The St.Emlyn's Podcast

Ep 54 - Intro to EM: Analgesia in the ED.

Iain and Simon discuss the core skills that all EM clinicians need to manage pain in the ED.

These are the basics, but don't be put off. The basics are more important than the fancy stuff that we will discuss in a later podcast.

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Ep 55 - Communicating (not Breaking) Bad News with Liz Crowe

Liz Crowe joins Iain Beardsell to discuss really difficult conversations in the ED. How do we communicate terrible news in the ED and critical care.

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St.Emlyn's

Ep 59 - Lessons learned from the November Paris attacks with Youri Yordanov

We are truly honored to listen and learn from Dr Youri Yordanov from Paris. Youri was the senior emergency physician on duty on the 13/11/15 during the brutal and terrifying terrorist attacks in Paris. Here he joins St.Emlyn's to discuss how they managed a mass casualty incident with lessons for us all.

There is no doubt that without the skills, preparation and response of Youri, his ED team, the wider hospital and the emergency service in general the death rate would have been much worse.

Thanks Youri for your wisdom and reflections.

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Ep 60 - Londoon Trauma Conference 2015 Day 1 Summary

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.

Ep 61 - Grief at Christmas with Liz Crowe

Iain and Liz discuss how we can manage bad outcomes at Christmas. It's especially tough for patients and their families when tragedy occurs at times when we are all suposed to be festive. It's also tricky for staff and their families. Liz and Iain talk through why we feel like we do and how we can manage ourselves and others better.

Ep 62 - The role of paediatric surgeons in trauma with Ross Fisher (LTC)

Simon and Ross Fisher from Sheffield discuss the emerging role of paediatric surgeons in trauma. This podcast was recorded at the London Trauma Conference (so sorry for a bit of background noise at times).

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Ep 63 - The Role of UK Trauma Units with Tim Coates (LTC)

Iain Beardsell joins Tim Coats, chair of the UK Trauma Audit Network, to discuss the role of trauma units within major trauma networks.

Ep 64 - International Meeting for Simulation in Healthcarewith Sandra Viggers and Vic Brazil

Sandra Viggers and Vic Brazil grace St.Emlyn's with a conference report from Sand Diego and the International Meeting for Simulation in Healthcare (IMSH) #IMSH2016.

Ep 65 - The management of Paediatric trauma in the UK with Ross Fisher

Ross Fisher, consultant paediatric surgeon and lead for TARNlet joins Simon Carley at the London Trauma Conference to discuss the challenges in managing paediatric trauma in the UK.

Ep 66 - When Professional and Personal Worlds Collide with Liz Crowe

Iain and Liz discuss boundaries and medicine. What do you do when your personal life impacts on your clinical practice. 

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Ep 68 - An Englishman in South Africa with Robert Lloyd

Robert Lloyd aka @ponderingEM from the Pondering EM blog joins Simon to talk about his experiences in a South African ED. This is an amazing tribute to the work our South African colleagues and how an Englishman found a way to adapt to the challenges (and there are many) of SA EM practice.

You can find his references for the talk here.

Ep 75 - Critical Appraisal Nugget 1: Randomisation

Our series on critical appraisal nuggets in 5-10 mins. This week it's Randomisation. Great if you are revising for an exam in critical appraisal (e.g. FRCEM).

Ep 79 - Critical Appraisal Nugget: Selection Bias

Prof Rick Body and Niall Morris, Clinical Research Fellow, discuss selection bias and how it can affect clinical research.

This podcast is the third in the St Emlyn's series "Clinical Appraisal Nuggets".

Ep 80 - EuSEM Half Time Talk

Simon and Iain chat about the first few days at EuSEM in Vienna. Some of the clinical and social highlights. We also have a bonus podcast at the end recorded with a volunteer at Iain's "Podcasting for Beginners'" talk. For more from EuSEM (The European Society for Emergency Medicine) congress follow the #eusem16 hashtag on Twitter.

Ep 81 - Difficult Conversations with Children in Critical Care with Liz Crowe

The fabulous Liz Crowe (@LizCrowe2) returns to the St Emlyn's podcast to chat with Iain about how we can communicate more effectively with children in critical care. This podcast explores topics that are important not just for clinicians, but anyone who works with or has children.

Ep 82 - Apparent Life Threatening Events in Babies

Here's the podcast on BRUE and ALTE's in the emergency department. 

Check the associated blog too http://stemlynsblog.org/alte-brue/ 

Nat and Simon talk through the key points.

