The St.Emlyn’s Podcast
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Episodes
Wednesday Dec 22, 2010
St.Emlyn's
Wednesday Dec 22, 2010
Wednesday Dec 22, 2010
EBEM stands for evidence based emergency medicine. We are a group of emergency physicians based in Manchester, England who are passionate about getting academic 'evidence' into clinical practice. We are researchers, clinicians, teachers and enthusiasts for moving our speciality forward.
Our aim is to link the best of academic emergency medicine into clinical practice. You can learn more by visiting our related websites.
Bestbets at http://www.bestbets.org is a repository of over 2000 evidence based articles on emergency clinical practice.
StEmlyns at http://www.stemlyns.org is our virtual hospital
StEmlyns (Moodle) at http://classroom.stemlyns.org.uk is our online classroom
Do visit and subscribe to our blog at http://stemlynsblog.org
So have a look around and listen to the podcasts. You might learn something, or you might be able to teach us something. Give us feedback and argue your case. We'd love to hear from you.
Wednesday Jun 04, 2014
Ep 2 - SMACC Chicago
Wednesday Jun 04, 2014
Wednesday Jun 04, 2014
The St.Emlyn's choirmaster has asked Iain and Simon to deliver a sermon on the importance of attending the SMACC Chicago conference in May 2015. After their pilgrimages to Australia in 2013 and 2014 they came back enthused and at times rather annoying about how jolly marvellous it all was. We felt that it was important for them to share their thoughts and to ask if anyone wishes to join them on their planned trip to the Northern Americas next year. AS Choirmaster at St.Emlyn's I have reluctantly decided to give them some air time.I have the honour to be, as always, your most dutiful servants.Yours etc.The St.Emlyn's Choirmaster
Tuesday Jun 10, 2014
Ep 3 - Understanding diagnostics 1. SNout SpIn and Probability. St.Emlyn's
Tuesday Jun 10, 2014
Tuesday Jun 10, 2014
A podcast discussing sensitivity and specificity of diagnostic tests and how we can use this in our everyday medical care of patients.
This article from the Centre for Evidence Based Medicine is also useful.
Sunday Jun 22, 2014
Ep 5 - Understanding diagnostics 3. Why prevalence helps us stay in practice
Sunday Jun 22, 2014
Sunday Jun 22, 2014
Iain and Simon tackle the effect of prevalence on diagnostic performance. Mrs Trellis of North Wales makes a return appearance to discuss the delicate issues of sensitivity and Rick Body joins us by mail to raise concerns about the difficulties of missing patients with myocardial disease.Listen and enjoy, visit the blog site and keep in touch.Don't forget to subscribe to the podcast via iTunes, to subscribe to the blog site and to like us on facebook.vbS
Thursday Jun 26, 2014
Ep 6 - SMACC Back-Back on What to believe and when to change.
Thursday Jun 26, 2014
Thursday Jun 26, 2014
Hopefully you will have already seen and listened to my SMACC talk on 'What to believe and when to change'. If not then please whizz over to the site now and have a listen. I really enjoyed exploring the uncertainties that exist around when we decide to adopt or abandon therapies.My belief is that it's really difficult to define the perfect moment and that it's only in retrospect that we can define it.Since appearing on the ICN network and St.Emlyn's, Scott Weingart, one of the best and most innovative clinicians I know has come back and argued for early adoption. You can check out his rationale on his site and see what you think.I actually agree with many of the things he tells us, although he has confined himself to one side of the argument. In terms of a defence of early adoption he makes a good case, but like all debates there needs to be another side to the story, so sit back and listen to why we must reflect hard on the decisions we make in deciding what we do, why we do it, and most importantly when.vbS
Sunday Jun 29, 2014
Sunday Jun 29, 2014
Iain and Simon chat about how we can start to translate research findings in to natural frequency summaries that help clinicians and patients alike understand the value of therapeutic interventions.The NNT site we mention is just fantastic. Visit them here
Great revision page here by the amazing LITFL crew The NNT for tranexamic acid is 67 not 50.S
Tuesday Jul 08, 2014
Ep 8 - Trauma Team Leadership
Tuesday Jul 08, 2014
Tuesday Jul 08, 2014
Iain and Simon discuss the challenges of getting our trauma patients to the CT scanner within 30 minutes of arrival.The 30 minute target is a UK standard, and we did not set it! All UK trauma centres are judged against the target and (rightly or wrongly) it has become a real issue for many centres. We would be really be interested in what our International colleagues think about the target and the resultant strategies outlined by the team. There's more on this at the St.Emlyn's website.As always, we'd love to hear your comments.vbS
Thursday Jul 17, 2014
Ep 9 - What can we do about targets in the ED?
Thursday Jul 17, 2014
Thursday Jul 17, 2014
It is a little known fact that to be successful as an emergency physician in the UK it is vital to take a three month rotation in Archery. Archery is a key skill for us all dating back to Medieval times when we introduced the longbow into warfare. This devastating tool could cause panic in opposing forces, scattering them into many wide and ineffective directions. In short they were an effective tool to cause and disruption inthe opposition ranks whilst the noble English armies of old strode forward with their visions of the future. Soldiers trained using targets to hone their skills and to focus on the aim - meeting the target.Of course these days we do not have real bows and arrows in the emergency department, but archery remains alive and well. In the modern NHS we still train our troops in archery, or at least in the principle aim of archery - to meet the target.With our long history of target setting and target hitting it is therefore no suprise that we are world leaders in standards/targets/indicators....., whichever term you prefer in fact and it has to be said that a target culture in the NHS has been criticised widely, even being blamed for the exodus of trainees to Southern climes, but there is arguably more to it than that.In last weeks episode we touched on new targets around trauma care in the UK and that raised many questions and opened a debate on twitter. This week we want to take those thoughts further and ask what we, as the archiest of arch archers across the entire NHS can do with these externally set targets.What we forgot to say in the podcast is the absolute need to work alongside a short stay admissions unit under the ED umbrella. Without that you would really struggle to deliver safe and efficient care. We both work in units with short stay admission units that allow us to deliver safe diagnostic and therapeutic interventions to our patients.So, with some trepidation Iain and I ask whether all targets are a bad thing....vbS
Monday Jul 21, 2014
Ep 10 - Intro to EM: Staying safe in your first job
Monday Jul 21, 2014
Monday Jul 21, 2014
If you're starting out in EM then it can be a scary time. Iain and Simon talk through some of the initial anxieties and ask what you need to know to be safe, sensible and super.
