The St.Emlyn’s Podcast
A UK based Emergency Medicine podcast for anyone who works in emergency care. The St Emlyn ’s team are all passionate educators and clinicians who strive to bring you the best evidence based education. St Emlyn’s We are a team of emergency medicine and critical care specialists working to improve the education of clinicians and the care of patients. The four pillars of learning are evidence based medicine, clinical excellence, personal development and the philosophical overview of emergency care. We have a strong academic faculty and reputation for high quality education presented through multimedia platforms and articles. St Emlyn’s is a name given to a fictionalised emergency care system. This online clinical space is designed to allow clinical care to be discussed without compromising the safety or confidentiality of patients or clinicians. You can read more about the development of the blog in the Postgraduate Medical Journal article. Creators and Chief Editors Professor Simon Carley: Creator, Webmaster, Chief Editor. Emergency Physician. Professor Richard Body: Co-creator, Chief Editor. Emergency Physician. Section and Podcast Editors. Dr Iain Beardsell: Podcasts Dr Janos Baombe: Infectious Diseases Dr Alan Grayson: Toxicology Mrs Elizabeth Crowe: Wellbeing Dr Natalie May: Paediatrics and Medical Education Mr Ross Fisher: Presentation skills
Episodes
Saturday Mar 12, 2022
Ep 199 - Feedback: Update and inter-speciality complexity. St Emlyn’s
Saturday Mar 12, 2022
Saturday Mar 12, 2022
Simon and Natalie discuss some of the complexities of feedback when it involved different specialities and patients. We also review our general rules of feedback.
See https://www.stemlynsblog.org/?s=feedback for more.
Friday Mar 25, 2022
Ep 200 - February 2022 Round Up
Friday Mar 25, 2022
Friday Mar 25, 2022
We made it! A double century of podcasts. In this month's update Iain and Simon talk through myth busting in resuscitation, Rick Body's airway expertise (with a side mention for high sensitivity troponin), a paper about resuscitative thoracotomy, ACPs in EM and how we all could set future research priorties.
Thank you again for listening to the St Emlyn's podcast. We really do hope that you enjoy it and have found our witterings over the last 200 episodes useful.
Hopefully we'll see some of you at the RCEM CPD Conference in Bournemouth next week.
Please do rate us on iTunes, like, subscribe, tweet and tell you friends about the podcast.
Thursday May 12, 2022
Ep 201 - March/April 2022 Round Up
Thursday May 12, 2022
Thursday May 12, 2022
After a brief hiatus we're back with more from the St Emlyn's Blog. We discuss a wide range of topics from crowding in Emergency Departments and the RePHILL trial to breastfeeding, genetic testing and diagnosing DVTs, as well as our highlights from the recent RCEM CPD Conference in Bournemouth. There really is something for everyone!
Thursday Jun 16, 2022
Ep 202 - May 2022 Round Up
Thursday Jun 16, 2022
Thursday Jun 16, 2022
Our monthly round up of all from the St Emlyn's blog. We discuss pathways into emergency care research, pad positioning in cardioversion of AF and possible gender differences in the presciption of TXA in trauma.
We also chat about travel in Lithuania, memories of defibrillating with hand held paddles and Simon's recent forst infection with COVID.
We mention a post on Lyme disease which you can read here (especially if you live near the New Forest...)
Sunday Aug 07, 2022
Ep 203 - June and July 2022 Round Up
Sunday Aug 07, 2022
Sunday Aug 07, 2022
Simon and Iain run through the latest highlights from the St Emlyn's blog and podcast, including the FORCE study, the EXIT study and more about Vitamin C in sepsis...
We hope you enjoy the podcast. Please do like and subscribe on your preferred podcast app and tell your friends and colleagues about us.
Saturday Oct 08, 2022
Ep 204 - August 2022 Round Up
Saturday Oct 08, 2022
Saturday Oct 08, 2022
This is our round up of all that happened on the St Emlyn's blog in August 2022 (yes - we know it's a bit late, but there's been a lot going on!).
Listen to Simon and Iain discuss the latest therapies in COVID, particularly Baricitinib, calcium in trauma and how we find balance in our work-life blend.
