Emergency Medicine

Emergency care moves fast, it leaves no room for hesitation. Every second counts and every decision demands precision, whether in a quiet clinic or a crowded hospital hallway. 

In places like Biruni Hospital, those moments are met with structured systems, trained staff and the kind of readiness built through years of practice not theory. While Turkey continues to refine its broader health approach, frontline medical teams focus on getting the job done, even when the system gets messy.

What is emergency medicine ?

Emergency medicine is the work done when things cannot wait, it deals with sudden injuries and illnesses that need fast action. The focus is on figuring out what’s wrong quickly and stopping it from getting worse.

Emergency rooms, ambulances and trauma centers are where this happens. The goal is to keep patients stable and get them the right care fast.

Some important parts are : 

• Sorting patients to treat the most urgent first.
• Dealing with critical problems like heart attacks, strokes and big injuries.
• Using tests like scans and blood work to understand the situation.
• Working with other doctors to make sure patients continue to get care.
• Following steps to restart breathing control pain and stabilize.
• Being ready to change plans when things do not go as expected.

What are the types of emergency medicine procedures ?

Emergency medicine is built around speed, precision and the ability to work under pressure. It covers a wide range of situations where delays can be fatal. From trauma to infection to sudden collapse, emergency care teams step in when time is running out. 

The methods used vary depending on the condition, but all share one thing in common, they must be done fast and with a clear plan.

Cardiac resuscitation

Cardiac resuscitation is used when the heart suddenly stops pumping blood effectively, this is called cardiac arrest and it needs fast action. The goal is to restart circulation and breathing before organs suffer damage. 

Most cases happen outside hospitals and the first response usually comes from paramedics. Inside the emergency room, the whole team works together to bring the patient back. Every second counts and how quickly things start makes all the difference.

Steps and aspects of cardiac resuscitation

• Check if the patient is responsive and has a pulse.
• Begin chest compressions if there is no pulse.
• Use a defibrillator when the rhythm can be shocked.
• Manage the airway with a bag valve mask or advanced tools.
• Deliver rescue breaths when needed.
• Give medications like epinephrine during the process.
• Watch oxygen levels and blood circulation at all times.
• Look for causes like collapsed lungs, low potassium or bleeding.
• After restoring the pulse, continue care to protect the brain and body.

Advanced trauma life support

Advanced trauma life support handles patients with severe injuries from car crashes, falls, gunshots or other physical trauma. The idea is to look for life threats in a specific order without wasting time. 

In trauma cases there is no second chance to catch a mistake. Teams follow a structured plan where roles are clear and every step has a reason. 

If the patient is stable enough they move on to surgery or critical care, but in the first minutes it is about staying alive.

Steps and aspects of trauma life support

• Do a primary survey to find what could kill the patient now.
• Secure the airway and protect the neck if injury is suspected.
• Check breathing and make sure both lungs are working.
• Stop visible bleeding and check pulse.
• Evaluate mental status and look for brain injury.
• Cut off clothes to check the whole body.
• Keep the patient warm to prevent shock.
• Start IV lines and send blood for tests.
• Order scans to find internal damage.
• Give medicine to manage pain and keep the patient calm.
• Decide if the patient goes to surgery or intensive care.

Sepsis management

Sepsis is the body’s extreme reaction to an infection; it begins small but spreads fast and can shut down major organs. The emergency team needs to move quickly to stop the damage. 

Patients with sepsis may look fine at first then suddenly crash. The job is to spot the signs, start fluids, give antibiotics and support the body until the infection is under control.

Steps and aspects of sepsis management

• Notice warning signs like confusion, fast heart rate and low blood pressure.
• Take blood cultures before giving antibiotics.
• Start powerful antibiotics right away.
• Give fluids through a vein to support blood flow.
• Measure lactate to check if oxygen is reaching tissues.
• Use medication to raise blood pressure if fluids are not enough.
• Keep an eye on kidney, liver and heart function.
• Find where the infection started and stop it.
• Remove any source like an infected line or abscess.
• Adjust treatment based on lab results.
• Keep checking if the patient is improving or getting worse.

Stroke protocol

When blood stops reaching part of the brain the result is a stroke; this can come from a clot or a ruptured vessel. Each type needs a different treatment but both need fast action. 

