It is an understatement to say that the pandemic that continues to spread across the globe has brought about change in many forms. Industries and sectors of society have been at the forefront of instigating these changes, be it in operations, management, or even in outlooks.
Among these are the operations of those in the medical field. Local medical and healthcare workers have worked tirelessly during the pandemic, especially at the very beginning. There are specialized medical workers, however, who lead the way for others, being the respondents at the doors of the emergency rooms (ERs) and during triage. These are the Emergency Medicine professionals.
At the front of the frontlines
By definition, Emergency Medicine is the specialization that deals with the illnesses and injuries requiring immediate medical intervention. “Some call it the ‘first 15 minutes of all specialties’, others dub it as the [specialization for the] jack of all trades, master of none,” describes Dr. Patrick Tiglao, Philippine College of Emergency Medicine secretary general, in an interview with The LaSallian.
“The pandemic had affected all the specialties in terms of the protocol of interacting with patients. Wearing full personal protective equipment became a must, but we still are able to do what needs to be done to the patient. We are the frontlines of the frontliners. That being said, we were trained in this kind of scenario without compromising the safety of ourselves and the patient,” he attests.
Emergency Medicine first stemmed from general physicians who applied their skills in emergency situations; its scope was broad, encompassing a variety of illnesses. In its earlier days, the ER was an “accident room” for patients who sustained traumatic injuries.
In the 60s, however, the ER evolved into a center where patients with broader medical conditions could seek and receive care. As national interest grew, medical leaders were able to increase awareness with emergency services and encouraged strategies for improvement. Its essential role in the healthcare system was accompanied by change and activism, coinciding with economic prosperity, the civil rights movement, and emerging feminism in America.
“The institutionalization of the Emergency Department started from the University of the Philippines-Philippine General Hospital (UP-PGH) where it was initially called DEMS (Department of Emergency Medical Services) during the early 90s,” comments Tiglao. The decade also saw the creation of certification processes, guidelines and standards based on the training programs developed by the American College of Emergency Physicians to maintain academic status and accreditation.
He further relays that the now Philippine College of Emergency Medicine was the fruit of two pioneering Emergency Medicine societies—that of UP-PGH and Makati Medical Center—merging together. Like other doctors, emergency physicians continue to support the very foundation of our medical systems. “We had been involved in many aspects of healthcare especially in this pandemic where we stand in the frontlines,” he asserts.
A ‘passionate’ specialty
Among the responsibilities of Emergency Medicine specialists, they mainly focus on “life-saving procedures” says Tiglao. “Clinically, we manage the initial and essential ABCDE’s of life…We multitask without compromising prioritization of those who need the most care and attention. We don’t delay the management, and make timely decisions for the patient’s benefit,” the physician expresses. Apart from that, emergency physicians also handle the timely disposition of patients, the prioritization of patients during triage, and organization of the department. Personally, however, he sees the specialty as a “passionate” one. “The specialty doesn’t choose whatever patients consult at the emergency department. There is no prejudice whatever age, disease, or economic class enters the emergency department.”
Aspiring physicians are met with the reality of years of rigorous training, sometimes even sacrificing time with loved ones and leisure for hours in a hospital. Following an individual’s undergraduate career and the completion of medical school, they are met with a multitude of medical specialties to choose from.
These different disciplines of Medicine may speak to a particular interest or personality one has and for Emergency Medicine specialists, a physician must be decisive, calm under pressure and good at time management when treating patients under critical conditions. Those hoping to become a board-certified emergency physician will undergo three to four years of residency training after medical school, learning an array of ailments at the ER in varying stages to ensure proper and comprehensive delivery of emergency care.
According to Tiglao, all physicians who are “willing to learn and to embrace the practice of emergency medicine” are eligible to become emergency physicians. “If you are talking about personality or traits, I think the most important one is the willingness to be trained,” he remarks.
They may never know what will be on the other side of the door, but their preparedness and commitment to saving the lives of others are what will carry them through. This, in essence, is the very situation emergency physicians train and prepare for.