Please do like and subscribe to the podcast and tell your friends and colleagues. We've lots of exciting stuff coming your way over the next few months.
Tuesday Oct 18, 2022
Ep 205 - September 2022 Round Up
Tuesday Oct 18, 2022
Tuesday Oct 18, 2022
Join Iain and Simon for this month's round up of September's blog content from St Emlyn's. They discuss managing harm in the ED; management of traumatic brain injury; Head Up mechanical CPR and fentanyl in RSI.
Lots to think about and discuss. Please do like and subscribe and get in touch if there is anything you'd like us to cover on the blog and podcast, or perhaps you'd even like to write something for publication.
Monday Nov 14, 2022
Ep 206 - October 2022 Round Up
Monday Nov 14, 2022
Monday Nov 14, 2022
In our new regular slot of the middle Monday of the month we're delighted to bring you the highlights from the St Emlyn's blog this month.,
Iain and Simon chat about batching in EDs, Ossilation in decision making and a whole lot more about trauma (chest drains, extrication, sex and TXA and rib fixation).
Please do like and subscribe and keep an eye out for our new sister website St Emlyn's Medical School and it's podcast series coming soon.
Sunday Nov 27, 2022
Ep 207 - Burnout with Liz Crowe
Sunday Nov 27, 2022
Sunday Nov 27, 2022
Burnout is a term that seems to be used a lot these days, but what does it really mean? In this episode Dr Liz Crowe explains all, and will almost certainly change the way you view burnout.
Liz, who be well known to St Emyn's audiences, has just completed her PhD on "Understanding the risk and protective factors for burnout and wellbeing of staff working in the Paediatric Intensive Care Unit: PICU staff wellbeing" and has an unrivalled real world and evidence based experience of what these terms really mean.
In this first in a special series Liz goes into depth describing not only what burnout is, but how it can be measured (and the limitations of this) and most importantly how this is a system issue and not a diagnosis.
In the next episode we will discuss another commonly used term 'wellbeing'.
We think this series is incredibly important and hope you will help us share it far and wide. You can read the accompanying blogpost here.
Saturday Dec 10, 2022
Ep 208 - What is Wellbeing with Liz Crowe
Saturday Dec 10, 2022
Saturday Dec 10, 2022
Wellbeing is very complex, as it is an individual construct that is strongly aligned and interpreted through a lens of personal values, philosophy, culture, faith, and goals for life. Most importantly, wellbeing is dynamic rather than homeostatic and a subjective state determined by the individual.
Yet we use the term wellbeing to describe a wide variety of different things (often in terms of being the opposite of burnout which it most certainly isn't).
In this second episode of our series Liz Crowe discusses in detail what the literature says about wellbeing and how we may be able to use this going forward.
Please do like and subscribe. Thanks for listening.
Monday Jan 16, 2023
Ep 209 - November and December 2022 Round Up
Monday Jan 16, 2023
Monday Jan 16, 2023
A special double edition covering the blog posts from November and December and more. We discuss evidence based medicine with the DoseVF trial, and more from RECOVERY, discussion about 'what is downtime' and how we organise follow up for patients who don't live in our area and what happened at the amazing London Trauma Conference
We also announced some of the plans for StEmlynsWILD. Look out for booking details and more in the coming weeks.
Monday Feb 13, 2023
Ep 210 - January 2023 Monthly Round Up
Monday Feb 13, 2023
Monday Feb 13, 2023
Lots of chat about St Emlyn's WILD and just what you can expect if you join us in the Lake District in June, as well as discussion about ECMO in cardiac arrest and just how many of our patients with 'minor head injuries' will actually have ongoing symptoms weeks and even months later.
Click here to buy tickets for #StEmlynsWILD
Monday Feb 27, 2023
Ep 211 - Semi structured interviews (CAN 9)
Monday Feb 27, 2023
Monday Feb 27, 2023
Long term listeners to the St Emlyn’s podcast may remember our series entitled ‘Critical Appraisal Nuggets’ (CANs). We are absolutely delighted to reinvigorate this project under the leadership of Professor Rick Body, with the episode on semi structured interviews.