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Ep 83 - The Teaching Course in NYC Round Up

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)

Ep 85 - Top tips for chest drains.

This podcast accompanies the St.Emlyn's blog post on top tips for chest drainage.

http://stemlynsblog.org/chest-drain-excellence-microskills/

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Ep 88 - ED transfers. Patient, Preparation and People.

Nat and Simon discuss the complexities of transferring a patient from the resus room to CT and back again. Look out for the blog post soon on stemlynsblog.org

Ep 89 - March 2017 Round Up

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.

Ep 90 - Top Ten Trauma Papers 2016

Iain and Simon chat through our top ten trauma papers for 2016. Lots here for anyone who is interested in trauma including whole body CT, traumatic cardiac arrest, neurosurgery in severe head injury and much more. As ever we'd suggest you read the original papers, references for which along with a blogpost can all be found here http://stemlynsblog.org/top-10-trauma-papers-2016-st-emlyns/

 

 

Ep 95 - Burnout in Critical Care with Liz Crowe

Iain (@docib) and Liz (@LizCrowe2) discuss one of the hottest topics in medicine - Burnout. What is it, who gets it and what can we do about it? Liz brings her huge knowledge and experience to a topic that is often discussed, but not always understood. Essential listening.

Ep 97 - Foreskins: A PED primer with Ross Fisher

A podcast on foreskin problems in the paediatric emergency department with Ross Fisher and Simon Carley.

This podcast links to the blog post which you can find here. Foreskins a PED primer.

Ep 98 - Life as an EM trainee in South Africa. A panel discussion

I recently met up with some amazing UK docs working in South Africa at the EMSSA conference. This conference was held in Sun City near Johannesburg and brought together emergency physicians from across the contient.

It was great to catch up some UK docs who were on postgraduate electives  working in hospitals like Khayelitsha which you may remember from this amazing blog by Robert Lloyd.

So please listen, learn and get in touch if it's something that you want to do.

On the podcast we have

Simon Carley (@EMManchester), Jennifer Hulse (@coffeeheadaches), Chris Wearmouth (@CCWearmouth), Jacob Smith (@DrJacobSmith), Emma Gold (@EmmaRGold) and Chloe Sanderson.

There are also Marina Queisser & Eveline Baerends in the photo.

Ep 106 - Debriefing in Critical Care with Liz Crowe

In this episode, the fabulous Liz Crowe (@LizCrowe2) discusses how to approach debriefing after critical (and non critical) incidents in healthcare. We focus on the debriefing that takes place 5-7 days after an incident. For more on a "hot" debrief listen to this podcast by Ashley Liebig and Rob Orman 

Ep 108 - February 2018 Round Up

Iain and Simon review the best of the blog from February 2018.

Simon Carley

Ep 111 - April 2018 Round Up

Simon and Iain talk through what the team has been up to in April. All the blogs should be on the website and of course you can subscribe to the podcast via iTunes or via PodBean.

Key publications in April.

1. Our e-book on health and wellbeing for the resuscitationist. http://stemlynsblog.org/the-resuscitationists-guide-to-health-and-wellbeing-a-st-emlyns-e-book/

2. Police drop offs for penetrating trauma in the US. http://stemlynsblog.org/to-protect-and-serveand-drop-off-st-emlyns/

3. The latest blogs on the amazing #badEMfest18 conference in South Africa http://stemlynsblog.org/bademfest18-day-3-st-emlyns/

4. The top 10 trauma papers of the year http://stemlynsblog.org/top-10-trauma-papers-2017-2018-for-traumacareuk-conference-st-emlyns/

5. Complications of anticoagulation http://stemlynsblog.org/complications-of-anticoagulation-and-how-to-manage-them-st-emlyns/

6. Trauma CT in kids http://stemlynsblog.org/jc-trauma-paediatric-wbct/

7. The folly of dichotomous diagnosis http://stemlynsblog.org/50-shades-black-white-folly-dichotomy/

8. Bonded in Blood with Ashley Liebig and Noah Gallagher http://stemlynsblog.org/bonded-in-blood/

9. How to coach your team and the Austrian EM conference http://stemlynsblog.org/how-to-coach-feedback-team-st-emlyns/

Gosh, when you write it down and think about all the work the rest of the team puts in to teach and learn it makes me kind of proud. Don't forget to join us later this year for the live version at #stemlyneLIVE in Manchester.