Remember our top ten tips...
Respect those around you and value their opinion
The History is everything
There are 4 key treatments we give in the ED – think whether every patient you see needs any of these and you will save lives and relieve pain
Oxygen
Fluids
Analgesia
Antibiotics
Think ‘What difference have I made to this patient?’. Always try to make a difference, however small (it may “just” be getting them an extra blanket)
No patient (almost) wants to be in the ED. They really don’t. It wasn’t what they planned for their day.
Spend twice as long with patients you don’t like or don’t get on with.
Look the part. Be smart. Behave in the way you would expect anyone to behave towards you.
Be on time. Always. Ansd leave on time if at all possible.
Take your breaks – eat when you can and drink water when you can’t.
Enjoy yourself…
Sunday Jul 27, 2014
Ep - 11 Understanding Troponin Part 1
Sunday Jul 27, 2014
Sunday Jul 27, 2014
Do you remember when it took three days to 'rule in' or 'rule out' an acute myocardial infarction (AMI)? When I was a medical student doing my first clinical attachments, I remember doing ward rounds on the CCU seeing patients with suspected AMI. The way they were managed is a million miles from what we do now. Back then, patients would have serial ECGs and then be admitted for cardiac enzyme evaluation over the course of the next 3 days. We'd measure CK, AST and LDH. 'CK' was the so-called 'early marker', which would rise early after the start of an AMI. Today we use CK as a marker of skeletal muscle damage (e.g. rhabdomyolysis). AST and LDH (today we think of these as liver function tests, I know) were the 'late markers' - and by late I really mean late - we might see a rise on days 2 and 3.Could you imagine for a second, in today's world, ruling out AMI because their CK and LFTs were normal? It's completely unthinkable. That's how much cardiac troponin has changed our practice. We rely on it so completely to diagnose AMI. And yet, it's one of the most misunderstood tests in medicine. Given how much we use it, I guess we feel that we all should know lots about this test. But doctors still have so many questions. Here are just a few:What is cardiac troponin?Why is it a marker of AMI?What else causes a raised troponin and how?Should we be doing troponins at 3 hours, 6 hours, 12 hours? What's the difference and what's the evidence?What is a 'delta troponin'?What do you need to 'rule in' AMI?How do you use cardiac troponin in patients with renal failure?This is just a brief list. With the research I do in this area and my experience developing protocols/guidelines, people get in touch to ask questions like this quite a lot. There are loads of questions that people ask - but there are lots of themes in common. We thought it was about time we produced a handy run down in the true spirit of #FOAMed.Take a listen to Part 1 of our troponin podcast. While Simon and Iain have been prolifically churning out spectacular stuff for some time now, this is my debut on the St. Emlyn's podcast. I really enjoyed talking about troponin with Iain - and I hope we covered some useful stuff.We'll cover more in part 2, when we'll move on to discussing high sensitivity troponins, what they are, how to use them and how to speak the troponin lingo. Please get in touch if there's anything we haven't covered that you'd like us to, or if there's anything you'd like us to elaborate on some more!Rick
Wednesday Aug 06, 2014
Ep 14 - Exeter CEM conference with Adam Reuben
Wednesday Aug 06, 2014
Wednesday Aug 06, 2014
Adam Reuben is a super chap. A rugby playing, friendly, engaging, hard working, researching, teaching emergency physician from Exeter in the lovely county of Devon. In addition to being generally awesome he is also the convener of this year's College of Emergency Medicine conference in Exeter from the 9th to the 11th of September 2014. There is still time to come and the program looks really good and features some fantastic presenters.
#AWESOME ALERT - CLIFF REID WILL BE THERE - YOU HAVE TO BE TOO!!!!I'll be there with many others from St.Emlyn's so if you see me say hi.You can see the program herevbS
Thursday Aug 07, 2014
Ep 15 - Understanding Troponin Part 2
Thursday Aug 07, 2014
Thursday Aug 07, 2014
Recently we published part one of our series on cardiac troponins. If you haven't checked it out yet, you can find it here.
In the second part, we're going to take a look at high sensitivity
troponins and some of the more advanced areas around understanding
cardiac troponin and its use in practice. We'll give you a quick run
down on the troponin lingo - the language you need to be able
to speak in order to fully understand how to use high sensitivity
troponin in your practice, including terms like the limit of blank, limit of detection, co-efficient of variation and 99th percentile.We'll also ask whether Joe Lex had a point when he stirred up controversy around these assays with this legendary tweet:What if we called it "low specificity troponin" instead of "high sensitivity troponin?" Would that knock some sense into people?— Joe Lex (@JoeLex5) October 9, 2012So, check out the associated BLOG POST here and listen to the podcast. There is more on diagnostics and troponin to come very soon.Hope you enjoy! Please keep the feedback, questions and comments coming. As always, we'd love to hear from you.RickDOI:
Much of my research work involves HsT. To help with this I have
received reagents from companies who make HsT assays, but I not received
any other financial benefit or gifts in kind as part of my work and
have no financial ties to any companies.