In this easily digestible and succinct podcast Rick and Laura Howard go through the pros and cons of setting up semi structured interviews and how these can be used effectively in qualitative research.
In the latest episode, we cover a qualitative research technique: semi-structured interviews. Qualitative research might be out of your comfort zone: we’re generally more comfortable with quantitative measures – numbers and statistics. It’s something they have experience with, having previously published a paper exploring the impact of events that happen at work on the wellbeing of emergency physicians. This was a labour of love for Laura. Laura wrote a powerful blog about it here.
Semi-structured interviews are a great way to get the really rich data we need to understand something in greater depth. They allow us to ask ‘why?’ as well as just ‘what?’, ‘who?’ and ‘when?’. But reading qualitative research papers can be difficult when it takes us out of our comfort zone. In this CAN podcast, Laura and Rick take us through what semi-structured interviews are, why we might use them, how you design and conduct them, and they also have some pearls of wisdom about how to make transcribing them a lot less painful. By the end, we hope that you’ll feel confident with the basics of the technique. And if you want to practice your critical appraisal, why not put their study under the microscope?
Monday Mar 20, 2023
Ep 212 - February 2023 Monthly Round Up
Monday Mar 20, 2023
Monday Mar 20, 2023
Our regular monthly round up and chat from the St Emlyn's blog. We talk about the use of artificial intelligence in research and the use of remifentanil instead of neuromuscular blockade in rapid sequence intubation. Plus more about the StEmlynsWILD conference and Simon's new role as Dean of RCEM and how you can get involved.
Monday Apr 17, 2023
Ep 213 - Sensitivity and Specificity (CAN 10)
Monday Apr 17, 2023
Monday Apr 17, 2023
The latest CAN is one of our brand-new 'revision editions' -- brief podcasts aimed at covering the essentials of critical appraisal for medical students and junior doctors preparing for exams.
With the help of Gregory Yates, an academic doctor based in Manchester, this episode introduces two core concepts: sensitivity and specificity. These are two ways of thinking about the accuracy of a diagnostic test. Knowing the sensitivity and specificity of an investigation will give you a decent idea of how it should be used in the emergency department.
Sensitivity (Sn) describes the chance that a test will be positive if your patient has the condition you're testing for. Some people call it the 'true positive rate' or alternatively the positivity in disease (PID) rate. If you need a hand remembering it, you can always remember that PID is a sensitive issue.
Meanwhile, specificity (Sp) considers the chance of a test being negative if the patient doesn't have the condition you're testing for. It's the 'true negative rate' or alternatively the negativity in health (NIH) rate. There are times when we particularly need a test to have a high sensitivity. This is generally when we want to be particularly confident that a test accurately identifies everyone with the relevant condition because we really don't want to miss it. We need a high sensitivity to rule out disease. (Sn-uff it out). At other times, we need to be confident that a patient with a positive test actually has the disease - for example, if the treatment is unpleasant or involves exposing patients to risk. In that case, we want a high specificity to rule in disease. (Sp-in it in).
In this CAN, we use D-Dimer as an example of a very sensitive investigation: it’s positive in nearly 100% of cases of venous thromboembolism. Specificity describes the likelihood that the test will be negative if your patient does not have the disease. We use HbA1c as an example of a highly specific investigation: it’s rarely used in the emergency department, but if it’s elevated, we can be almost certain that the patient is diabetic. HbA1c is almost never (
Monday Apr 24, 2023
Ep 214 - Shock from St Emlyn’s Medical School
Monday Apr 24, 2023
Monday Apr 24, 2023
This is the first podcast in our new series from St Emlyn's Medical School. They are specifically aimed at healthcare students and focus on the Medical Licensing Assessment (UK) presentations in particular but will be useful wherever you listen in the world.
Each episode has a standard format with a case to set the scene, a set of learning objectives, a discussion, a summary and a case resolution.
There are comprehensive listening notes on the dedicated website, as well as a growing set of other resources.
We hope you enjoy listening. The rest of the podcasts can be found on Spotify, or wherever you get your podcasts.
