Background
The structure and practice of EM in Ireland has, until the last decade, closely paralleled that of the United Kingdom. The establishment of the National Health Service (NHS) in 1948 was followed during the 1950s by the realisation that the hospital “Casualty” Department was often the portal of entry for the sickest and most seriously injured patients into the hospital. The 1960s saw the appointment of the first Casualty Surgeons; the title reflecting the fact that the nature of the emergency treatment delivered then was predominantly of a surgical nature.
Developments in bedside ultrasound techniques, organ support, thrombolysis, reperfusion therapy, the management of sepsis, pre-hospital care systems, trauma management and the increasing survival and return to the community of patients with multiple complex medical conditions has meant that the emergency management of medical conditions now forms a major part of the practice of modern EM.
Specialty training in EM is overseen by the Irish Committee for Emergency Medicine Training (ICEMT) under the governance of the Royal College of Surgeons in Ireland (RCSI) with representation from the Royal College of Physicians of Ireland (RCPI). The London-based Royal College of Emergency Medicine, of which the National Board for Ireland is one of four national boards, provides guidance on best practice and service delivery in EM and directs the postgraduate examinations for doctors training to become EM specialists.
Milestones in Emergency Medicine in Ireland
The major milestones occurring over each recent decade are linked below:
British organisations influencing the development of EM in Ireland
Many of the original cohort of doctors working in Accident & Emergency Medicine, later Emergency Medicine, in Ireland were members of what were primarily British organisations. This reflected the training of many of these doctors in the UK, the close historical ties between Britain and Ireland and the absence of sufficient numbers to develop parallel bodies in Ireland.
Casualty Surgeons Association (CSA)
Founded in 1967.
It was retitled British Association for Accident & Emergency Medicine (BAEM) in 1990.
British Association for Accident & Emergency Medicine (BAEM)
Later retitled British Association for Emergency Medicine (BAEM) in 2004.
Faculty of Accident & Emergency Medicine (FAEM)
The intercollegiate Faculty of Accident & Emergency Medicine became the College of Emergency Medicine in January 2006.
Prior to then it had a complex structure with the UK Surgical & Medical Royal Colleges and the College of Anaesthetists as its parents.
Royal College of Emergency Medicine
Royal College of Emergency Medicine
Created by the merger of the earlier College of Emergency Medicine and the British Association for Emergency Medicine in February 2008.
The College was granted the Royal appellation on 4th February 2015 by Queen Elizabeth II and became The Royal College of Emergency Medicine.
Further Reading: “A History of Accident and Emergency Medicine, 1948-2004” published by Palgrave MacMillan.
Its structure involves National Boards for the devolved countries within the United Kingdom (Northern Ireland, Scotland & Wales), Regional Boards for the English regions and a National Board for Ireland.