Friday Aug 22, 2014
Friday Aug 22, 2014
This podcast is part of our induction series for new docs starting in UK emergency departments. You can check out the full post and supporting materials over at the main St.Emlyn's website.vbS
Friday Sep 12, 2014
Ep 17 - Diffuse Axonal Injury with John Hell
Friday Sep 12, 2014
Friday Sep 12, 2014
John Hell is a Neurointensivist at University Hospital Southampton
and very kindly gave up an afternoon to record his thoughts and share
his considerable wisdom about Diffuse Axonal Injury.I also
managed to get him to discuss some other topics including the choice of
induction agents and intravenous fluids in patients with head injury.Please listen, enjoy and comment. We'd love to hear from you, and don't forget to visit the blog site for additional information, slides and content.vbIain Beardsell
Tuesday Sep 23, 2014
Ep 18 - Victoria Brazil on great presentations with St.Emlyn's
Tuesday Sep 23, 2014
Tuesday Sep 23, 2014
Vic Brazil of #FOAMed and #SMACC fame came to talk to the St.Emlyn's team in Virchester. Listen in for top tips on looking great and sounding super.vbS
Tuesday Oct 28, 2014
Ep 21 - Code for Cash and Credibility
Tuesday Oct 28, 2014
Tuesday Oct 28, 2014
Simon and Iain discuss what might appear to be a rather dull subject, but it's not. Coding is a key to developing your department and also to secure the functions of UK emergency departments.A great primer for everyone coming up to FCEM and to anyone interested in how Emergency Departments are funded in the UK.Follow this link to the associated blog post http://stemlynsblog.org/show-money/vbS
Friday Oct 31, 2014
Ep 22 - Button Battery ingestion in children
Friday Oct 31, 2014
Friday Oct 31, 2014
Simon and Nat with a linked podcast to the blog post on the ingestion of button batteries by children.
http://stemlynsblog.org/button-batteries/S
Friday Oct 31, 2014
Ep 23 - Smacc Chicago update
Friday Oct 31, 2014
Friday Oct 31, 2014
Iain and Simon talk about the upcoming SMACC conference in Chicago and do their very best to persuade you to come to the best conference in the worldVisit the site for the full program here. http://www.smacc.net.au/SDOI - Both Iain and myself are being funded to attend.
Wednesday Nov 12, 2014
Ep 24 - Getting started in Emergency Medicine Research
Wednesday Nov 12, 2014
Wednesday Nov 12, 2014
The Challenge and Value of Research in Emergency Medicine: at DGINA 2014Rick Body's talk from DGINA on the need for research in EM.Check out the associated blog post at http://stemlynsblog.org
Saturday Nov 29, 2014
Ep 27 - Intro to EM: The patient with chest pain
Saturday Nov 29, 2014
Saturday Nov 29, 2014
Iain and Simon discuss the dilemmas of dealing with the patient presenting with chest pain to the ED.Blog post link here
Thursday Dec 11, 2014
Ep 31 - London Trauma Conference: Day three round up.
Thursday Dec 11, 2014
Thursday Dec 11, 2014
It's prehospital and helicopter day at #LTC2014! Iain and guest podcaster Caroline Leech chat through the key points of the day.Download the GoodSAM app! https://www.goodsamapp.orgBWNat
Tuesday Jan 06, 2015
Ep 33 - Impact Brain Apnoea with Gareth Davies from London HEMS (LTC 2014)
Tuesday Jan 06, 2015
Tuesday Jan 06, 2015
First of our podcasts from the London Trauma Conference.A fantastic episode with Iain talking to Gareth Davies (from London HEMS) talking about Impact Brain Apnoea.vbSt.Emlyn's
Wednesday Jan 14, 2015
Ep 34 - Intro to EM: Problems in Early Pregnancy
Wednesday Jan 14, 2015
Wednesday Jan 14, 2015
The number of patients seen in each ED with problems relating to
early pregnancy in the UK is very variable - some hospitals have rapid
referral pathways for patients who know they are pregnant. It's still
worth thinking about early pregnancy problems though as all EDs see
young women and many of these may not yet know that they are pregnant.Our induction podcast covers our approach to women presenting to the EDNat and Iain :-)
Sunday Feb 22, 2015
Ep 39 - Prof. Tim Harris on Shock Assessment (LTC 2014)
Sunday Feb 22, 2015
Sunday Feb 22, 2015
Do you think you're awesome at assessing shock?Think again!The stupendous Prof Tim Harris (who St.Emlyn's loves) tells us that all is not quite as it seems.....Listen, learn, be awesome.vbS
Friday Feb 27, 2015
Ep 40 - Opiate overdose in the ED
Friday Feb 27, 2015
Friday Feb 27, 2015
Simon and Iain debate how the management of opiate OD has changed in the ED.Surely you're not still giving massive doses of naloxone IV and IM are you? Really? Maybe this will make you think again.vbS
Sunday Mar 22, 2015
Ep 42 - Paediatric Major Trauma with Ross Fisher (LTC 2014)
Sunday Mar 22, 2015
Sunday Mar 22, 2015
I recently met Ross in the flesh. What a super chap. A great clinician who really wants to improve care for injured children in the UK and around the world.In this podcast he gives us a paediatric perspective on how we should approach the seriously injured child.Great stuff, controversial in places, challenging to adult dogma and always excellent.SPS. If you ever get to hear him speak.... then do, he's awesome. Check this out.
Thursday Mar 26, 2015
Ep 43 - APLS 2015 updates for the management of the serious injured child
Thursday Mar 26, 2015
Thursday Mar 26, 2015
A short podcast updating the UK Advanced Paediatric Life Support (APLS) course guidelines for the management of trauma in children.Don't forget to read the blog post here. APLS Updates: New kids on the block,vbS
Saturday Apr 18, 2015
Ep 44 - Tim Draycott on Obstetric Trauma (LTC 2014)
Saturday Apr 18, 2015
Saturday Apr 18, 2015
Iain interviews the wonderful Tim Draycott on the management of the Obstetric patient with trauma.Tim is a consultant Obstetrician from Bristol and is a great speaker on this rather terrifying topic!
Thursday Jun 04, 2015
Ep 48 - Intro to EM: The patient with back pain.