The music for this series (just as it is for the St Emlyn's Podcast) is composed by Greg Beardsell
Wednesday May 03, 2023
Ep 215 - March 2023 Monthly Round Up
Wednesday May 03, 2023
Wednesday May 03, 2023
Our monthly podcast round up from St Emlyn's Blog. This month Simon and Iain discuss the prehospital use of troponin measurement in the assessment of patients with chest pain and the use of AI in medicine, as well as an update about St Emlyn's WILD.
Please do like and subscribe
Saturday Jun 10, 2023
Ep 216 - April 2023 Monthly Round Up: HALO procedures and Blood Transfusion
Saturday Jun 10, 2023
Saturday Jun 10, 2023
The monthly round up of all the blog posts at St Emlyn's, including a deep dive into HALO (high acuity, low occurrence) procedures and blood transfusion.
Thanks again for listening. Please do like and subscribe here.
Tuesday Jun 13, 2023
Ep 217 - Weaning the wheezy child with David James at the PREMIER Conference
Tuesday Jun 13, 2023
Tuesday Jun 13, 2023
This is the first in a series of podcasts, recorded live at the Premier Conference in Winchester.
In this episode, David James challenges our current practice when we give a 'weaning plan' for children discharged with wheeze.
There is a plan here that you can review and give to patients and their carers.
More information at these excellent websites
PIER Network
Southampton Oxford Retrieval Team
Healthier Together
David James has been a PEM Consultant at University Hospital Southampton since 2018. His main interests are in training and education, adolescent emergency medicine and Quality Improvement. He is the Divisional Director of Medical Education and a Training advisor on the PEMISAC. He is the acute care lead for Wessex Healthier Together and has led several projects including those around acute wheeze at UHS and regionally. Outside of work he enjoys swimming, cycling and running and is extremely average at triathlons.
Thursday Jun 15, 2023
Ep 218 - Non epileptiform seziures with Steve Warriner at the PREMIER Conference
Thursday Jun 15, 2023
Thursday Jun 15, 2023
This is the second in our series of talks recorded live in June 2023 at the PREMIER conference.
Looking after patients with non-epileptiform seizures are a challenging, and common, event in the Emergency Department. 10% of attendances at paediatric neurology clinics are thought to be 'functional' and a lot of these will also present to the ED. These problems can involve a wide range of physical or sensory manifestations, almost all of wide have significant differentials which we cannot miss.
A large number of these patients can end up with an incorrect diagnosis, some of this due to confirmation bias by clinicians, but also some with psychogenic non-epileptiform seizures may coexist with organic problems.
The history is key and can be helped significantly by watching videos of events. There may be other factors giving a clue to a non-epileptic cause. Sometimes this will only happen in one place, like school, and the history may be inconsistent. Awareness and generalised bilateral movements, with episodes that are different each time all point to a non epileptiform origin. And then there are symptoms just 'not fitting' with our knowledge of dermatomal distribution.
There are Red Flags - Events happening during exercise, neurological signs, unpredictability and patterns to the events all point to a more sinister diagnosis
Management is incredibly difficult, particularly in trhe ED. Don't suggest an organic diagnosis and leave some ambiguity. There is time to get more information and there are few definitive diagnostic tests. EEGs are notoriously unreliable. Self help groups can help.
Steve Warriner has worked as a paediatrician at the QA in Portsmouth for the last 16 years. He trained in various regions in the UK including the Midlands, Yorkshire and the North East of England before working in Somerset for a brief period. He has a particular interest in epilepsy and neurological conditions in children and lead the district epilepsy service in Portsmouth. He teaches on the British Paediatric Neurology Association epilepsy training courses both in the UK and across the world. He was part of the team who designed and implemented the training course (initially in Myanmar) and the method of cascade training has recently been recognised by the World Health Organisation and the course now runs in nearly 30 counties in 3 languages. Steve recently chaired a multidisciplinary working group to update the Advanced Life Support Group guideline for management of prolonged seizures. In his spare time, Steve is a triathlete who qualified for and competed in the World Ironman Championship race in Hawaii in 2022.
