oa SA Pharmaceutical Journal - Emergency medicine, resuscitation and acute prescribing : review

Volume 77, Issue 4
  • ISSN : 2221-5875
  • E-ISSN: 2220-1017



The speciality of Emergency Medicine is new in South Africa. Registration with the Health Professions Council of South Africa was approved in March 2003. In contrast, the USA was the first country to register emergency medicine as a speciality in 1979.

The traditional "casualty" model for managing acutely ill patients in South Africa has generally been geared to each speciality, "donating" junior doctors to the "front shop" of the hospital. The sorting or triage of patients has been, at best, rudimentary, with eyeball triage being the standard in many facilities. Furthermore, Emergency Medicine Departments are seldom structured and many hospitals run separate emergency areas such as medical, surgical and paediatric.
The Anglo-American model that channels all emergencies through a specialised unit has been adopted in South Africa as the proposed system for Emergency Medicine. However, each country using this system has different variations of the model. For example, the United Kingdom has implemented a 4-hour waiting time target for all patients who attend the Emergency Medicine Departments. This means that 98% of all patients should spend no longer than 4 hours in an Emergency Medicine Department. They also have distinct areas for treating patients. These are See and Treat, Minor Injuries, Major Medical and Resuscitation. Some have 24-hour stay observation wards for monitoring conditions such as head injuries and overdoses. The final South African Model has yet to be established and is currently in evolution.
The Goal of Emergency Medicine Departments is to offer a rapid and high standard of care to all patients who require acute treatment. Many acutely ill patients initially present in a pharmacy, because the pharmacist is easily accessible and can offer early treatment or advice in many instances. The pharmacist is thus faced with a range of patients who require medical attention, from minor complaints to potentially life-threatening emergencies such as a sudden acute myocardial infarction and even cardiac arrest.
Although this article does not intend to cover emergency medicine or principles of first aid in any detail, it does create an awareness for the pharmacist that there are new developments in emergency medicine in South Africa. Pharmacists, especially those in rural areas, may benefit from learning Basic Life Support Skills and are encouraged to undertake training in this field.

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