Thursday Jun 04, 2015
Thursday Jun 04, 2015
Another induction podcast on a common condition in the ED. Back pain in the ED - it's not all musculoskeletal and there are some really risky diagnoses out there that you need to think about.Back pain is a multi system disorder....., until you can prove otherwise.Don't forget to listen to Iain's talk on chronic pain link here. https://vimeo.com/97811644vbSRed flag symptoms and analgesia advice below.
Saturday Nov 28, 2015
Ep 58 - Clinical Judgement for the Emergency Physician
Saturday Nov 28, 2015
Saturday Nov 28, 2015
My talk from the RCEM conference in Manchester 2015. Linked blog post here. http://stemlynsblog.org/making-good-decisions-in-the-ed-rcem15/Slides are here http://www.slideshare.net/simoncarley7/making-good-decisions-rcem-2015-manchester-wednesdayHave fun and enjoy your emergency medicine.S
Tuesday Dec 08, 2015
Ep 60 - Londoon Trauma Conference 2015 Day 1 Summary
Tuesday Dec 08, 2015
Tuesday Dec 08, 2015
Greetings from the London Trauma Conference!As
has become our pre-Christmas custom, Iain and I have been hanging out
at the fabulous London Trauma Conference, hearing about advances and
controversies in trauma care and tracking down some of the speakers to
find out exactly what they really think (and recording it, for podcasts we'll release in due course).The
conference extends over four days, incorporating the Air Ambulance and
Prehospital Day and the Cardiac Arrest Symposium; unfortunately we can't
stick around for those but our colleagues over at the RCEM FOAM network will be podcasting from those days too, so keep an eye on their site and podcast feed too.
Wednesday Dec 09, 2015
Ep 61 - Londoon Trauma Conference 2015 Day 2 Summary
Wednesday Dec 09, 2015
Wednesday Dec 09, 2015
Our summary of Day 2 of the excellent London Trauma Conference. A unique threesome from Nat, Simon and Iain.....
Friday Jul 08, 2016
Friday Jul 08, 2016
Whilst we were in Dublin at the SMACC conference we took the opportunity to get some great minds together on the subject of ED handover at the point between prehospital and hospital teams for the critically ill or injured patient in the resus room.
This is an area of some difficulty in many areas (prob shouldn't be, but it is) and we thought it would be fun and useful to get perspectives from both sides.
As ever, we are not here to be definitive and your service may have a fantastic model that works well. This podcast is to help you think about what you're doing and to consider whether it can be improved.
Doug Lynch is a retrieval doctor from Australia
Ashley Voss-Liebig is a flight nurse from Texas
Natalie May is a retrieval doctor from Sydney (Virchester Alumnus)
Rusty Carroll is a senior paramedic from Virchester and a great supporter of the ATACC group.
We don't have all the answers, but we do have the ideas.
In Virchester it can certainly be improved.....
Tell us what you think and keep an eye out for the blog post on the same subject coming soon.
vb
S
Sunday Jul 31, 2016
Sunday Jul 31, 2016
Part 2 of our podcasts on major trauma handovers. This follows on from the discussion at SMACC and is intended to operationalise the concepts we talked about then. This is aimed at a UK audience but should apply pretty much anywhere. So hands off, eyes open and listen in, here we go.
Thursday Nov 17, 2016
Ep 83 - The Teaching Course in NYC Round Up
Thursday Nov 17, 2016
Thursday Nov 17, 2016
A quick round up of events from the excellent Teaching Course in New York (https://flippingmeded.com/) with guests Ross Fisher (@ffoliet), Ashley Leibig (@ashleyliebig), Sandra Viggers (@StarSkaterDK) and Camilla Sorenson (@Camillabirgitte).
For brilliant summaries of each day, with details from every talk, visit http://scanfoam.org/teaching-course-nyc-day-1-ttcnyc16/ (Day 1) and http://scanfoam.org/teaching-course-nyc-day-2-ttcnyc16/ (Day 2)
Saturday Jan 14, 2017
Ep 87 - Critical Appraisal Nugget 6: Retrospective and Prospective studies
Saturday Jan 14, 2017
Saturday Jan 14, 2017
Rick and Simon talk about the merits of prospective and retrospective studies
Sunday Mar 05, 2017
Ep 89 - March 2017 Round Up
Sunday Mar 05, 2017
Sunday Mar 05, 2017
In a new podcast format Simon (@EMManchester) and Iain (@docib) discuss the month's offerings from the St Emlyn's blog and podcast (www.stemlynsblog.org).
It's been a month full of interesting posts on subjects as diverse as Thrombolysis in Stroke (Alan Grayson), The Future of Emergency Medicine in the Social Age (Simon), Cardiac Arrest Centres (Simon), Love in Critical Care (Liz Crowe), Transfers (Nat and Simon), Thrombolysis in PE (a guest post from FOAMed legend Anand Swarminathan) and Benzos in Back Pain (Janos). Head to the website for the articles themselves and all the references and links you need.
We're aiminig to make this a regular monthly podcast - let us know if it's useful and enjoyable and how we could make it even more educational.
Monday May 15, 2017
Monday May 15, 2017
A critical appraisal nuggest on simple ways to understand the true effect of an intervention. Also see this more in depth podcast done with Iain Beardsell
http://ebem.podbean.com/2011/11/03/statistics-2/
vb
S
Wednesday Aug 02, 2017
About us
Wednesday Aug 02, 2017
Wednesday Aug 02, 2017
St.Emlyn's is a virtual hospital based in Virchester.In
reality we are a team of Emergency Physicians, friends and colleagues
interested in medical education, emergency medicine and critical care.