Brain cells begin dying after just a few minutes, the emergency team must act with precision. There is no time to wait for slow tests or second opinions. The faster the team works the better the outcome.

Steps and aspects of stroke protocol

• Watch for symptoms like trouble speaking weak limbs or facial droop.
• Check with a stroke scale to measure severity.
• Order a CT scan to know what type of stroke it is.
• If there is a clot, give clot busting drugs if the timing is right.
• Use devices to remove clots in large arteries when possible.
• Control blood pressure and oxygen during care.
• Start medicine to prevent more clots if needed.
• Call in the stroke team to take over long term management.
• Send the patient to a stroke unit for full recovery planning.
• Plan physical therapy, speech therapy or other rehab if needed.

Airway management

Airway management is about keeping oxygen flowing when a patient cannot breathe well or at all. This could be due to injury, blockage or a medical condition. Without oxygen the brain begins to fail fast. 

This is one of the most important skills in emergency care. It takes practice because there is very little room for error and not much time to think.

Steps and aspects of airway management

• Look to see if the patient is breathing normally.
• Try simple head tilt or jaw thrust to open the airway.
• Insert basic airway tools if needed.
• Use a bag valve mask to give oxygen.
• Choose if a tube needs to go in the windpipe.
• Get tools and medications ready for the procedure.
• Place the breathing tube and check it is in the right place.
• Hold the tube in place so it does not move.
• Use other tools if the first attempt fails.
• Do a surgical airway if no other option works.
• Keep watching and adjust oxygen as needed.

What are the training and education models for emergency medicine at Biruni Hospital ?

Training in emergency medicine at Biruni Hospital is built around action, not theory. Residents are placed in real situations under close supervision and are expected to learn by doing. 

Each part of the program focuses on building judgment under pressure and making fast decisions that count.

Clinical rotations in core emergency fields

Residents at Biruni rotate across departments including trauma, intensive care, cardiology and pediatrics. These rotations ensure broad exposure and build the capacity to respond across multiple age groups and types of emergencies. 

Trainees do not observe from a distance, they are part of the decision process.

Key aspects of clinical rotations

• Work directly with patients from first contact to outcome.
• Take shifts in pediatric adult and trauma emergency settings.
• Develop diagnostic and procedural skills in real time.
• Learn to adapt clinical decisions based on evolving conditions.
• Handle critical transitions between emergency and inpatient care.

Mentorship by senior emergency physicians

Each resident trains under the eye of a senior physician. The goal is not just to follow orders but to understand when, how and why decisions are made. 

This helps cut hesitation and gives new doctors a solid base to work from.

Key aspects of mentorship

• Daily shadowing and supervised clinical decision making.
• Immediate feedback after cases or procedures.
• Review of errors and alternative approaches.
• Gradual increase of autonomy over time.
• Direct observation during high pressure interventions.

Simulation based learning and crisis drills

Simulation training uses lifelike medical scenarios to teach fast action without risk to real patients. These sessions are treated like real emergencies where every second and decision matters.

Key aspects of simulation training

• Use of advanced mannequins that mimic human response.
• Timed decision making under simulated pressure.
• Practice with tools and medication handling.
• Crisis team drills for multi patient situations.
• Feedback after each scenario to correct hesitation or errors.

Interdisciplinary emergency collaboration

Doctors do not work alone in emergency medicine. Training includes working with specialists from other units to make sure care is complete. This teaches residents how to lead, coordinate and move patients through the system without delay.

Key aspects of team based training

• Joint sessions with different medical departments.
• Shared case reviews with other specialists.
• Learning referral protocols and patient handoff.
• Understanding lab imaging and surgical priorities.
• Resolving conflicts between departments under time pressure.

Continuous evaluation and skills monitoring

Progress is measured every step of the way. Residents are constantly reviewed based on how they perform in real cases, not theory or exams only.

Key aspects of evaluation

• Weekly feedback from attending physicians.
• Case reviews and skill audits after shifts.
• Tracking of procedures handled and clinical decisions made.
• Assessment of communication under pressure.
• Guided improvement plans based on individual gaps.

Where precision meets urgency

Emergency medicine at Biruni Hospital is not shaped by guesswork or routine. It is built on action, consistency and sharp decision making. Whether it is trauma, cardiac arrest or stroke, what matters is not just what gets done. But how fast and how well it happens. The system is tight, the training is real, and every second is accounted for.