International Conference on Emergency & Acute Care Medicine August 22-23, 2018 Tokyo, Japan

Endocrine emergencies represent a group of potentially life-threatening conditions that are frequently overlooked, resulting in delays in both diagnosis and treatment, factors that further contribute to their already high associated mortality rates. As such, the true incidence of primary endocrine emergencies is not well defined, which is likely because the disease process is often not recognized. Although endocrine emergencies are often encountered in patients with a known endocrinopathy, the emergency may be the initial presentation in previously undiagnosed individuals. If these endocrine disorders are not rapidly identified or if specific treatment is delayed, significant complications or even death may occur.

Acute orthopedic problems make up a large part of everyday emergency department practice. Misdiagnosis of these injuries often results from failure to consider certain clinical entities as a cause of the patient's complaints, and may result in unnecessary complications for the patient. Indeed, missed orthopedic injuries are the leading cause of malpractice claims in emergency medicine.

The orthopedic injuries that most notoriously escape detection by the primary care physician are closed tendon injuries of the hand, carpal bone injuries, occult fractures about the elbow, femoral neck fractures, posterior dislocation of the shoulder, epiphyseal plate injuries, fractures of the pubic ramus, patellar tendon rupture, Lisfranc injuries, compartment syndromes, and multiple injuries. If the physician is unaware of these entities when evaluating the patient, he will not make the diagnosis. 

Toxicology focuses on the diagnosis, management and prevention of poisoning due to drugs, occupational and environmental toxins, and biological agents. Examples of exposures commonly evaluated by medical toxicologists include acute drug overdoses, envenomation’s, ingestions of food borne or plant and mushroom toxins, hazardous exposures to chemical products, and the management of drug withdrawal syndromes. Medical toxicologists practice in a variety of professional settings including the direct treatment and consultation of acutely poisoned patients in emergency departments or intensive care units, poison control center management, industry and commerce, as well as government regulatory bodies (e.g., CDC, FDA, OSHA, EPA)

Emergency Medicine is a medical specialty a field of practice based on the knowledge and skills required for the prevention, diagnosis and management of acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioral disorders

Physicians specializing in emergency medicine can enter fellowships to receive credentials in subspecialties such as palliative care, toxicology, wilderness, disaster , pediatric emergency medicine, sports medicine, tactical medicine, ultrasound, pain medicine, pre-hospital emergency medicine, or undersea and hyperbaric medicine.

Abdominal pain is the most common reason for a visit to the emergency department (ED), accounting for 8 million (7%) of the 119 million ED visits in 2006. Obviously, anyone practicing emergency medicine (EM) must be skilled in the assessment of abdominal pain. Although a common presentation, abdominal pain must be approached in a serious manner, as it is often a symptom of serious disease and misdiagnosis may occur. Abdominal pain is the presenting issue in a high percentage of medicolegal actions against both general and pediatric EM physicians. The modern physician should be humbled by the fact that, despite diagnostic and therapeutic advances (computed tomography, ultrasonography, and laparoscopy), the misdiagnosis rate of the most common surgical emergency, acute appendicitis, has changed little over time.

 often arise and, if not diagnosed and treated quickly, they can have catastrophic results, with high rates of long-term disability and death. Prompt recognition is an important skill. During the past decades, the world has witnessed a significant improvement in the treatment of neurologic diseases. In addition, emergency department (ED) management of patients with neurological emergencies, including stroke, traumatic brain injury, and subarachnoid hemorrhage, continues to evolve at a rapid pace. Point-of-care technologies that impact the triage, transport, or treatment of these patients are critically needed. 

One of the leading reasons for people seeking care in an emergency room is heart failure, a chronic condition that can trigger symptoms such as shortness of breath, fluid retention, rapid or irregular heartbeats, and more. Cardiac emergencies are life-threatening disorders, they should be recognized and treated immediately to minimize morbidity and mortality. The rates of cardiovascular related deaths are decreasing from the last few years.

In both pre-hospitalization situations and emergency care units, healthcare providers have rallied to the task with awareness, more effective methods and medications have taken great strides forward in the care of emergent needs.

The most important changes in the fields of emergency medicine and surgery have come about because of the tremendous advancements in radiologic imaging that we have witnessed in the past years. Emergency radiology is now becoming a specialist area and the presence of radiologists on site in major accident and emergency departments is essential for the smooth running of the service. Teleradiology is the transmission of radiographic images from one location to another for interpretation by an appropriately trained professional, usually a Radiologist or Reporting Radiographer. The major benefit of teleradiology is the facility to use it in different time zones to provide real-time emergency radiology services around-the-clock.

An emergency nurse is typically assigned to triage patients as they arrive in the emergency department and as such are the first professional patients see. Therefore, the emergency nurse must be skilled at rapid, accurate physical examination, early recognition of life-threatening conditions. In some cases, emergency nurses may order certain tests and medications following "collaborative practice guidelines" or "standing orders" set out by the hospital's emergency physician staff.

Emergency nursing is a specialty within the field of professional nursing focusing on the care of patients with medical emergencies, that is, those who require prompt medical attention to avoid long-term disability or death. Emergency nurses are most frequently employed in hospital emergency departments (EDs), although they may also work in urgent care centers, sports areas, and on medical transport helicopters and ambulances.

