Emergency medical care

Medical care that provides emergency treatment and diagnosis, examination, and treatment to patients who require urgent care due to sudden illness, injury, poisoning, etc. The main targets are cases where emergency treatment is required, such as trauma from traffic accidents or sports, burns, acute pain, etc., and diseases that may affect the prognosis of life if not treated urgently, such as cerebral infarction, myocardial infarction, acute poisoning, and pneumonia, and require rapid diagnosis, examination, and immediate treatment. Depending on the severity of the patient treated, it is divided into primary emergency, secondary emergency, and tertiary emergency. In addition, each medical system is to be established for each medical area, with primary medical areas being based on the city/town/village unit, secondary medical areas being based on the wide-area city/town/village unit, and tertiary medical areas being based on the prefecture unit except for wide-area prefectures such as Hokkaido.

Primary emergency (initial emergency) medical care is for mildly ill patients who do not require hospitalization and can be treated as outpatients and return home. Local governments at the city, town, and village level establish systems for this purpose, and the role is played by on-call doctors at hospitals, clinics, and hospitals such as internal medicine, surgery, and pediatrics departments at night and on holidays, as well as holiday nighttime emergency centers, pediatric emergency centers, and holiday dental clinics.

Secondary emergency medical care is for seriously ill patients who require hospitalization or surgery. Medical districts are set up at the municipal level, and systems are established for each location. In order to prevent patients from being passed around, a rotation system is used among hospital groups to determine which hospital is on duty, and emergency hospitals, pediatric emergency hospitals, and maternal and child perinatal medical centers in each base play a central role in regional medical care.

Tertiary emergency care is for critical emergency patients who require particularly advanced treatment or for whom every second counts, such as injuries and illnesses that cannot be handled by secondary emergency medical care, such as those involving multiple medical specialties. Specialists provide advanced medical care and treatment within prefecture-level medical districts that cover a wide area, and this role is played by various emergency medical centers, pediatric emergency centers, and comprehensive perinatal maternal and child medical centers.

[Editorial Department]

Source: Shogakukan Encyclopedia Nipponica About Encyclopedia Nipponica Information | Legend

突然の病気、けが、中毒など、急を要する患者に対して、緊急処置と診断・検査・治療を行う医療。交通事故やスポーツなどによる外傷、熱傷、急性疼痛(とうつう)など緊急の処置が必要な場合や、脳梗塞(のうこうそく)、心筋梗塞、急性中毒、肺炎など緊急対応しないと生命の予後を左右しかねない疾患がおもな対象であり、迅速な診断と検査、即効的な治療が要求される。扱う患者の重症度に応じて一次救急、二次救急、三次救急に分けられる。また、それぞれの医療体制は医療圏ごとに整備することになっており、一次医療圏は市町村単位、二次医療圏は広域市町村単位、三次医療圏は北海道など広域道県を除き都府県単位が標準となる。

　一次救急（初期救急）医療は、入院を必要とせず、外来で対処できる帰宅可能な軽症患者を対象とする。市町村レベルで自治体が体制を整備し、内科・外科・小児科などの夜間や休日の当番病院や診療所・医院の在宅当番医、休日夜間急患センター、小児救急センター、休日歯科医院などがその任にあたる。

　二次救急医療は、入院治療や手術を必要とする重症患者を対象とする。広域市町村レベルで医療圏を設定し、地点ごとに体制を整備する。患者のたらい回し防止のため病院群輪番制によって当番病院を決めて任にあたり、拠点ごとの救急病院や小児救急病院、周産期母子医療センターなどが地域医療の中核的役割を果たす。

　三次救急は、複数の診療科領域にわたる傷病など、二次救急医療では対応できない、とくに高度な処置が必要であるか、一刻を争う重篤な救急患者を対象とする。広範な地域をカバーする都府県レベルの医療圏のなかで救急医療に特化した高度な診療や処置を専門医が施し、各種救命救急センターや小児救急センター、総合周産期母子医療センターなどがその役割を担う。

［編集部］

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