We blog because education matters. Our numbers are growing every day...
please feel free to contact us.Senior EditorsProfessor Simon Carley FOAM(Ed)
Professor of Emergency Medicine, Manchester Metropolitan University;
Consultant in Emergency Medicine. Co- founder of BestBets, StEmlyns, MSc
in EM and other stuff. Research interests in diagnostics, MedEd, Major
incidents & Evidence based Emergency Medicine. *Read Posts*Professor Rick Body MB ChB, MRCSEd(A&E), FCEM, PhD
Consultant in Emergency Medicine at Manchester Royal Infirmary and
Honorary Lecturer in Cardiovascular Medicine at the University of
Manchester. Major research interests are in the early diagnosis of acute
coronary syndromes and humane approaches to improving patient
well-being in the ED. Methodological expertise in clinical decision
rules, diagnostic studies and cohort studies. - Research - Blog - *Read Posts*Editorial Board Dr Natalie May MBChB, MPHe, MSc, MCEM, FCEM
Consultant Emergency Physician with speciality training in Paediatric
Emergency Medicine, currently working in Prehospital and Retrieval
Medicine at Sydney HEMS. Numerous interests in medical education, leadership and emergency paediatrics. #FOAMaoke queen, obsessed with running. *Read Posts*Dr Iain Beardsell FOAM(Ed)
Consultant in Emergency Medicine and Clinical Lead, University
Hospitals Southampton and HIOWW HEMS doctor. A passionate advocate for
EM with a cup that is (almost) always half full. *Read Posts*Dr Alan Grayson
Grumpy, balding Yorkshireman, who despite practising medicine on the
good folk of Manchester and its environs, still lives in god's own
county, after a brief sabbatical learning medicine in Edinburgh and then
training in EM in Newcastle and NW England. Has an unhealthy interest
in bikes, pies, cricket and Huddersfield Town FC. *Read Posts* Dr Richard Carden BSc, MSc, MBChB, MRCEM, RAMC(V)
Emergency Medicine trainee. Captain in the Royal Army Medical Corps.
(Reserves). Former MSc Trauma Sciences (Military and Austere) student,
impending Centre for Trauma Sciences PhD student, current Diploma in
Medical Care of Catastrophes student. Interested in trauma, toxicology,
psychology, physiology and critical care. Trainee rep on the St.Emlyn's
team. *Read Posts* Dr Janos Peter Baombe MD FRCEM FEBEEM PgCert MSc
Emergency medicine consultant, Manchester Royal Infirmary. Fellow of
the Royal College of Emergency Medicine. Passionate about european EM
networks, infectious disease outbreaks and ED preparedness,
ultrasonography. World traveller and keen sportsman. *Read Posts* Liz Crowe BSW PhD Candidate
Advanced Clinician Social Worker who has worked extensively in ED and
PICU. Specialises in counselling children,families and staff impacted by
loss, trauma, crisis and bereavement. Doing a PhD on Staff Wellbeing in
Critical Care. Author of 'The Little Book of Loss and Grief You Can
Read While You Cry'. Enjoys Gallows Humour. *Read Posts* Dr Chris Gray BSc MBBS MRCP MRCEM
Emergency Medicine trainee at the Royal Manchester Children's Hospital.
Interested in pre-hospital care, trauma, and critical care. Keen
educator, musician and cake-maker. *Read Posts* Ashley Liebig RN Vet 101st Airborne combat medic. Flight Nurse & Helicopter Rescue Specialist. ECMO enthusiast. #FOAMed lover #SMACC & #SMACCFORCE Organising Committee #TTCNYC16 #resuscitateNYC17. *Read Posts* Dr Laura Howard Junior doctor in Virchester. Interested in mountain bikes, resuscitation, trauma and critical care. *Read Posts* Mr Ross Fisher
Consultant Paediatric Surgeon at Sheffield Children's Hospital and
Chairman of TARNlet. Visiting lecturer in Virchester and basically
anywhere else that will pay bus fare. Owns more Moleskine notebooks than
is healthy, most of them full of ideas on #presentationskills
Passionate convert to all things #FOAMy *Read Posts*Dr Dan Horner BA, MBBS, MRCP, MCEM, FRCEM
Consultant Emergency Physician at Salford Royal Hospitals Trust with
subspecialty training in Intensive Care Medicine. Researcher with
specialist interest in EBM and thromboembolic disease. New to all this
blogging and tweeting, but old to the general chaos and lividity of the
Emergency Department. An interest in VTE, Critical Care and a bit of
trauma now and then. Also trying to stay sane while being overworked and
underpaid. *Read Posts* ContributorsDr Gareth Hardy
Emergency Medicine trainee with a long running and excellent blog.
Thinks beyond the superficial and constantly questions the evidence for
what we do.(Ed - A great asset and probably the only person here who
knows what he's doing!) *Read Posts*Dr Craig Ferguson FCEM
Emergency physician, Manchester Royal Infirmary. Interests in medical
technology, resuscitation and medical research. Research interests in
the diagnosis of acute heart failure in the ED. Fellow of the College of
Emergency Medicine. *Read Posts*
Wednesday Jan 24, 2018
Wednesday Jan 24, 2018
In this podcast Simon talks to Dan Harvey (ITU) and Mark Wilson (Neurosurgeon) on the management of complex patients with a perceived devastating brain injury.
This podcast is linked to the blog on the St.Emlyn's website.
http://stemlynsblog.org/jc-devastating-brain-injury-complex-decisions-in-the-resus-room-st-emlyns/
S
Monday Apr 02, 2018
Ep 107 - January 2018 Round Up
Monday Apr 02, 2018
Monday Apr 02, 2018
Iain and Simon round up the blog posts from January 2018. You can listen to the podcast below. Links to all the blog posts mentioned are listed below.
