As I was editing a manuscript on patients undergoing surgery for brain tumors, I came across the sentence, “Patients who required emergency care were admitted to the hospital and classified as needing emergent or urgent surgery.” As I reread the sentence, the terms emergency, emergent, and urgent started to swim before my eyes, each backstroking to take the place of the other. Soon I was reading, “Patients who required urgent care were admitted to the hospital and classified as needing emergency or emergent surgery.” And then, “Patients who required emergent care were admitted to the hospital and classified as needing emergency or urgent surgery.” What was going on? Was my late-night habit of perusing stylebooks and usage guides before bedtime starting to produce side effects (oops, I mean adverse effects)? Was I no longer able to delineate the difference between commonly used medical terms? I had to take action.
Diligent medical copy editor that I am, I turned to my bookshelf, which is chock full of dictionaries and grammar, usage, and editing books. Now I would be able to solve this conundrum. I would take this problem step by step, or rather word by word, and find the resolution. Here’s what I found:
Emergency
Stedman’s Medical Dictionary1 defines emergency as “an unexpected development or happening; a sudden need for action.”
Dorland’s Illustrated Medical Dictionary2 defines emergency as “an unlooked for or sudden occurrence, often dangerous, such as an accident or an urgent or pressing need.”
Merriam-Webster’s Collegiate Dictionary3 defines emergency as “an unforeseen combination of circumstances or the resulting state that calls for immediate action.”
Consensus! There’s nothing a copy editor likes better.
Resolution: An emergency is basically an unexpected event that requires immediate action.
Emergent
Dorland’s defines emergent first as “pertaining to an emergency” and second as “coming into being through consecutive stages of development, as in emergent evolution.”
Stedman’s omits the definition stemming from the term emergency and defines emergent first as “arising suddenly and unexpectedly, calling for quick judgment and prompt action” and second as “coming out; leaving a cavity or other part.”
Merriam-Webster’s defines emergent as “arising unexpectedly” or “calling for prompt action.”
This one’s a little trickier. Dorland’s relates the term emergent to emergency and Stedman’s and Webster’s simply define emergent as the adjectival form of the noun emergency. So, is there a difference between these 2 words or are they synonymous? It was time to reach deeper into my bookshelf.
I first turned to the classic text A Dictionary of Modern English Usage by H. W. Fowler.4 I knew Fowler wouldn’t let me down. Fowler’s entry on emergence and emergency reads as follows, “The two are now completely differentiated, -ce meaning emerging or coming into notice, and -cy meaning a juncture that has arisen, especially one that calls for prompt measures.”
After some additional research, I found this entry in Common Errors in English Usage by Paul Brians5: “The error of considering ‘emergent’ to be the adjectival form of ‘emergency’ is common only in medical writing, but it is becoming widespread. ‘Emergent’ properly means ‘emerging’ and normally refers to events that are just beginning—barely noticeable rather than catastrophic. ‘Emergency’ is an adjective as well as a noun, so rather than writing ‘emergent care,’ use the homely ‘emergency care.’”
Eureka! Emergent means beginning to arise and emergency means arising unexpectedly.
Resolution: Use emergent to mean emerging (as in Dorland’s section definition of “coming into being through consecutive stages of development, as in emergent evolution”) and emergency to mean an unexpected event that calls for immediate attention.
But then what about urgent?
Urgent
Neither Dorland’s nor Stedman’s defines the term urgent.
Merriam-Webster’s Collegiate Dictionary defines urgent as “calling for immediate action.”
So, can urgent and emergency be used interchangeably? The Children’s Hospital of Wisconsin website provides a list of surgery types. It groups urgent or emergency surgery and defines it as surgery “done in response to an urgent medical need, such as the correction of a life-threatening congenital heart malformation or the repair of injured internal organs after an automobile accident.”6 However, the website Trivology.com states, “There is major difference between elective, urgent, emergency surgery. In urgent surgery we can wait until the patient’s health is unwavering but it has to be performed in 1-2 days. But emergency surgery needs to be performed without any impediment otherwise there will be colossal risk to patient’s life.”7
Therefore, in medical editing, be careful of changing emergency to urgent because emergency means immediate attention is required and urgent indicates quick but not immediate action is required. There is no such thing as emergent surgery unless you mean surgery that is just beginning.
Resolution: Although emergent and urgent both indicate calls for swift action, urgent is more, well, urgent.