Saturday Jun 17, 2023
Ep 219 - Blast Injuries with Chris Hillman at the PREMIER Conference
Saturday Jun 17, 2023
Saturday Jun 17, 2023
Chris brought us his reflections amnd knowledge from some of his extensive experience as a military EM consultant in two wars. Blast injury could be blunt, penetrating, may involve major haemorrhage: you have to expect any injury possible. It’s worldwide and it’s getting more common.
Blast injury affects every body cavity, but it is the CABC approach that matters, Doing the basics well is still the key. Bleeding points may not be obvious so apply tourniquets wherever stops the bleeding.
Often patients will not arrive in ones or twos but as a whole group affected by an incident, so it is vital we are prepared. The Paediatric Blast Injury Field Manual is a free resource available to download here and is highly recommended.
Chris Hillman is a Consultant in Emergency Medicine and Paediatric Emergency Medicine, working in Southampton. Serving in the Royal Navy since university, he has deployed on Ships, Submarines and with Commando units globally, and with the Army to Afghanistan and Iraq. He is the outgoing Consultant Advisor in Emergency Medicine and Clinical Director Commando Forward Surgical Group.
Monday Jun 19, 2023
Ep 220 - Penetrating Injuries with John O’Neil at the PREMIER Conference
Monday Jun 19, 2023
Monday Jun 19, 2023
This episode of the podcast is a live recording from the PREMIER Conference of John O Neil discussing penetrating injuries with learning points that are useful for clinicians who look after both adult and paediatric patients.
There are three main mechanisms – violence, impalement and self harm, although the first is by far the most common.
Penetrating injuries are rare but have significant morbidity and mortality. The key is early and accurate diagnosis, and many can be managed conservatively. The distribution of penetrating injuries across the UK differs widely, with most in the London area, although as seen in the news recently can happen anywhere.
Remember how traumatic it is to be a trauma patient. We put you on a bed, cut off your clothes, stick needles in you and take your family away. Some will also just not engage with you (teenage boys particularly) making assessment difficult. Be kind. Don’t get frustrated.
Physiologically there may be a strong vagal response that can hide some of the signs we’d expect. Also, bear in mind the events prior to the injury – the child may have been running a considerable distance (before and after the incident) raising their lactate (but don’t assume this is the cause). Children tend to ‘fall off a cliff’ – they appear well, but can suddenly decompensate – keep the momentum to definitive management going and do not be falsely reassured.
John mentioned a great friend of St Emlyn’s Vic Brazil and we would heartily endorse you have a look at her work.
You can find more information about the Reducing Knife Crime initiative here
Wednesday Jun 21, 2023
Ep 221 - Brief Resolved Unexplained Events with Jilly Boden at the PREMIER Conference
Wednesday Jun 21, 2023
Wednesday Jun 21, 2023
The clue to these is very much in the Title – BRUE is a diagnosis in itself. Children often do weird stuff, but they rarely do weird scary stuff.
In this talk, Jilly goes talks through how we can define these events as high and low risk and gives us tools to manage these patients (and their parents)
Along with colleagues, Jilly has written a guideline for BRUE, the full version of which you can find here
Jilly also mentions a flowchart from Peds Cases, which you can find here
There is also this superb blog post from Natalie May on the St Emlyn's website which accompanies this podcast, which goes through some really useful cases.
As a Wessex ST7 in Paediatric Emergency Medicine (RCPCH), Jilly Boden currently works in Queen Alexandra Hospital (Portsmouth). Her specialist interests include acute stabilisation and transfer of the critically ill patient, having spent a year with the 'Southampton & Oxford Retrieval Team' (SORT) and hopes to find a way of combining this with her future PEM career.Jilly has a passion for education, particularly 'PEM to the non-paediatrician', including international teaching of the tri-service military GPs, and being on the national committee to write a new standardised paramedic paediatric curriculum.In her free time (you know, apart from the kids and all that) she works as part of the track medical team for the 'British Motorcycle Racing Club', providing pre-hospital care to high velocity polytrauma patients in the 'golden hour' following collisions often exceeding 120mph.