As 2017 ends and we look forward to 2018 it’s time to reflect on a year with the St.Emlyn’s team. Despite our chronological and geographical dispersal it’s really felt like a team effort in 2017. We have travelled, learned, listened,…Read more
JC: Devastating Brain Injury. Complex decisions in the resus room. St.Emlyn’s
Simon Carley January 4, 2018 3 Comments Social media can sometimes give the impression that all is rosy in the world of resuscitation. We hear of the amazing saves, the wonders of ECMO, helicopters and heroic acts with great outcomes, but the reality is of course very…Read more
[caption id="attachment_31228" align="alignleft" width="300"] northern emergency medicine conference[/caption]
St.Emlyn’s goes further north – NEM Conference #NEMC18
Chris Gray January 9, 2018 0 Comments It’s the second time I’ve been to the Northern Emergency Medicine conference, this year held in the sunny city of Durham. I say sunny… I needed my jacket. Last year’s programme was great and included some fantastic speakers, including our…Read more
JC: Can I safely discharge dizzy patients from the ED?
Janos Baombe January 12, 2018 4 Comments Last month, I came across a clinical review published in the Annals of Emergency Medicine1 that got me really excited! It got me excited (in a geeky professional sense of course…) as it covered a topic that causes significant…Read more
On Reflection
Natalie May January 16, 2018 3 Comments On Reflection I’ve been reflecting on reflection for some time now, at least since I started formally collecting my lessons from Sydney HEMS and probably even before that, because this sort of meta nonsense is something medical education enthusiasts like…Read more
CRYOSTAT-2 with Ross Davenport
Richard Carden January 21, 2018 2 Comments You might be aware that an exciting new trial has started called Cryostat-2. This is exciting as it has the potential to improve patient outcomes, but also because it will involve all the Major Trauma Centres in England and 8…Read more
The End of the ‘Roid? JC: ADRENAL
Dan Horner January 22, 2018 4 Comments So another year, another Critical Care Reviews meeting. Rob is doing an absolutely fantastic job with these, inviting lead authors from major critical care trials to present and defend their work. In fact, this is going so well that this…Read more
Belgian EM at BeSEDiM 2018.
Simon Carley January 28, 2018 0 Comments Last weekend, the BeSEDiM (Belgian Society of Emergency and Disaster Medicine) organised their annual symposium. It is the scientific organization of the Belgian emergency physicians with Said Idrissi as chairman. 13 years ago, Belgian Emergency medicine was born as a…Read more
Is there anything else I need to know? Working in Africa.
Simon Carley January 29, 2018 0 Comments This is a guest post from our good friend Stevan Bruijns aka @codingbrown Stevan has been an advocate of international emergency medicine for many years and he, like us feels that there is much that high income countries can do…Read more
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@EMManchester
Before you go please don’t forget to…
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Simon and Iain belatedly reflect on a tough winter and the posts in January.
Check out stemlynsconference.com if you want to know more about #StEmlynsLIVE
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Tuesday Apr 24, 2018
Ep 108 - February 2018 Round Up
Tuesday Apr 24, 2018
Tuesday Apr 24, 2018
Iain and Simon review the best of the blog from February 2018.
Simon Carley
Sunday Oct 28, 2018
Ep 120 - The pursuit of excellence with Nat May at #stemlynsLIVE
Sunday Oct 28, 2018
Sunday Oct 28, 2018
This presentation was given at the inaugural #stemlynsLIVE conference on the 8th of October 2018 in Manchester. You can read more about the presentation and the conference here. https://www.stemlynsblog.org/in-pursuit-of-excellence/
Wednesday Nov 28, 2018
Ep 122 - Beyond ALS with Salim Rezaie at #stemlynsLIVE
Wednesday Nov 28, 2018
Wednesday Nov 28, 2018
Salim Rezaie from the REBEL EM podcast takes us through the optimal management of cardiac arrest and also explores some of the controversies and difficulties that make the difference to our patients.
You can read a lot more about the background to this talk, see the evidence and watch the video on the St Emlyn's site. Just follow this link. https://www.stemlynsblog.org/beyond-acls-salim-rezaie-at-stemlynslive/
Sunday Dec 23, 2018
Ep 125 - November 2018 Round Up
Sunday Dec 23, 2018
Sunday Dec 23, 2018
November was a busy month for the St Emlyn's team with a variety of blogs on conferences, EBM, philosophy and education. Here's the podcast and the links to the blogs mentioned in November.
FeminEM part 2 with Natalie May https://www.stemlynsblog.org/fix18-part-two/
FeminEM part 3 with Natalie May https://www.stemlynsblog.org/fix18-part-three/
Dan Horner on the POLAR trial of hypothermia in brain injury https://www.stemlynsblog.org/jc-hypothermia-in-brain-injury-the-polar-trial-st-emlyns/
Zaf Qasim on whole blood in trauma https://www.stemlynsblog.org/whole-blood-in-trauma-st-emlyns/
Nick Smith on Cognitive Load theory https://www.stemlynsblog.org/education-theories-you-should-know-cognitive-load-theory-st-emlyns/
Claire Bromley on her experience on elective in Cape Town https://www.stemlynsblog.org/south-africa-as-a-medical-student-elective-claire-bromley/
Natalie May on why resuscitation is not sexy https://www.stemlynsblog.org/so-unsexy/
Learning in the social age with Simon Carley https://www.stemlynsblog.org/learning-in-the-social-age-st-emlyns-at-emerge10/
Salim Rezaie on Advanced ACLS - beyonfd the guidelines https://www.stemlynsblog.org/beyond-acls-salim-rezaie-at-stemlynslive/
Friday Jan 11, 2019
Ep 127 - The Journey that Matters with Clare Richmond at #stemlynsLIVE
Friday Jan 11, 2019
Friday Jan 11, 2019
This podcast and presentation was recorded at the St Emlyn's LIVE conference in Manchester 2018. In this presentation Clare takes us through the rationale, principles, training and practice that we need in order to continually develop as prehospital and resuscitation practitioners.
You can read more from the event at http://www.stemlynsblog.org
This is a great presentation for anyone interested in continually developing their own and their colleagues practice, delivered by someone who really knows what they are talking about and who works for one of the best developed resuscitation services in the world.
