrophes in which the victims received fractures, ruptures of body tissues, bleeding and other life-threatening injuries;
• difficulty breathing (regardless of etiology, this condition can lead to suffocation and death);
• symptoms of acute fever: high fever, which is not relieved by antipyretics, convulsions, suffocation, headaches;
• acute pain in the abdominal cavity, which literally deprives a person of the ability to move (these may be signs of peritonitis, appendicitis, acute pancreatitis, ulcerative lesions of the stomach and intestines);
• sharp pains in the chest, which can radiate to the shoulder, back, neck, jaw, arm;
• if there are signs of a stroke and heart attack (numbness of the extremities, dizziness, loss of consciousness, temporary loss of vision, numbness of half of the face, nausea and vomiting, severe chest pain, lack of air, weakness, a sharp unreasonable increase in temperature).

There are cases when calling an ambulance doctor is not necessary. The ambulance does not deal with calls to fulfill the appointments of the attending physician (injections, droppers, dressings), to issue sick leaves and certificates, to provide dental care, to provide assistance with exacerbation of chronic diseases, if the patient’s condition does not require emergency medical intervention, as well as to transport the dead to the morgue.

Today, you can get emergency medical care both from ambulance teams from public hospitals and from private clinics.

Methods of examination and treatment used by emergency doctors

The specificity of this doctor’s work lies in the fact that he is very limited in time and in the means of diagnosing. The main methods that he uses to determine the causes of the patient’s dangerous condition are external examination, palpation of the abdomen (palpation and pressure in the abdominal cavity), listening to the heart and lungs using a stethoscope, measuring blood pressure and body temperature, and conducting electrocardiography. If the patient is conscious, the doctor interrogates him.

After checking the main vital signs of the body, analyzing the information received, the physician decides on the need for urgent resuscitation measures or urgent transportation of the victim to a medical facility. If the doctor ascertains the cessation of breathing and cardiac function, he proceeds to conduct defibrillation of the heart, the implementation of artificial respiration and pumping activity of the heart.

If the victim is diagnosed with injuries (fractures, ruptures, dislocations), the physician takes measures to immobilize him and deliver him to the hospital.

The doctor uses medical methods of assistance (injections, droppers, sprays, tablets), in some cases, may perform surgery, such as a tracheotomy.

The doctor of the medical care team must be a qualified specialist with a lightning-fast reaction, the ability to quickly respond and make decisions. Its competence includes the provision of care to patients with an immediate threat to life. It is this specialist who first arrives at the scene of an accident, catastrophe, electric shock, poisoning. All these threatening conditions, in the absence of prompt and adequate medical intervention, can cause disability or death, so an enormous responsibility falls on the shoulders of emergency doctors.