From Editor’s Desk

Perhaps in no other situation a physician experiences the same magnitude of agony and ecstasy as while attending an emergency. Though initially one tends to be ‘down in the dumps’ after being unsuccessful in a case or being euphoric over a successful management of a dire emergency, in due course one develops an attitude of equanimity. This attitude is essential so that our own emotions do not affect our management plans.

I have chosen two aphorisms in Medicine, ‘Primum non nocere’ and ‘Primum succurere’. While attending to a patient, if we are not able to cure him or relieve him it is excusable but we have to do our best not to harm the patient in the process and if we happen to be in the vicinity of any one in need of urgent medical attention, we shall hasten to attend to him, are the respective connotations of these aphorisms. Sometimes, we have hesitation in attending to a patient in need of medical attention when the given situation does not belong to our expertise lest we err in the management, like a physician at the site of a road traffic accident. The Supreme Court has ruled that a medical professional should not hesitate on such grounds and must try to provide whatever care he can provide in such cases. That exactly is what ‘Primum succurere’ means.

Emergencies in medicine include many sub specialities but to restrict the number of pages and the size of the Monograph, we are concentrating mainly on topics we face in our steady clinical practice as physicians.

I have attempted to present the management of the medical emergencies in different scenarios, such as situations where no assistance or special tools are available to situation where all types of assistance and tools are available as in an intensive care unit.

We have also included topics on the role of alternative medicine in emergency handling of cases.

This emergency medicine, a new branch of medicine has become so indispensable presently that the MCI (Medical Council of India) and its BOG (Board of Governors) in their notification on November 14, 2019 state as follows.

“No MBBS course nod to medical colleges in the country without emergency department (ED)”. The measures call for all medical colleges to have freely functional ED as per the MCI norms by 31th march 2022, adding that all new medical colleges seeking LOP (Letter of Permission) w.e.f. 2021—2022 MBBS batch should ensure that a freely functional ED is in existence as per the MCI norms.

Hubballi, 01/01/2020

Karnataka