Thursday Jul 13, 2023
Ep 222 - Monthly Round Up June 2023 - Airways, AMAX4, Head Injuries, TXA and more
Thursday Jul 13, 2023
Thursday Jul 13, 2023
Welcome to a bumper edition of the podcast discussing content from St Emlyn's for June 2023.
In this episode, Simon and Iain talk about DL vs VL, the PATCH trial, drug pushers, packers and stuffers, the new head injury guidelines from NICE and the AMAX4 algorithm and much more.
If you would like to submit something to St Emlyn's for consideration we'd love to hear from you.
Times are tough in the NHS at the moment, but we hope at St Emlyn's we can remind you of all the best parts of the incredibly important and rewarding job we do.
Take care.
Monday Sep 18, 2023
Ep 223 - July and August 2023 Monthly Round Up
Monday Sep 18, 2023
Monday Sep 18, 2023
After a long, hot and relaxing summer (!) Simon and Iain return with all the content from the St Emlyn's blog in July and August. They discuss four papers in detail, including the ARREST trial about cardiac arrest centres, whether clinical examination can identify life threatening injuries in trauma, the TOP-ART study looking at a novel agent in trauma management and the use of REBOA.
Please do like and subscribe and get in touch if you would like to contribute to the blog site.
Wednesday Oct 11, 2023
Ep 224 - September 2023 Monthly Round Up - Top Ten Papers and more
Wednesday Oct 11, 2023
Wednesday Oct 11, 2023
An EBM-packed episode where Iain and Simon go over ten of the top papers from the last year discussing all manners of things Emergency Medicine, including TXA in trauma, use of video laryngoscopy, defibrillation strategies in refractory VF, and ten-second triage in major incidents. There's also a very pertinent discussion about whether the age of your Emergency Physician might affect your outcome...
Thank you again for listening to the St Emlyn's podcast. Please do like and subscribe and get in touch if there is anything you'd like us to discuss or if you'd like to get involved.
Thursday Nov 09, 2023
Ep 225 - A deep dive into ECMO with Andy Curry
Thursday Nov 09, 2023
Thursday Nov 09, 2023
One of the benefits of the use of online platforms for meetings is the ability to record and disseminate talks more widely. This is an edited version of a talk given by Dr Andy Curry, Consultant Cardiothoracic Intensive Care Consultant at University Hospital Southampton, covering the origins of Extra Corporeal Membrane Oxygenation (ECMO) right up to the present day. Throughout the talk, he gives real world experience, coupled with a knowledge of the literature to communicate all you could ever want to know about this fascinating and potentially very exciting therapy.
References
Peek GJ, Clemens F, Elbourne D, Firmin R, Hardy P, Hibbert C, Killer H, Mugford M, Thalanany M, Tiruvoipati R, Truesdale A, Wilson A. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure. BMC Health Serv Res. 2006 Dec 23;6:163. doi: 10.1186/1472-6963-6-163. PMID: 17187683; PMCID: PMC1766357.
Stub D, Bernard S, Pellegrino V, Smith K, Walker T, Sheldrake J, Hockings L, Shaw J, Duffy SJ, Burrell A, Cameron P, Smit de V, Kaye DM. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation. 2015 Jan;86:88-94. doi: 10.1016/j.resuscitation.2014.09.010. Epub 2014 Oct 2. PMID: 25281189.
Belohlavek J, Smalcova J, Rob D, et al. Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2022;327(8):737–747. doi:10.1001/jama.2022.1025
Martje M. Suverein, M.D., Thijs S.R. Delnoij, M.D., et al. Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. The INCEPTION trial. N Engl J Med 2023; 388:299-309. DOI: 10.1056/NEJMoa2204511
The Alfred ECPR Role Cards
The Bottom Line ECMO Reviews
Monday Dec 18, 2023
Monday Dec 18, 2023
In this bumper double edition Simon and Iain chat through all the recent content on the St Emlyn's blog site, including a review of CRYOSTAT-2 and the DAShED study, a review of the new ILCOR guidelines, flow in the ED and why silence might just be the tonic we all need.
All of us at St Emlyn's wish you all, wherever you are on the world a peaceful, happy and restful Christmas.