Well, there you have it. I guess that original sentence I was editing makes sense after all. “Patients who required emergency surgery [immediate surgery because of the unforeseen nature of the incident] were admitted to the hospital and classified as needing emergent [with a few hours] or urgent [within 24 hours] care.”— Laura King, MA, ELS (January 2013)
1. Stedman’s Medical Dictionary. 26th ed. Baltimore, MD: Williams & Wilkins; 1995.
2. Dorland’s Illustrated Medical Dictionary. 32nd ed. Philadelphia, PA: Elsevier Saunders; 2012.
3. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc; 2003.
4. Fowler HW. A Dictionary of Modern English Usage. 2nd ed. Oxford, England: Oxford University Press; 1965.
5. Brians P. Common Errors in English Usage. 2nd ed. Sherwood, OR: Williams James & Co; 2008.
6. The Children’s Hospital of Wisconsin website. Types of Surgery. http://www.chw.org/display/PPF/DocID/22082/router.asp. Accessed January 10, 2013.
7. Trivology.com. http://www.trivology.com/articles/209/what-is-elective-surgery.html. Accessed January 10, 2013.
very interesting – A French doctor friend asked me the difference and I said that emergent in that medical sense was probably either a mistake or American…
thanks for the clarification
It appears that in some countries where English is used but not as a common language this mistake is common, and was brought along with immigrants to the US. It is a non-idiomatic translation from their common language. A similar error from the same source is usage of “revert” to mean “reply,” as in “If you are interested in our offer, please revert immediately.”
I was always taught that emergent meant that something (a plant, a problem) was just beginning to be visible, and had nothing to do with an emergency. I also learned that urgent meant something had to be dealt with quickly, but was not (yet) an emergency. It’s been only in the last 10-20 years that I’ve noticed people (medical personnel, in particular) using emergent like emergency.
Good job on this Laura. You have confirmed for me and others the problem with using this term in national guidelines.
Thank-you for this excellent disambiguation. I have worked in hospitals for 35 years and only in the last few months have I begun to hear medical know-it-alls using the term “emergent” to mean situations that present with a higher acuity than urgent. I wish hospitals had medical-grammar stewards who could prohibit this usage.
Thanks so much for the excellent research. I am a translator of medical documents from German and Russian into English and expect I will be applying it to my own work. “Emergent” especially has drawn my notice, as I was given a handout at the doctor’s recently that said “non-emergent” calls would be returned within 2 business days. I guess my take-away from this is that “emergent” in the medical milieu is “emergency,” perhaps with the intent of sounding more professional. I am certainly okay with that; it’s their profession after all.
Their profession, but I think there is enough of medical jargon already and common English should not be owned by any profession.
Just well said
Thanks for this excellent piece. There’s a need for a shortened form of “emergency” that could be used in charting, and “emergent” has started to take on that role. But that’s not what it means! I’m taking a medical scribing course and, as a writing center tutor and logophile, it has been tormenting me that so many healthcare professionals use “emergent” when they mean “emergency” or “urgent.”
“There’s a need for a shortened form of “emergency” that could be used in charting.”
How about “emrg” when written?
I’m thoroughly impressed by this deciphering of a conundrum that’s been puzzling me for quite some time now. Please let me preface this comment with the fact that I don’t work in the medical profession or have any formal training so I defer to those of you here who do. However, I am a woman with many medical conditions, regularly having procedures, 3 surgeries just in the last 14 most, and almost constantly seeing doctors therefore having to communicate accurately many medical situations. I also am a lover of the English language and utilizing my vocabulary properly. I am simply qualifying why I am daring to comment without being formally qualified. I say all that to say this: If emergent properly refers to a state of emergence, there is a need for an abbreviated form of emergency but one that could be interchangeable in both charting and verbalization, it doesn’t make sense technically to consider an emerging surgery, then because of all those reasons, which I’ve gathered from the comments everyone here seems to be in agreement with, then as long as it’s used in this context or others where there could be no confusion ( such as emergent situation) but rather where it couldn’t make sense as anything other than a shortened form of emergency (such as emergent surgery, emergent procedure) then doesn’t it fit the bill for its need? I certainly understand and respect the imperative need for accuracy in the medical field, especially in such situations as these words delineate or myself certainly and others. But if context is everything, it’s used properly, and there’s a need, aren’t we cutting off our noses to spite our faces in this instance with our absolute need for English root word accuracy?
