The NHS plans to set up mental health emergency departments throughout England. A survey discussed this episode highlights the importance of mental health assessments, finding that nearly a quarter of suicide deaths in a one year period had come after hospital or emergency department contact. Another survey raises the question, "How well is your ED prepared for a major incident?" and the statistics do not inspire confidence. Two more papers in this episode offer potential bulwarks against burnou...
Jul 04, 2025•27 min•Ep. 118
Can salbutamol be used be used to relieve pain in renal colic patients? Starting off this month's episode, a randomised trial seeks to find the answer. Then a topic of interest for anyone seeing patients with a phobia of needles, namely a study comparing coolant spray with topical anaesthetic cream for reducing pain from intravenous cannulation. Next, randomisation is a necessary tool for many trials, but what if you want something that's less high-tech, and more high-street? That's right, scrat...
Jun 05, 2025•34 min•Ep. 117
A new survey has found that less than one third of end-of-life patients in Irish emergency departments have their own room. This is only one of the shortcomings found in end-of-life care, explored in two papers to start this episode. Following on from that is a comparison of video and direct laryngosocopy for intubation outcomes. There's also a "Best Evidence" review of the use of nasal clips for stopping nosebleeds, an approach which appears likely to offer advantages over the hands or inventiv...
May 01, 2025•31 min•Ep. 116
Trauma and paediatrics are the themes for this month's collection of papers. Starting off is a review of the effectiveness of prehospital ultrasound in detecting lung injury, with some surprising statistics. Next is a letter on the topic of self-presentation by paediatric patients with major trauma, which is thankfully a rare occurrence. The third paper looks at prehospital testing of trauma patients for low fibrinogen levels, a condition which can lead to worse bleeding, increased transfusions,...
Apr 01, 2025•34 min•Ep. 115
Advance clinical practitioners (ACPs) can have a big role to play in the emergency department, but their career paths are not always well understood. This episode features three papers from the journal which begin to address that - a census survey of over 1000 ACPs, a qualitative study on their experiences in emergency care, and a commentary on how to improve ACP training. There is also a paper from Canada discussing considerations to be made for patients living with dementia, as well as their c...
Mar 03, 2025•31 min•Ep. 114
Another packed issue of the journal this month, and a podcast to match. Starting off with the Editor's Choice paper, on the important topic of sex and gender disaggregation in emergency medicine trials. Sex and Gender Equity Reporting (SAGER) guidelines were introduced in 2016 but poor adherence is still found in current publications. Next is a paper with high seasonal relevance, addressing the sensitivity and specificity of multiplex lateral flow tests for Flu A, Flu B and COVID 19. There's als...
Feb 05, 2025•28 min•Ep. 113
A special bonus podcast this time, on the perennial issue of crowding. Rick and Sarah are joined by Royal College of Emergency Medicine president Dr. Adrian Boyle, and EMJ's editor-in-chief Prof. Ellen Weber. They address recent evidence for crowding's harmful impact, the arm-twisting needed to shape policy, how it shapes patient confidence, and what the future of crowding looks like. Links: Association between delays to patient admission from the emergency department and all-cause 30-day mortal...
Jan 16, 2025•28 min•Ep. 112
It's a celebration of qualitative research to start the new year, with a collection of papers offering new perspectives on emergency department issues. First is a pair of papers centred on the theme of pre-alerts to the emergency department. Setting the scene for a patient's arrival is a vital process, yet it can generate fear of criticism for getting the balance wrong, when it comes to over- and under-alerting. Following on is a paper taking a look at the human experience of working in the emer...
Jan 07, 2025•30 min•Ep. 111
Subarachnoid haemorrhage is a diagnosis that can't be missed, but it is not a simple process to detect it. The first paper for discussion this month questions if a CT scan within 6 hours is sufficient for exclusion in patients with acute headache. Then there is a large-scale analysis of over 400 million ED visits in the USA, focussing in on the significant issue of self-harm in the homeless population. Next is a paper on a decision tool for suspected acute aortic syndrome, and to finish, a discu...
Dec 03, 2024•26 min•Ep. 110
Upper limb injuries make up about three-quarters of the limb injuries to children seen in the emergency department. But when it comes to the elbow, just how good are clinicians at diagnosing based on radiography? The first paper this month is a study putting over 300 global participants to the test. There's also a practice review highlighting the concept of shared decision making with frail elderly patients, a discussion of biomarkers for aortic dissection detection, more on telephone triage, an...
Nov 01, 2024•30 min•Ep. 109
There's a whole pile of blocks in this month's papers, with the first being a trial of Erector-Spinae Plane (ESP) blocks, not for rib fractures as you might expect but Hepato-Pancreato-Biliary (HPB) pain instead. Following on from that is a retrospective study comparing the resource utilisation of haematoma blocks, Bier’s blocks and procedural sedation for patients with forearm fractures. The next paper sets the performance of unassisted radiographers against those armed with artificial intellig...
Oct 01, 2024•33 min•Ep. 108
Being fallible was one of the most valued characteristics in a consultant, according to new doctors going through their induction - that's the subject of the first paper this month. Next up is a study on the impact of noise on hospital staff, which includes some simple interventions with measurable impact. There's also a discussion on pain relief for rib fractures, and how frailty scores are linked to 30-day mortality in patients. Read the issue highlights: September 2024 Primary Survey Articles...
Sep 04, 2024•34 min•Ep. 107
The recovery of laceration repair patients is the topic of this month's first paper, looking at behavioural disturbances in children following these difficult medical procedures. The second paper deals with pre-hospital use of tranexamic acid for trauma, and surfaces some demographic discrimination in its rates of application. Next there is an observational study which has developed a score for indirect signs of appendicitis on ultrasounds where the appendix is not visualised. Finishing off the ...
