During our EM rotation, it was emphasized time and again how important every second is when saving people from acute life-threatening conditions. We are taught the ABCDE approach as a quick assessment and urgent management of life-threatening conditions because seconds lost can mean life or death. If you miss out on a tension pneumothorax, the patient can die. If you miss out on sources of bleeding, the patient can die. We are taught that seconds can mean a heart muscle dying or a part of the brain dying.
Emergency care bridges the gap between the community and the hospital for the acutely ill. They bridge a potentially life-threatening condition to stability by ensuring that the right life-saving interventions are given at the right time and to the right patient who needs it. Part of emergency care is the pre-hospital care system which is all of the care received by the patient from an emergency medical service before arriving at the hospital. The initial stabilization given by pre-hospital care not only gets the patient through from a life-threatening condition to a state of stability. At the top of my head, i can imagine c-spine immobilization to prevent further cervical trauma, application of pressure to prevent massive bleeding, to giving epinephrine to a patient with anaphylactic shock.
However, it does not stop at helping someone through that life threatening condition,. There is a need to bring the patient to a facility that can address their needs and make the resources accessible to them for the definitive management and hopefully improve outcomes for the patient. But how do we get there when pre-hospital care remains difficult to access, when there is difficulty in reaching patients in far-flung areas, and when there are no nearby hospitals available for the patient? That’s why we need to improve the bridge between the community and the resources for their health needs -- while also empowering the community and ensuring resources for health are available for those who need it.