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• 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
• Come join us at our conference in October 2018

Ep 113 - The best of badEMfest 2018

Nat and Simon discuss the recent #badEMfest18 conference.

You can read more about the conference on our posts on the stemlynsblog website.

Day 1

Day 2

Day 3

Day 4... it's coming

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Ep 114 - The past, present and future of IV Fluids in Paediatric Practice with Steve Playfor

Steve Playfor is an paediatric intensive care consultant at the Royal Manchester Children's Hospital here in the 'real' Virchester.

He is an expert in the management of fluid balance in children and has been instrumental in many of the changes to our attitudes, beliefs and practice around IV fluid management.

In this episode Simon and Steve discuss the somewhat crazy story of IV fluid management in kids, the pseudo-science, the custom and practice and finally the potential future of IV management.

I can guarantee that you will learn something here folks.

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Ep 119 - September 2018 Round Up

Here's our round up of the best of the blog from September 2018.

The following blogs are discussed.

OOHCA and airway management. Do we need a tube?  http://www.stemlynsblog.org/jc-oohca-and-airway-management-do-we-need-a-tube-st-emlyns/

The Zero Point Survey. Optimising resuscitation teams in the ED. https://www.stemlynsblog.org/jc-the-zero-point-survey-optimising-resuscitation-teams-in-the-ed-st-emlyns/

Subacute and massive PE management https://www.stemlynsblog.org/we-call-it-massiiiiiiivve-pe-at-st-emlyns/

EMS Gathering and podcast https://www.stemlynsblog.org/ems-gathering-review-and-podcast-st-emlyns/

ResusTO: A simulation/resuscitation conference like no other https://www.stemlynsblog.org/resusto-a-simulation-resuscitation-conference-like-no-other/

Monkeypox has arrived https://www.stemlynsblog.org/monkeypox-has-arrived-is-the-panic-justified-st-emlyns/

Micro Machines: Sick neonates at RATH18 https://www.stemlynsblog.org/micromachines/

Equality and Diversity in EM. What I learned as a recovering racist. https://www.stemlynsblog.org/equality-and-global-health-what-i-learned-from-being-a-recovering-racist/

StEmlyn's at EusEM (Four posts)

• https://www.stemlynsblog.org/st-emlyns-at-eusem18-day-4/
• https://www.stemlynsblog.org/st-emlyns-at-eusem18-day-3/
• https://www.stemlynsblog.org/st-emlyns-at-eusem18-day-2/
• https://www.stemlynsblog.org/st-emlyns-at-eusem18-day-1/

 

 

Ep 121 - October 2018 Round Up

Here's our round up of the best of the blog from October 2018.

In Pursuit of Excellence with Natalie May from #stemlynsLIVE https://www.stemlynsblog.org/in-pursuit-of-excellence/

A FeminEM in NY with Natalie May Part 1. https://www.stemlynsblog.org/fix18-part-one/

JC: Cricoid Pressure, Do we still need it? Simon Carley https://www.stemlynsblog.org/jc-cricoid-pressure-and-rsi-do-we-still-need-it-st-emlyns/

Teaching and Learning in Stretched Environments with Simon Carley https://www.stemlynsblog.org/teaching-and-learning-in-stretched-environments-rsm-2018-st-emlyns/

Five free strategies to improve your resuscitations Simon Carley https://www.stemlynsblog.org/stemlynslive-five-free-strategies-to-improve-your-resuscitation-practice-st-emlyns/

PTSD and me, EMDR therapy with Rusty Carroll https://www.stemlynsblog.org/ptsd-and-me-part-3-emdr-therapy-st-emlyns/

 

Ep 122 - Beyond ALS with Salim Rezaie at #stemlynsLIVE

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/ 

Ep 123 - Five strategies to improve your resuscitations with Simon Carley at #stemlynsLIVE

Five strategies to improve your resuscitations.

1. Zero point survey

2. Peer review

3. 10 in 10

4. Hot debriefs

5. Fly the patient

You can read about these strategies, watch the video and learn about the background on the St Emlyn's blog here https://www.stemlynsblog.org/stemlynslive-five-free-strategies-to-improve-your-resuscitation-practice-st-emlyns/ 

Ep 124 - Human factors, technology and humanity in critical care with Peter Brindley

This podcast was recorded at the Intensive Care Society State of the Art meeting in London 2018. Simon Carley interviews Prof Peter Brindley on the interface of technology, humans and humanity in critical care. The audio was recorded live and at the venue so there is a fair bit of background noise, but we hope that this does not distract from a wide ranging and fascinating podcast.

