Featuring:

• Mike Dalliday, CCPA is a graduate of McMaster's PA Class of 2013, and currently works in Emergency Medicine in Campbellford, Ontario. Prior to this he worked in Emergency Medicine for 5 years as a PA at Sunnybrook's Emergency Department.

• Stephanie Schneider, CCPA is a graduate of Manitoba's MPAS Class of 2013, and currently works in the Emergency Department in Thompson, Manitoba - a town in northern rural Manitoba that is 700 km north of Winnipeg.

Working in Emergency Medicine

The Emergency Department (ED), also known as the Emergency Room (ER), is a critical area within a hospital or medical facility specifically designed to provide immediate treatment to patients suffering from acute illness or injury. The primary goal of the ED is to stabilize patients as quickly as possible, whether they have life-threatening conditions or less severe problems requiring urgent attention. It is a unique and essential component of the healthcare system, operating 24/7 and prepared to handle a vast array of medical emergencies at any given time.

What is Emergency Medicine?

Emergency Medicine as a specialty is dedicated to the diagnosis and treatment of unforeseen illness or injury. It encompasses a broad spectrum of physical and psychological conditions across all age groups, genders, and complexities of health. Physician Assistants, in collaboration with supervising physician(s), are highly trained to make rapid, critical decisions to prevent death or further disability in patients. They manage conditions ranging from heart attacks and strokes to fractures and acute infections, as well as coordinate care with specialists when needed.

Key characteristics of Emergency Medicine and the ED include:

• Accessibility: The ED is typically open 24 hours a day, 365 days a year, providing access to urgent medical care at any time.

• Triage: Upon arrival, patients are assessed through a process called triage, which prioritizes their care based on the severity of their condition. This ensures that those in the most critical state receive immediate attention.

• Multidisciplinary Approach: Emergency Medicine involves a team approach, with emergency physicians, nurses, physician assistants, technicians, and other healthcare professionals working together to provide comprehensive care.

• Acute Care: The focus is on rapid assessment, stabilization, and treatment of acute medical conditions. This may involve resuscitation, pain relief, and the initiation of investigations and interventions to diagnose and treat illnesses.

• Referral and Follow-up: After initial treatment, patients may be discharged with instructions for follow-up care, admitted to the hospital for further treatment, or referred to appropriate specialists.

PA Role in the Emergency Department

Physician Assistants (PAs) in Emergency Medicine play a critical and dynamic role. PAs are medical professionals who are trained to diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient's principal healthcare provider. In the emergency department (ED), their roles include:

• Patient Assessment: PAs perform comprehensive assessments, including taking medical histories, performing physical exams, and ordering and interpreting diagnostic tests to determine patient needs.

• Urgent Care and Procedures: They provide urgent care for a wide range of conditions from injuries to acute illnesses, perform minor surgical procedures (such as suturing, splinting, and incision and drainage), and assist in more complex operations under the supervision of a physician.

• Patient Management: PAs in the ED manage ongoing care for patients, adjusting treatment plans as necessary, and coordinating with specialists and other healthcare providers.

• Education and Counseling: They provide education and counsel to patients and their families about acute conditions, preventive care, and follow-up recommendations.

• Triage: In many emergency departments, PAs are involved in triaging, which is the process of determining the priority of patients' treatments based on the severity of their condition.

• Emergency Procedures: Depending on their training and the scope of practice in their jurisdiction, PAs may perform or assist in emergency procedures such as advanced airway management, insertion of chest tubes, and central venous catheter placement.

The integration of PAs into emergency medicine teams allows for more efficient patient flow and care, as they work alongside physicians, nurses, and other healthcare professionals to provide high-quality emergency care. The extent of a PA’s role can vary on the laws of the province or territory they practice in, the policies of the hospital or clinic, and their level of experience and training.

PAs in emergency medicine must be highly adaptable, able to make quick decisions, and possess strong clinical skills to thrive in the fast-paced, often high-pressure environment of the emergency department.