The risk for injury during and after a natural disaster is high. Any wound or burn has the potential for becoming infected and should be assessed by a health-care provider as soon as possible. The treatment of these patients is often lengthy and requires extensive resources. Intensive and specialized burn centers are in existence all over the world but are very often situated in high-income countries.

These innovative and expensive treatment techniques play an important part, and the way in which a burn suffering patient is initially managed carries an equally important role. Burn care should begin at the site of injury and continue through prehospital care and transportation to the closest burn center, or to the closest emergency department (ED) with advanced life support capability. Wounds in complex patients which are poorly managed can lead to the development of a chronic wound. 

In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy.

Environmental emergencies are defined as “sudden-onset disasters or accidents resulting from natural, technological or human-induced factors, or a combination of these, that causes or threatens to cause severe environmental damage as well as loss of human lives and property.”

Following a disaster or conflict, an environmental emergency can occur when people’s health and livelihoods are at risk due to the release of hazardous and noxious substances, or because of significant damage to the ecosystem. Examples include fires, oil spills, chemical accidents, toxic-waste dumping and groundwater pollution.

The Environmental Emergencies Forum is a unique biennial international forum that brings together disaster managers and environmental experts from governments, UN agencies, industries, academies, NGOs and civil society to improve prevention, preparedness, response and overall resilience to environmental emergencies. 

The ruling anaphylactic reactions are to foods, insect stings, medications. Human immune system exaggerates to allergen by releasing chemicals into blood stream that cause allergy symptoms. Anaphylaxis needs immediate medication, with a prompt injection of epinephrine and a trip to a hospital emergency department. Anaphylaxis can be fatal if it isn’t treated properly. Accurate diagnosis and successful management of allergies is essential.

The effectiveness of epinephrine and a growing awareness of the seriousness of food allergies made deaths from anaphylaxis not common. Those at highest risk for fatal reactions appear to be teenagers or young adults who also have asthma and who delay in receiving epinephrine. Research has shown that many fatalities could have been prevented if this life-saving medication had been administered immediately.

Anesthesia is given to a patient to control pain during a surgery or procedure by using medicine called anesthetics. It can help control your breathing, blood pressure, blood flow, and heart rate and rhythm. Various types of anesthesia affect the nervous system in different ways by arresting nerve impulses causing pain. In today's hospitals and surgery centers, highly trained professionals use a wide variety of safe, modern medications and extremely capable monitoring technology. A medical specialist specialized in injecting and managing anesthetics is an anesthesiologist. The anesthetic medications will numb a section of the body or make you fall and stay asleep.

Dermatologic problems represent about 15%–20% of visits to family physicians and emergency departments. Life-threatening dermatologic conditions include Rocky Mountain spotted fever; necrotizing fasciitis; toxic epidermal necrolysis; and Stevens-Johnson syndrome. It is necessary to acquire skills in ‘emergency dermatology’, where a dermatologist’s right decision and intervention can make an important difference between life and death. Emergencies in dermatology are best categorized into primary skin diseases and severe systemic disorders with cutaneous manifestations.

Dermatologic Emergencies could all lead to acute skin failure with its attendant sequelae such as sepsis, multi organ failure and pulmonary embolism. Skin failure is an emerging concept which refers to a state of total dysfunction of the skin resulting from different aetiological factors.

People suffer with different types of psychiatric health problems during and long after emergencies. Patients will be more likely to recover if they feel secured, connected, calm and hopeful; have access to social, physical and emotional support; and seek ways to help themselves. In spite of their mental disorders, psychiatric emergencies are also chances to build better mental health systems for all patients in need. Global progress on mental health reform will happen more quickly if, in every crisis, efforts are made to convert short-term interest in mental health into momentum for long-term improvement. Mental health is essential to the overall wellbeing, functioning, and resilience of individuals, societies, and countries recovering from emergencies.

occur mostly in women of reproductive age but can affect women of all ages. The most common emergencies were prolonged/obstructed labor, postpartum hemorrhage, fetal distress, severe pregnancy-induced hypertension/eclampsia, and antepartum haemorrhage. Prevention/effective management of obstetric emergencies will help to reduce maternal and perinatal mortality in our environment. Non-pregnant women with abdominal pain often present diagnostic difficulties. The incidence of pelvic inflammatory disease is increasing, despite advances in diagnosis and treatment. Uterine haemorrhage remains a common problem which often responds to modern medical treatments, including progestogens, intravenous oestrogen.

The lung has umpteen functions beyond ‘simple’ gas exchange one function is to strain out large solid things from the circulation, so they don’t hit your brain, heart or other important organs Respiratory emergency develops when lungs become very inflamed due to a severe infection or injury. The inflammation causes the air sacs to collapse and fluid from nearby blood vessels to leak into the lungs. Over time, the lungs will become so full of fluid that breathing becomes and will lead to death. A patient’s airway and breathing are critical to their survival. A large, prospective European trial estimated that 7.1 percent of patients admitted to an ICU and 16.1 percent of all patients on mechanical ventilation develop acute lung injury or ARDS. The in-hospital mortality rate for these conditions is estimated to be between 34 and 55 percent.