 

Ep 126 - December 2018 Round Up

This is the monthly round up of blogs from the St Emlyn's team

Tribalism with Ross Fisher https://www.stemlynsblog.org/breaking-down-tribalism-onetribeemta-st-emlyns/

Conservative management of chest trauma https://www.stemlynsblog.org/jc-conservative-management-of-chest-trauma-st-emlyns/

ICS SOA day 1 https://www.stemlynsblog.org/st-emlyns-on-tour-icssoa2018/ 

Handover principles https://www.stemlynsblog.org/handover-process-practice-and-controversy-icssoa2018-st-emlyns/ 

ICS SOA day 2 https://www.stemlynsblog.org/icssoa2018-day-2-st-emlyns-on-tour/ 

ICS SOA day 3 https://www.stemlynsblog.org/icssoa2018-day-3-st-emlyns-on-tour/ 

FeminEM part 4 https://www.stemlynsblog.org/fix18-part-four/ 

PEP, PEPSE and HIV https://www.stemlynsblog.org/pep-prep-and-all-things-hiv-st-emlyns/ 

Game of Thrones https://www.stemlynsblog.org/ste-journal-club-a-christmas-games-of-thrones-issue/ 

Ep 128 - Can we use diagnostic probability to guide treatment thresholds in ACS with Charlie Reynard and Rick Body

This is a really important concept developed by Charlie Reynard and Rick Body here in Manchester. There is an accompanying paper in the EMJ that you can read via this link https://emj.bmj.com/content/34/12/A870 

This concept could radically change how we make probabilistic prescribing decisions in the ED. Have a listen and look out for a blog post on St Emlyn's soon.

Ep 129 - January 2019 Round Up

The latest blog posts, ideas and thoughts from the St Emlyn's podcast. This month with Simon Carley and Rick Body,

Ep 130 - Critical Appraisal Nuggets: p-values

Part of the critical appraisal nuggets series. You can read more here https://www.stemlynsblog.org/cans-critical-appraisal-nuggets-st-emlyns/ 

Also mentioned in this podcast

1. Definition of p-values on the bottom line https://www.thebottomline.org.uk/blog/ebm/p-value/

2. Fragility index https://lifeinthefastlane.com/ccc/fragility-index/ 

3. Confidence interval https://en.wikipedia.org/wiki/Confidence_interval 

Ep 131 - South African Emergency Medicine with Kat Evans at #stemlynsLIVE

Last year we were honoured to bring Kat Evans to Manchester to talk at the #stemlynsLIVE conference. We've covered emergency medicine in South Africa before on the blog, but there is no substitute to hearing about it from someone who actually works there.

Ep 132 - Aortic Emergencies with George Wills at #stemlynsLIVE

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

Ep 133 - February 2019 Round Up

Our regular monthly round up of the best of the blog from Feb 2019.

Ep 134 - March 2019 Round Up

Here’s our regular monthly round up of the best of the blog from March 2019

 

Ep 135 - April 2019 Round Up

Here is the latest from the St Emlyn's team

 

Ep 138 - Traumatic Cardiac Arrest with Prof Jason Smith RN

This is the podcast that accompanies the recent blog post on Jason's latest research on traumatic cardiac arrest and closed chest compressions. This discussion is more wider ranging and explores how the management of TCA has changed, and is changing as we begin to gain a better understanding of the physiological mechanisms underpinning our resuscitation strategies.

Read the blog here. http://www.stemlynsblog.org/jc-should-we-use-chest-compressions-in-traumatic-cardiac-arrest-st-emlyns/

Key references

Closed chest compressions reduce survival in an animal model of haemorrhage-induced traumatic cardiac arrest.Watts S, Smith JE, Gwyther R, Kirkman E. Resuscitation. 2019 May 9;140:37-42. doi: 10.1016/j.resuscitation.2019.04.048. [Epub ahead of print]

 

Paediatric traumatic cardiac arrest: the development of an algorithm to guide recognition, management and decisions to terminate resuscitation. Vassallo J, Nutbeam T, Rickard AC, Lyttle MD, Scholefield B, Maconochie IK, Smith JE; PERUKI (Paediatric Emergency Research in the UK and Ireland). Emerg Med J. 2018 Nov;35(11):669-674. doi: 10.1136/emermed-2018-207739. Epub 2018 Aug 28.

5.

