Team Members of an ER and their Roles

May 12 13:36 2021 Print This Article

Emergency medical care can cut down fatality rate, improve treatment outcomes, reduce rehabilitation time, and optimize treatment costs for many patients. That is why an emergency room or ER is an indispensable part of any reputed, optimally sized hospital.

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Over the years, emergency medical care has evolved significantly and become a specialty of its own. There are clear strategies or approaches for providing emergency care, all medical equipment required for it in one location, and healthcare professionals who are trained and/or specialize in emergency medical care manage the ER. Today, we shall understand these ER professionals.

For those who travel abroad occasionally, it’s important to note that ER is called differently in different parts of the world. Other names include emergency department, emergency ward, casualty department, casualty ward, accident & emergency, etc. In the same way, the ER professionals are also called differently in different countries. Further, the nature of professionals who constitute the ER can vary from hospital to hospital, depending on size, availability of the professional, geographical location and its limitations, specialty of the hospital, etc. So we will cover a general or typical list of professionals.

Who is Who in the ER

• Emergency Medical Technician (EMT) or Paramedic: When the patient or his/her family/friend makes a call to a hospital or a central ambulance number, an ambulance is dispatched to the patient’s location. The staff inside the ambulance are paramedics, who have a certain amount of medical training but are not qualified nurses, doctors, or medical students. They quickly observe the symptoms, provide emergency support while coordinating telephonically with the hospital. They will do all they can to prevent the patient’s condition from deteriorating before reaching the hospital.
• Triage Nurse (TN): When the ambulance arrives at the hospital and the paramedics inside bring in the patient, a specially trained nurse will quickly observe the symptoms, record BP, temperature, and then prioritize the patient depending on the severity of the condition. This process of prioritization is called triage. Patients who are in serious risk of losing life or limbs are categorized as ‘major’ and sent to the ER. Some may be suffering from chest pain, breathing difficulty, neurological complaints, or abdominal pain. Those with fractures, dislocations, and lacerations are sent to an inpatient ward or another department for treatment.
• Emergency Physician (EP): Once the patient categorized as major has arrived at the ER, the emergency physician takes over. He/she is a general physician trained or certified in emergency medical care which covers accident, trauma, and common medical emergencies. Based on the patient’s condition, he/she may order for tests of the blood and urine along with ultrasonography, MRI, or CT scan. He/she will order for required supply of blood, plasma, IV fluids, and any medication required in the immediate.

• Radiology Technician (RT): Once the emergency physician calls for X-ray, CT or MRI scan, the radiology technician will take away the patient for the same or perform the ER test if its equipped for this. He/she will then share the test reports/results with the emergency physician who will initiate next steps.
• Emergency Nurse (EN): Like the emergency physician, an emergency nurse is trained or certified in emergency medical care. She will manage the team of nurses involved in the case, coordinating with the doctors, pharmacists, radiology technicians and the hospital administration. In some hospitals, a specific nurse is assigned to each patient, in which case, she will be called the case nurse. In addition to the above tasks, she will also be the single point of contact for the patient’s family updating them on the patient and treatment. In hospitals where electronic medical records (EMRs) of patients are maintained/updated, the EN will update the records with information regularly until the patient is discharged.
• Nursing Assistants: These are nurses who may or may not be trained in emergency medical care. However, they are trained nurses. They will take instructions from the emergency nurse or the emergency physician and do the needful. They will monitor the patient round the clock, administering medications, dressings and all such auxiliary care.
• Junior Doctor / Intern / Trainee Doctor: As the name implies, these are resident interns or recent graduates trained to be full-fledged doctors very soon. Some of them may even become emergency physicians in the future. The emergency physician instructs them to do the needful on every case. This way, some of the load is taken off the EP, while they get training and precious experience on real cases.
• Unit Secretary / Admin Assistant: This person coordinates with the above team members as well as the patient and family members. He/she will record basic patient info, details of medication and treatment provided, bills and invoices to be made, collect insurance details, etc., and manage all the statutory paperwork.
• Consulting Physician: Since the EP is not a subject matter expert in every branch of medicine, he/she will call for specialist physicians who are in-house or available at short notice.
• Psychiatrist: If the patient appears to have mental health issues, a psychiatrist will do an evaluation after the patient’s condition is stabilized. This is important as it has a bearing on the effectiveness of the treatment.

 Other Personnel in ER

• Respiratory Therapist (RT): In case of patients having breathing problems, a Respiratory therapist will help manage the airways, ask for relevant equipment like a ventilator, heart-lung machine, ECMO He/she may be called in as and when needed. All the other team members can also handle breathing issues. However, a RT provides additional insights which may be useful in the case.
• Social Worker: Some patients may have serious challenges such as affordability issues, communication or language barriers, lack of transportation, minor children at home, disability issues, etc. In such cases, a social worker takes charge of the case, makes necessary contacts and coordination to help ease the challenge for the patient. All hospitals maintain a dossier of such workers.

Frequently Asked Questions

1. Who are the main team members in an emergency room (ER)?

The main team members include paramedics, triage nurses, emergency physicians, radiology technicians, and emergency nurses.

2. What does a paramedic do in the ER?

Paramedics provide emergency support in ambulances and assist in stabilizing patients before they reach the hospital.

3. What is the role of a triage nurse?

Triage nurses prioritize patient care based on the severity of their condition when they arrive at the ER.

4. Who is an emergency physician?

An emergency physician is a general doctor trained in handling accidents, trauma, and medical emergencies in the ER.

5. What does an emergency nurse do?

Emergency nurses manage patient care, coordinate with other healthcare professionals, and update families on patient status in the ER.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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Updated on 23^rd Feb 2024