Context is not–or *should* not–be EVERYTHING. Why? Because when it comes to good judgement about creating and using new words (or new senses for old words), the communicator should realize that there’s a nearly ineluctable tendency for things originally intended for one special context to wander into other contexts. And this often leads to confusion. This is one of the best reasons to NOT stipulate or adopt novel, unintuitive uses unless its really, really necessary. (And “sounding more professional” does not count as really necessary in my book.)
Note that “emergent” has one fewer letters than “emergency”. Would the very small benefit of this difference, as supposedly accrued in the realm of charting, justify all the resultant confusion and usage discussion? Call me HIGHLY skeptical.
Is it one fewer letters or one fewer LETTER?
Thank you for clarifying these terms. I am new to ED lingo and came across these terms and was super confused. English is not my first language so I asked my partner and he explained it the same way you interpreted these terms; I countered that the documentation I was reading made it sound like “emergent” was more ‘urgent’ than “emergency.”
It does seem like medical literature now is using ’emergent’ to mean an emergency and more time-sensitive than ‘urgent.’ Quite confusing!
Still confused, I guess. Emergent is more time-sensitive than urgent. But emergency demands the most time-critical call to action.
Is this a correct understanding?
“Emergent” and “urgent” are not related in this manner; “emergency” and “urgent” are, with “emergency” being more time-critical than “urgent.”
Thanks for clarifying. My wife (medical) uses “emergent” synonymously with “emergency situation”, which has never felt correct. As an ecologist, I tie emergent to arise, as in “emergent wetland vegetation” pokes above the water surface.
The somewhat emergent agreement regarding “emergent” usage makes me feel correct. Still, I resolve not to correct my wife.
Thank heck you solved this conundrum. I read about EMS personnel responding to “emergent” and “non-emergent” situations and I started to black out. How could I go nearly 50 years and not know that “emergent” was a form of “emergency?” The answer: It isn’t. The world makes sense again.
Good Luck righting the ship!
I am also confused as to the emergence of “emergent” when the meaning dictates “emergency.” I had tried to find the source of that error. It appears that in some countries where English is used but not as a common language this mistake is common, and was brought along with immigrants to the US. It is a non-idiomatic translation from the common language. A similar error from the same source is usage of “revert” to mean “reply,” as in “If you are interested in our offer, please revert immediately.”
BTW, there are two errors in the article. I believe that the “There is major difference between elective, urgent, emergency surgery” is a misquote. I believe it is missing an “and” before “emergency.”
The other error is in “as needing emergent [with a few hours] or urgent [within 24 hours] care.” I believe that a suffix “in” is missing from “[with.”
I disagree with the use of “emergent” in “as needing emergent [with a few hours] or urgent [within 24 hours].” I still feel the usage would be properly “as needing immediate [within a few hours] or urgent [within 24 hours]” surgery. Alternatively, “as needing emergency [with a few hours] or urgent [within 24 hours]” surgery, though I prefer my former use since “emergency” should imply “immediate,” and “within a few hours” is not “immediate.”
Finally, in “There is no such thing… as emergent surgery, unless … just beginning,” is incorrect. “Emergent” does not mean “beginning” but rather “becoming apparent.”
It’s not about perfectly correct grammar, it’s about standardizing the priority of unplanned care so as to mitigate the extra rate of complications that accompany unplanned surgeries.
How does using “emergent care” as a synonym for “emergency care” help with the standardization you’re suggesting is the most important focus in this medical context? (That’s a fair question, right?–since this is a discussion about English usage, not about the calculus of medical triage.)
Understandable. One does not want to create an emergency over “emergent.”
If the word “emergent” in medical sense is becoming common and is in some dictionaries, defined as “pertaining to an emergency” why would you ever recommend it be used to mean something different, or be used at all?
It would seem to me, that if one recommend people use the word as in this article, if someone saw the word and didn’t understand what was meant and looked it up in say, Merriam-Webster, they could mistake its use to mean emergency. Or worse, they could look up this article, and mistake something that is an actual emergency for something that is just beginning and not really a big deal yet. It seems to me one should just recommend people not use it at all.
I work in the fire service as a career assistant chief. The use of emergent or more specifically non-emergent has become increasingly prevalent. Someone somewhere heard another person say “I will continue to the scene non-emergent”. It has stuck. I have tried to explain it is an incorrect use of the English language but it has become the vernacular for our department In place of non-emergency.
A Japanese English student took exception to the use of emergency in a business sense, saying only urgent was correct and implying that even foreign companies must acknowledge this.