Please do like and subscribe and get in touch if you'd like to contribute to our ongoing work.
Friday Feb 02, 2024
Friday Feb 02, 2024
It's the last episode of season 10 and Iain and Simon discuss December 2023's blog posts. In a packed podcast they discuss prehopsital blood transfusion decision making, E-scooter injury patterns, the potential for AI in medicine and selective aortic arch perfusion.
Please do get in touch if you would like to contribute to St Emlyn's and as ever do like and suscribe and tell your friends (if you think the podcast is any good).
Mentioned in the podcast
Gary Klein - Streetlights and Shadows
Critical Appraisal Nugget - Semi Structured Interviews
EMCrit - Shadowboxing
EMCrit - Interview with Gary Klein
A Skeptic's Guide to Emergency Medicine
Life in the Fast Lane - What is AI and How Does it Work
T-MACS scores
Homo Deus: A Brief History of Tomorrow by Yuval Noah Harari
East Anglia Air Ambulance RAID Conference
Saturday Feb 24, 2024
Saturday Feb 24, 2024
It's episode one of season 11 and Simon and Iain chat through the blog content from St Emlyn's from January 2024. There's discussion about New Year resolutions and how to make them habits, intubating poisoned patients with a decreased conscious level and what we can possibly do to improve the working conditions in our Emergency Departments.
As ever, we hope you enjoy the podcast. Please do like and subscribe, and if you'd like to contribute to St Emlyn's in any way please get in touch.
2 days ago
2 days ago
In this two part podcast special Iain and Simon go through twenty of the top papers from the last year or so, as presented by Simon at the Big Sick Conference in Zermatt earlier this year. All the details and more discussion can be found on the blog site.
In Part 1 they discuss all things airway, including where we should be intubating patients needing immediate haemorrhage control. VL vs DL, the effect of blade size on intubation success, whether small adult ventilation bags are better than larger versions, intubating comatose poisoned patients, and more.
Check out part 2 for papers about major haemorrhage, trauma, cardiac arrest and more.
Papers
Dunton Z, Seamon MJ, Subramanian M, Jopling J, Manukyan M, Kent A, Sakran JV, Stevens K, Haut E, Byrne JP. Emergency department versus operating room intubation of patients undergoing immediate hemorrhage control surgery. J Trauma Acute Care Surg. 2023 Jul 1;95(1):69-77. doi: 10.1097/TA.0000000000003907. Epub 2023 Feb 28. PMID: 36850033.
Prekker et al: Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults August 3, 2023 N Engl J Med 2023; 389:418-429 DOI: 10.1056/NEJMoa2301601
Landefeld KR, Koike S, Ran R, Semler MW, Barnes C, Stempek SB, Janz DR, Rice TW, Russell DW, Self WH, Vonderhaar D, West JR, Casey JD, Khan A. Effect of Laryngoscope Blade Size on First Pass Success of Tracheal Intubation in Critically Ill Adults. Crit Care Explor. 2023 Mar 6;5(3):e0855. doi: 10.1097/CCE.0000000000000855. PMID: 36895888; PMCID: PMC9990830.
Snyder BD, Van Dyke MR, Walker RG, Latimer AJ, Grabman BC, Maynard C, Rea TD, Johnson NJ, Sayre MR, Counts CR. Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Resuscitation. 2023 Dec;193:109991. doi: 10.1016/j.resuscitation.2023.109991. Epub 2023 Oct 5. PMID: 37805062.
Freund Y et al. Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial. JAMA. 2023 Dec 19;330(23):2267-2274. doi: 10.1001/jama.2023.24391. PMID: 38019968; PMCID: PMC10687712.
Eastwood G et al, TAME Study Investigators. Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2023 Jul 6;389(1):45-57. doi: 10.1056/NEJMoa2214552. Epub 2023 Jun 15. PMID: 37318140.
Downing J, et al. Prevalence of peri-intubation major adverse events among critically ill patients: A systematic review and meta analysis. Am J Emerg Med. 2023 Sep;71:200-216. doi: 10.1016/j.ajem.2023.06.046. Epub 2023 Jun 28. PMID: 37437438