The role of neurosurgeons in emergency medical services

Abstract

  Rural‒area health facilities may face many difficulties when a critical patient’s case is encountered. When an emergency room (ER) physician accepts a critical patient whose condition is not within his or her specialty, the physician may experience stress. Toward the goal of decreasing such stress, we have introduced a consultation network of specialists that a physician can access at any time via a tablet based on information and communication technology (ICT). We also began providing an educational system for inexperienced physicians that can be accessed during the daytime. In April 2016, the Minami‒nara General Medical Center was established in the southern region of Japan’s Nara Prefecture, in a rural area where there are no other emergent medical services. In the present study we examined the role of neurosurgeons at the Center’s ER, based on the ER’s acceptance of critical patients. Between April 1, 2016 and December 31, 2017 (a 15‒month period), our ER was able to accept 22,369 patients including 6,929 (31%) who were brought to our facility by ambulance and 272 (1.2%) who were transported by a medical‒emergency helicopter. These numbers are approximately twice as many patients as the numbers of ER patients accepted in the prior 15‒month period. We distributed a five ‒item questionnaire about emergency care issues to our ER staff (n=57), and their responses (from 80.7% of the staff) revealed that when the ER physician on duty accepted a critical patient, neurosurgeons were the most frequently consulted specialists. Our consultation system and the availability of neurosurgeons are clearly necessary to decrease ER physicians’ stress when they accept emergent critical patients.