Paediatric traumatic cardiac arrest: a Delphi study to establish consensus on definition and management. Rickard AC, Vassallo J, Nutbeam T, Lyttle MD, Maconochie IK, Enki DG, Smith JE; PERUKI (Paediatric Emergency Research in the UK and Ireland). Emerg Med J. 2018 Jul;35(7):434-439. doi: 10.1136/emermed-2017-207226. Epub 2018 Apr 28.

The outcome of patients in traumatic cardiac arrest presenting to deployed military medical treatment facilities: data from the UK Joint Theatre Trauma Registry. Barnard EBG, Hunt PAF, Lewis PEH, Smith JE. J R Army Med Corps. 2018 Jul;164(3):150-154. doi: 10.1136/jramc-2017-000818. Epub 2017 Oct 6.

Smith JE, Rickard A, Wise D. Traumatic cardiac arrest. J R Soc Med. January 2015:11-16. doi:10.1177/0141076814560837

May N. Traumatic Cardiac Arrest. St Emlyn’s. http://www.stemlynsblog.org/traumatic-cardiac-arrest/. Published 2012. Accessed 2019.

Ep 139 - May 2019 Round Up

Our regular monthly round up, this month with Ian and Simon chatting through the best of the blog.

The power of peer review: https://www.stemlynsblog.org/smacc2019-the-power-of-peer-review/

Virtual reality in PED: https://www.stemlynsblog.org/jc-virtual-reality-for-distraction-from-paediatric-procedural-pain/

Wellbeing for the broken: https://www.stemlynsblog.org/wellbeing-for-the-broken-part-3-the-podcast-st-emlyns/ 

Traumatic cardiac arrest https://www.stemlynsblog.org/wellbeing-for-the-broken-part-3-the-podcast-st-emlhttps://www.stemlynsblog.org/jc-should-we-use-chest-compressions-in-traumatic-cardiac-arrest-st-emlyns/

Should we cardiovert AF in the ED or wait? https://www.stemlynsblog.org/should-we-rapidly-cardiovert-af-in-the-ed-st-emlyns/ 

Prolonged field care in the ED https://www.stemlynsblog.org/prolonged-field-care-in-the-ed/

Keppra or Phenytoin for status epilepticus in kids https://www.stemlynsblog.org/jc-enter-sandman-which-agent-as-second-line-in-paediatric-status-epilepticus/ 

Ep 140 - GI emergencies with Chris Gray at #stemlynsLIVE

This is Chris's talk from #stemlynsLIVE on GI emergencies. Remember to check out the blog for the background, references and more.

 

Ep 141 - June 2019 Round Up

Here's our regular round up of the blog and podcast from June 2019.

 

Beyond ATLS https://www.stemlynsblog.org/beyond-atls-with-alan-grayson-at-stemlynslive-st-emlyns/

Traumatic Cardiac Arrest https://www.stemlynsblog.org/traumatic-cardiac-arrest-tca-podcast-with-prof-jason-smith-rn-st-emlyns/

The psychological impact of emergency medicine https://www.stemlynsblog.org/how-events-in-emergency-medicine-impact-doctors-psychological-well-being-st-emlyns/

Can we use IO aspirate for analysis https://www.stemlynsblog.org/jc-can-we-really-use-io-blood-for-analysis-st-emlyns/

Don't forget the Bubbles conference and site https://dontforgetthebubbles.com/ 

Ep 142 - Psychological performance in the Resus Room with Ashley Liebig

This talk focuses on how we can optimise our psychological performance in critical care situations, the type of situations that Simon describes as Time Critical, Information light. The Audio is available below, or watch the full presentation above.

Don't forget to watch the video on the St Emlyn's site http://www.stemlynsblog.org

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Ep 143 - The Future of Diagnostics with Rick Body

Prof. Rick Body is an internationally recognised expert in diagnostic testing. In this podcast he takes us through diagnostics today and also the near future which may change almost everything. 

You can read more and see the slides/video at http://www.stemlynsblog.com

Ep 144 - July 2019 Round Up

The best from the blog and podcast in July 2019. 

JC: Clot’s the Problem? Vena Cava filters in trauma patients. St Emlyn’s

Psychological performance in the resus room. Ashley Liebig at #stemlynsLIVE

JC: The Resuscitative Care Unit. St Emlyn’s

The great day paradox. St.Emlyn’s

All you need to know about Listeria. St Emlyn’s.

GI Emergencies – Chris Gray at #StEmlynsLIVE

Similar challenges, different approaches – Mass Casualty Incident training lessons from Pakistan. St Emlyn’s