The first doctoral thesis was defended at the University of Tartu, where the functioning of emergency medicine was studied. The research revealed several shortcomings in the work of EMOs.
Emergency medicine as a separate specialty was introduced in Estonia in 2000. Now Triinu Keskpaik, professor of emergency medicine at the Tartu University Clinic, has defended his first doctoral thesis, which was about the organization of work of the EMOs. In her work she took a closer look at patients who came to the EMO with acute abdominal pain or severe chest trauma. Abdominal pain was chosen because it is one of the top three reasons people go to the emergency room for help.
However, the causes of acute abdominal pain can be many and different and can also depend on age. Kespaik said that in younger patients, the cause of abdominal pain can often remain unclear. As a rule, there is no such disease, due to which you need to immediately rush to the operating room or stay in the hospital. However, diseases requiring hospitalization or surgery are increasing in the older age group. Instead there is a gallbladder or appendicitis or intestinal obstruction.
Kespaik said it’s not always easy to find the cause of abdominal pain. “A person experiences stomach pain, but the problem may be elsewhere,” she explained.
However, severe trauma represents a major public health problem in Estonia, mainly affecting young people. Although severe abdominal pain can have many causes, chest trauma usually occurs when you fall from a height or are injured in a car accident.
The doctoral thesis highlighted some shortcomings in the work of the emergency medicine department, especially in the case of patients with abdominal pain. The main problem is that complex patients spend too much time in the emergency room. “World literature also says that the reason is not in the EMO itself, but reflects the inadequacy of the entire system. The therapeutic path for emergency patients is a bit bumpy and they get stuck because they can’t find a bed in hospital, but the EMO is not designed for that,” Keskpaik said.
The doctor explained that the EMO is designed for the reception and triage of patients. After initial activities, including immediately necessary tests and urgent treatment, he is given a primary diagnosis and patients who need it are admitted to hospital. “Studies have also shown that it is actually harmful for patients to stay in the EMO for a very long period, because they do not receive the specific treatment that they would receive in the corresponding department,” Keskpaik added.
Staying in EMO too long is not just an Estonian problem, but tends to happen in other countries too. If a person arrived at EMO, after a maximum of six hours, he should move to another department or house. In Estonia, this time tends to be longer.
Another shortcoming that emerged from the work concerned the assessment and treatment of pain. Triinu Keskpaik said acute pain is a serious problem that needs to be treated. Otherwise, it may become chronic or develop complications. The doctoral thesis revealed that doctors can ask how severe the patient rates the pain, but the answer is not written down anywhere.
Shortcomings were also found in the speed of treatment of acute pain. “In general, if you ask about the pain and write it down and can see that the pain is strong, this also gets the patient to treatment faster. However, if the strength of the pain is not assessed, the pain may not be treated,” Keskpaik explained.
When considering the training of staff and equipment in EMOs, Keskpaik believes that the situation in regional hospitals is very good. The problem, however, is the lack of manpower. “Since there are not as many EMO employees as needed, unfortunately they are not distributed everywhere,” he said.
2024-01-24 09:09:00
doctoral-thesis-patients-in-need-of-urgent-care-stay-too-long-in-emo-health
#Doctoral #thesis #patients #urgent #care #stay #long #EMO #Health