Clare is an Emergency Physician and specialist in Pre-Hospital Care and Retrieval medicine based in Sydney, with Royal Prince Alfred Hospital and Sydney HEMS. She has completed a fellowship in simulation based education, and enjoys training with “real” people - patients, bystanders and the other clinicians we come across as we treat our patients every day. She is a lecturer with the University of Sydney, and is involved in education for the NSW Institute for Trauma Injury Management. When Clare is not working on helicopters or training teams, she is studying yoga or hanging out with her puppy, Archie.
Wednesday Apr 10, 2019
Ep 132 - Aortic Emergencies with George Wills at #stemlynsLIVE
Wednesday Apr 10, 2019
Wednesday Apr 10, 2019
Back in late 2018 we gathered in Manchester for the inaugural #stemlynsLIVE conference. Our friend Dr George Wills gave a great talk on Aortic Emergencies.
All emergency physicians know that it's all to easy to miss an aortic catastrophe. Listen to George's wisdom on common pitfalls and top tips to make you a better emergency clinician.
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Also check out these excellent #FOAMed resources.
Subscribe to the blog (look top right for the link)
Subscribe to our PODCAST on iTunes
Follow us on twitter @stemlyns
PLEASE Like us on Facebook
Find out more about the St.Emlyn’s team
Sunday May 19, 2019
Ep 136 - Wellbeing for the broken with Liz Crowe
Sunday May 19, 2019
Sunday May 19, 2019
This is the podcast that links to the following two posts on how to deal with some of the hardest events we have to deal with in emergency and critical care.
You can read more about the topic on the following two blogs.
https://www.stemlynsblog.org/wellbeing-for-the-broken-part-1-liz-crowe-for-st-emlyns/
https://www.stemlynsblog.org/wellbeing-for-the-broken-part-2-st-emlyns/
This is a tough listen so if you are affected by the content do chat through with colleagues.
Thursday May 30, 2019
Ep 137 - Beyond ATLS with Alan Grayson at #stemlynsLIVE
Thursday May 30, 2019
Thursday May 30, 2019
Alan Grayson takes us through his thoughts on ATLS. Is it really as terrible the #FOAMed world makes out?
Thursday Nov 14, 2019
Ep 150 - REBOA with Zaf Qasim
Thursday Nov 14, 2019
Thursday Nov 14, 2019
Simon and Zaf talk about the practicialities of REBOA and discuss whether it's ready for prime time in the UK.
Further reading
EMCrit guest post - the good, the bad, the ugly of the (original) Joint Statement https://emcrit.org/emcrit/good-bad-ugly-of-joint-statement-reboa/
Updated 2019 Joint Statement from the ACS-COT, ACEP, NAEMSP, and NAEMT: https://tsaco.bmj.com/content/4/1/e000376.info
London Air Ambulance Prehospital REBOA Case series: https://linkinghub.elsevier.com/retrieve/pii/S0300-9572(18)31110-9
Sunday Jan 19, 2020
Ep 153 - December 2019 Round Up
Sunday Jan 19, 2020
Sunday Jan 19, 2020
Our regular round up of the best of the blog from December 2019. Published a little late, largely because of Coronavirus issues and general business.
Wednesday Apr 22, 2020
Ep 162 - Beyond the ED: COVID-19 and Critical Care with Dan Horner
Wednesday Apr 22, 2020
Wednesday Apr 22, 2020
In this podcast, Dan and Iain talk about the clinical journey of a COVID-19 patient, beyond the ED, with insights from the critical care unit. There are some concepts here that we don’t have time to do full justice to in the podcast, so there is a comprehensive set of "show notes" and all the references at www.stemlynsblog.org/covid-19-and-critical-care
Sunday May 03, 2020
Ep 165 - April 2020 Round Up
Sunday May 03, 2020
Sunday May 03, 2020
It's been another busy month at St Emlyn's, with the publication of 15 blog posts and five podcasts, but there does seem to be an awful lot to talk about!
Of course there have been multiple posts and podcasts about COVID-19, and you can fiind all of these on our special St Emlyn's page. Highlights have included the three RCEM/St Emlyn's Webinars which we are delighted to host in podcast form.
It's not just been coronavirus though, we have also dipped out toes into exercise and nutrition, graphic design and horticulture!
Parts of the site have also undergone a bit of a redesign with the curriculum pages now easier to navigate to find that post to fioll an e-portfolio hole.
We hope you're finding all of our output useful. Please do subscribe to the website (in the top right hand corner) and rate our podcast on iTunes.
They'll be much more to come in May I am sure.
Take care
Iain
Podcast edited by Izzy Carley
Thursday May 07, 2020
Ep 166 - COVID-19 Journal Club #4 (May 2020)
Thursday May 07, 2020
Thursday May 07, 2020
Welcome to our fourth webinar and journal club reviewing recent research and featuring COVID-19 updates, hosted by the University of Manchester, Manchester Royal Infirmary and Royal College of Emergency Medicine in collaboration with St Emlyn's.
The live event tool place on Tuesday 5th May at 11.30am BST (10.30am GMT).
The panel was again be hosted by Rick Body The panel includes Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynard (NIHR Clinical Research Fellow), Dr Anisa Jafar (Academic Clinical Lecturer), Prof Pam Vallely (Professor of Medical Virology), Prof Simon Carley and special guest Justin Morgenstern to discuss six papers about COVID-19 infection.
There will be another COVID 19 Journal Club next week (Tuesday 12th May at 11am).
References
1. He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. Published online April 15, 2020. doi:10.1038/s41591-020-0869-5
2. Bahl P, Doolan C, de Silva C, Chughtai AA, Bourouiba L, MacIntyre CR. Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019? The Journal of Infectious Diseases. Published online April 16, 2020. doi:10.1093/infdis/jiaa189.