While I know this usage might be quite different from the triage above, correct me if I am wrong, but can it not be important to use the term “emergency” in some cases for business? For example, I imagine many companies called emergency meetings for Covid-19, critical business decisions, death of a corporate head or board member, etc.? As to emergent, this seems somewhat archaic in use. But in business, can’t a threat or opportunity be noted as “emergent?” I would never use it, favoring the present progressive “emerging,” but I am sure I have heard this usage.
Thank you for this. In my specialty of cardiology the term “emergent surgery” has become ubiquitous in international meetings and guidelines where it is used to mean “emergency”. Its use in this manner has always struck me as being incorrect and indicative of a misunderstanding of its true meaning. Like many medical specialties, cardiology is practised in the international arena with English used by individuals for whom it is not their native tongue and I suspect this might explain the origin of this error. Emergent has now become so widely understood to mean “emergency” in the language of international medicine that perhaps the language will evolve so that the two words become synonymous.
I am happy to read this clarification. I agree with you that nowadays it seems emergent and emergency are used interchangeably. My husband was in the hospital recently and both a nurse and a doctor used the word “emergent” to mean emergency. It was a new term for this old teacher!
> “Eureka! Emergent means beginning to arise and emergency means arising unexpectedly.”
No less an authority than the OED includes the following definition for “emergent”: “Casually or unexpectedly arising; not specially provided for.” It also includes usage examples for that definition ranging from the 16th to 19th centuries!
https://imgur.com/a/AUjJrJT
It’s all labeled by what priority of care should be or timeframes for treatment
Urgent Care (Facility)- you have a problem that you need fixed, but isn’t life threatening or would compromise your health. Examples : UTI, Bronchitis, sprained ankle, minor injuries
. Urgent care facilities usually open later but not 24/7
Emergency Room / ER- should be for serious injuries that need to be addressed today, but in reality , most Patients that come to the ER should have gone to urgent care . ER is open 24/7. ER billing is far more expensive as they are staffed to handle emergencies in skill and supplies. A sprained ankle in the emergency room costs 1600$ vs urgent care 200$ billed to insurance.
Emergency- layman talk for a pressing health concern
Emergent – (usually describes the urgency of a needed procedure or surgery . This is based off statistics that show outcomes depending on how long you can wait. An emergent condition, is one that requires relatively (immediate) intervention .
Examples : Perforated/Acute abdomen, appendicitis, gunshot wound to the chest, heart attack (emergent catherization)
Urgent (procedure or surgery) – statistically backed time frame that says an intervention needs to be done – not necessarily immediately, but within 36 hours.
Elective- (procedure or surgery)- an intervention that will correct a problem, but isn’t life threatening. Ex: cosmetic surgery, non-painful hernias, some reservations, Spinal fusion
Emergent > Urgent > Elective
Emergent surgeries are associated with poorer outcomes, independent of the disease, which infers making unplanned surgeries say at 3 am from an overworked surgeon and assembling tired staff increases work error. So don’t mAke a surgeon do your non painful hernia repair at 4am.
But obviously , a gunshot wound to the chest requires immediate (emergent) surgery and takes the increases error as collateral risk
It’s all about standardizing the timeliness of unplanned care
-MD
Nail email: Uh…I think you’re a little off-topic here. On second thought, make that “off-blog”.
The original post is a pretty useful discussion (thank you!), but it ends on a confused note. Earlier in the piece, you write, “Resolution: Use emergent to mean emerging…and emergency to mean an unexpected event that calls for immediate attention.” But near the end of your post you write, “Resolution: Although emergent and urgent both indicate calls for swift action, urgent is more, well, urgent.” And finally you write, “I guess that original sentence I was editing makes sense after all. ‘Patients who required emergency surgery…were admitted to the hospital and classified as needing emergent…or urgent…care.’” SAY WHAT?! Are you TRYING to endorse multiple meanings of “emergent”–both as a variant of “emergency” and not? (Hmm… I don’t actually think so.)
Hello. I work as an assistant chief in a modest sized career fire department in upstate New York. A few years ago it became commonplace for our firefighter/ emts to announce on the radio that they were responding to a call Emergent. This just didn’t sound right to me. English was my poorest subject but I did manage to Graduate from a “brick and mortar” University with a BSME degree. I did research online and discovered how wrong their usage was. I even tried to tell them. I was then hazed. At this point would it be fair to say the meaning of “Emergent” has changed to that of “Emergency” through the vernacular of those working in EMS? This has happened to so many words it’s difficult to converse with some people today.
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