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Working in Accident and Emergency (A&E)

Accident and Emergency departments are on the frontline of medicine. Find out what goes on behind the flashing blue lights.

What is Accident and Emergency?

Accident and Emergency departments – often called A&E - are the first point of treatment in hospitals for patients with severe injuries or illness. Patients may get there themselves, or in serious cases might arrive by ambulance after being treated at the scene by paramedics. Patients are only treated for a very short time in A&E before they are then moved to another ward such as an ICU, or discharged home if it is safe.

Most large hospitals have an A&E unit, which are normally open 24 hours a day. However, some might not have a major trauma centre in A&E to deal with extremely serious cases, such as people who need life-saving surgery after a car crash. Many hospitals also have Minor Injuries Units for patients with less serious injuries such as cuts and sprains.

Who works in Accident and Emergency?

Since A&E is so unpredictable, doctors working there have to be trained in dealing with a wide range of conditions. In major trauma cases or when people have had a heart attack, doctors might need to use resuscitation techniques and equipment such as defibrillators quickly to save people’s lives. These patients might then be treated by specialist surgeons or other teams. In other cases, patients who arrive at A&E are first seen by a triage nurse, who determines how serious their case is and how quickly they need to be seen.

As well as having quick thinking and clinical skills, medical staff in A&E also need to be able to deal with people in a lot of distress. A&E wards are often extremely busy, and doctors and nurses have to be calm when dealing with angry people who might have been waiting a long time. Amongst the specialist staff who work in A&E are:

  • Consultants are senior doctors in control of the overall department
  • Accident and emergency doctors are trained in resuscitation and other life-saving techniques
  • Accident and emergency nurses care for patients, treating some less severe injuries and assisting doctors with more extreme cases
  • Paramedics might be based in A&E
  • Radiographers are needed to perform CT scans and X-rays to assess people’s injuries
  • Trauma surgeons perform emergency surgery on patients who need immediate treatment
  • Psychiatrists work with people with serious mental health problems who are admitted to A&E

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