A History of Accident and Emergency Medicine, 1948-2004 by H. Guly

By H. Guly

This ebook describes the struggle to create a brand new clinical area of expertise of coincidence and emergency medication opposed to a lot competition from demonstrated specialties. The forte used to be first well-known in 1972. The ebook additionally charts the foremost advancements that happened within the first 30 years of emergency medication.

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Example text

The BOA detailed failures of organisation, staffing, accommodation and surgical training. Too many hospitals were trying to provide an accident service with limited facilities and staffing and they recommended that services should be concentrated on a smaller number of hospitals fully equipped and staffed to provide a full service round the clock. ’ The report suffered from being too focussed on trauma and essentially ignoring other emergencies. The Lancet agreed that improvement was needed but urged caution,2 believing that too much emphasis had been placed on the well-equipped and comprehensive centre and that ‘limelight on the specialised centres must not cast a shadow over the work done in collecting and screening the casualties on their way’.

It reasonably asked what was major and what was minor and said that surely an inhaled foreign body is an accident. It felt that ‘a case can be made out, in fact, for a review of the arrangements for hospital treatment of all 27 28 A History of Accident and Emergency Medicine emergencies’ and asked: ‘if casualty departments … are to exist no longer, what is to replace them? ’ The BMJ felt that organising a service by the state as a quasi-military operation did not seem appropriate but that each region should develop its own accident service according to its needs3 but others in the correspondence columns of the BMJ were more critical of this report: ‘it would be quite disastrous to abolish these departments without providing alternative services for the many non-traumatic conditions that are seen by the young casualty officers.

The first person to argue in the medical press that full time casualty consultants was the best way of managing casualty departments appears to have been Lamont, an SCO in Grimsby. 10 He felt that each casualty unit should have at its head a consultant of high attainment – ideally a man with surgical training and qualifications in industrial medicine whose ‘primary function … is to be a father figure to the young men who will make their career in the casualty service – translating into reality the platitude that casualty work can provide the young with invaluable experience’.

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