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Dr Mark Porter discovers the difference between the old-style Casualty and a modern hospital Emergency Department like Southampton's - where the latest technology is used to rapidly assess and treat everything from suspected strokes and heart attacks to febrile convulsions and broken limbs.

As well as running the busy Southampton ED - which treats 90,000 patients every year - Dr John Heyworth is also President of the College of Emergency Medicine. He says the discipline has managed to evolve - from one which provided a surgical "fixing" service 25 years ago - to today's, providing rapid support for an increasing number of critically ill patients. The complex needs of our ageing population puts extra demands on the staff - and Southampton has a consultant in the ED until midnight, every day of the week to provide the best possible care.

Specialist staff including Emergency Nurse Practitioners are on hand as a guide through how children are assessed and treated in a separate areas, the triage system and the infamous 4 hour waits. As well as a resuscitation area, the ED is close to the Cath Lab - where a balloon is used to widen blocked arteries. If a heart attack is suspected, a troponin blood test will be carried out quickly by the ED to give a definitive answer, giving a safe and timesaving outcome for patients.

Mark Porter asks how the ED in Britain compares with the rest of the world - and how emergency care will fare in these straitened times.
Producer: Paula McGrath.