3. Wang Y, Zhang D, Du G, et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. The Lancet. Published online April 2020. doi:10.1016/s0140-6736(20)31022-9
4. Rajendran K, Narayanasamy K, Rangarajan J, Rathinam J, Natarajan M, Ramachandran A. Convalescent plasma transfusion for the treatment of COVID‐19: Systematic review. J Med Virol. Published online May 2020. doi:10.1002/jmv.25961
5. Tedeschi S, Giannella M, Bartoletti M, et al. Clinical impact of renin-angiotensin system inhibitors on in-hospital mortality of patients with hypertension hospitalized for COVID-19. Clinical Infectious Diseases. Published online April 27, 2020. doi:10.1093/cid/ciaa492
6. Docherty AB, Harrison EM, Green CA, et al. Features of 16,749 hospitalised UK patients with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol. Published online April 28, 2020. doi:10.1101/2020.04.23.20076042
Podcast edited from a live webinar by Izzy Carley
Wednesday May 13, 2020
Ep 167 - Troponin Update and LoDED Study Review with Rick Body
Wednesday May 13, 2020
Wednesday May 13, 2020
Over the last few years many of us in the UK have started to incorporate high-sensitivity troponin into the assessment of patients presenting with chest pain.
We have seen these samples taken at ever shorter intervals, aiming to discharge low risk patients safely, sooner from the Emergency Department (ED). This has been driven in part by the "Four Hour Emergency Access Target" as well as increased crowding in overwhelmed EDs.
In this podcast, internationally renowned researcher Prof Rick Body discusses the latest in troponin research and the recent LoDED study.
The Shownotes
The various organisations mentioned by Rick can be found here:
The Innovation Agency Webinar Series
The NHS Accelerated Access Collaborative
The CQUIN that will be implemented later this year (page 15 for the Troponin section)
The Draft NICE recommendations
Friday May 22, 2020
Ep 169 - COVID-19 Journal Club #6 (May 2020)
Friday May 22, 2020
Friday May 22, 2020
Welcome to our sixth COVID-19 Journal Club Podcast.
The panel was hosted by Rick Body and included Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynard (NIHR Clinical Research Fellow), Dr Anisa Jafar, Prof Pam Vallely (Professor of Medical Virology), Prof Simon Carley and special guest Liz Crowe (Advanced Clinician Social Worker and PhD candidate in health staff wellbeing in Brisbane) to discuss four papers about COVID-19 infection. We were especially pleased to welcome Liz this week, which enabled us to focus on the important topics of grief, loss and communication during the COVID-19 pandemic.
References
1. Williamson E, Walker AJ, et al. OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. May 2020. doi:10.1101/2020.05.06.20092999
2. Menni C, Valdes AM, Freidin MB, et al. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med. May 2020.
3. Liu Y, Ning Z, Chen Y, et al. Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals. Nature. April 2020. doi:10.1038/s41586-020-2271-3
4. Selman LE, Chao D, Sowden R, Marshall S, Chamberlain C, Koffman J. Bereavement support on the frontline of COVID-19: Recommendations for hospital clinicians. Journal of Pain and Symptom Management. May 2020. doi:10.1016/j.jpainsymman.2020.04.024
Podcast edited from a live webinar by Izzy Carley
Thursday Jun 04, 2020
Ep 170 - COVID-19 Journal Club #7 (June 2020)
Thursday Jun 04, 2020
Thursday Jun 04, 2020
Welcome to our seventh webinar and journal club reviewing recent research and featuring COVID-19 updates, hosted by the University of Manchester, Manchester Royal Infirmary and Royal College of Emergency Medicine in collaboration with St Emlyn's.
The live event took place on Tuesday 26th May.
Today's panel will be hosted by Rick Body The panel includes Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynard (NIHR Clinical Research Fellow), Dr Anisa Jafar, Prof Pam Vallely (Professor of Medical Virology), Ellie Hothershall (Consultant in Public Health), Prof Simon Carley and special guest Kelly Ann Janssens (Emergency Physician in Ireland) to discuss five papers about COVID-19 infection.
This will be the last weekly journal club, but we will be back with more EBM goodness very soon. Do let us know what you like to be included at stemlyns@gmail.com
References
Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the Treatment of Covid-19 — Preliminary Report. N Engl J Med. Published online May 22, 2020. doi:10.1056/nejmoa2007764
Mehra MR, Desai SS, Ruschitzka F, Patel AN. Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. The Lancet. Published online May 2020. doi:10.1016/s0140-6736(20)31180-6
Gray N, Calleja D, Wimbush A, et al. “No test is better than a bad test”: Impact of diagnostic uncertainty in mass testing on the spread of Covid-19. Published online April 22, 2020. doi:10.1101/2020.04.16.20067884
Peyrony O, Marbeuf-Gueye C, Truong V, et al. Accuracy of Emergency Department clinical findings for diagnostic of coronavirus disease-2019. Annals of Emergency Medicine. Published online May 2020. doi:10.1016/j.annemergmed.2020.05.022
Ludvigsson JF. Children are unlikely to be the main drivers of the COVID‐19 pandemic – a systematic review. Acta Paediatr. Published online May 19, 2020. doi:10.1111/apa.15371
Podcast edited from a live webinar by Iazzy Carley
Saturday Jun 13, 2020
Ep 171 - May 2020 Round Up
Saturday Jun 13, 2020
Saturday Jun 13, 2020
Lots to chat about on the podcast this month, and not just COVID! There's been blog posts about clots, troponin and even telly, as well as the Journal Club series.
Keep a look out for the new St Emlyn's Lesson Plans that we hope will help usher in a new era of medical education in a socially distanced world.
If you would like to donate to the fund in the memory Adel Aziz you can find the link here.
We hope you're finding all of our output useful. Please do subscribe to the website (in the top right hand corner) and rate our podcast on iTunes.
Take care
Iain
Podcast edited by Izzy Carley
PS You can find the Lesson Plans here. Still a work in progress, but as you've read these "shownotes" you deserve to have a sneak preview...