Aug 02, 2024•33 min•Ep. 106
What might yawning and sneezing be signs of in a patient? This month's podcast features new RCEM and NPIS guidance on acute opioid toxicity, outlining a number of symptoms to stay alert to. Before getting to that there's a paper on bypassing hospitals for patients needing mechanical thrombectomy, a study on how austerity affected emergency admissions across a range of UK local authorities, and some research on the immune-related adverse affects that can arise in the ED amongst oncological patien...
Jul 04, 2024•26 min•Ep. 105
How well do patients in the emergency department judge the severity of their situation? Some may fear the worst for any hospital visit, and others not realise that their lives are in danger. This month's first paper is a review of the accuracy of self-prognostication and its relation to admission, severity, and length of stay. Then there's a trio of publications on the challenges of pain in various forms. Starting with a study on the links between red flags in headache assessment, and serious se...
Jun 06, 2024•32 min•Ep. 104
Should we be bringing preventative medicine into the emergency department, or is it just using up valuable time? Our first paper this month looks at the "Cessation of Smoking Trial in the Emergency Department (COSTED)" trial, which presents the case for opportunistic smoking cessation intervention. Next up is a topical research paper on interpreting CT scans with artificial intelligence, and how machine assessment measures up against experienced physicians. Then there's a trio of troponin papers...
May 09, 2024•30 min•Ep. 103
“Social distancing is a privilege,” is the core message underlying the first paper brought by Sarah to this month’s roundup, as it unpacks the stark differences in COVID-19 outcomes across the spectrum of racial and ethnic groups in the United States. A second paper examines the returning rates of COVID patients across a large group of emergency departments in Canada, and the factors at play there. The final topic is one of Rick’s favourites, focusing on troponin testing in ambulances. Articles ...
Apr 05, 2024•31 min•Ep. 102
A feast of aortic papers this month, including a study on missed aortic dissection diagnoses and an analysis of coroners' reports. Rick runs through the findings of an interesting study from the Trainee Emergency Research Network (TERN), and Sarah finishes off with a paper on predicting adverse outcomes in elderly patients with orthopaedic trauma. Articles discussed in this episode: Ohle R, Savage DW, Caswell J, et al. Mortality and risk factors associated with misdiagnosis of acute aortic syndr...
Mar 04, 2024•29 min•Ep. 101
There's a lot of drugs to be talked about this month, and a heap of randomised control trials to be covered too. Rick and Sarah talk though the combining of nitrous oxide and fentanyl for sedation, the environmental impact of analgesics, the efficacy of acute heart failure treatment with high-dose and low-dose nitrates, and more newly published work from the latest issue of the journal. Articles discussed in this episode: Safety and efficacy of a nitrous oxide procedural sedation programme in a ...
Feb 01, 2024•29 min•Ep. 100
What are the questions to ask when dealing with acute behavioural disturbance? Join Sarah and Rick this month for a discussion of this difficult presentation. They also explore the topics of reducing low-acuity attendance, taking NHS 111 online, and the impact of a health coaching intervention for potentially recurrent attendees. Articles discussed in this episode: Highlights of the January 2024 issue https://emj.bmj.com/content/41/1/1 Consensus on acute behavioural disturbance in the UK: a mult...
Jan 08, 2024•31 min•Ep. 99
Hear a summary of some of the best papers published in the December 2023 issue of the Emergency Medicine Journal. The podcast this month covers a trio of ultrasound papers addressing its use in the treatment of distal radial fractures, and thoracic and abdominal stab wound injuries. Featured also is a paper investigating the effectiveness of a predictive system for COVID-19 triage by telephone. Read the highlights: https://emj.bmj.com/content/40/12/803 The EMJ podcast is hosted by: Dr. Richard B...
Dec 06, 2023•32 min•Ep. 98
Hear a summary of some of the best papers published in the November 2023 issue of the Emergency Medicine Journal. This month's podcast discusses a wide array of topics like cauda equina syndrome, biases in blood alcohol testing services, bystander CPR effectiveness in cardiac arrest, and the healthcare impacts of e-scooter use. Read the highlights: https://emj.bmj.com/content/40/11/741 The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK ( @richardbody ...
Nov 01, 2023•34 min•Ep. 97
Hear a summary of some of the best papers published in the October 2023 issue of the Emergency Medicine Journal. This month's podcast covers a variety of topics from litigation issues in the ED, young people's experiences in the Paediatric ED, parental anxiety in the PED, and all about 'Silver trauma'. Read the highlights: https://emj.bmj.com/content/40/10/687 . The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK ( @richardbody ) Dr. Sarah Edwards, EMJ...
Oct 03, 2023•28 min•Ep. 96
This is the summary of some of the best papers we published in the September 2023 issue of the Emergency Medicine Journal. Rick and Sarah discuss a trio of papers on health services, the use of isopropyl alcohol as an anti-emetic, and they talk to Dr Anna Collini, co-author of a paper that explores how new emergency medicine consultants experience uncertainty ( https://emj.bmj.com/content/40/9/624 ). Read the highlights: https://emj.bmj.com/content/40/9/621 . The EMJ podcast is hosted by: Dr. Ri...
Sep 01, 2023•32 min•Ep. 95
A summary of some of the best paper we published in the August 2023 issue of the Emergency Medicine Journal. Rick and Sarah talk through topics touching on the assessment of scaphoid and ankle injuries, patient involvement in research, frequent attendees to the ED, and deciding which patients to escalate during a pandemic. Read the highlights: https://emj.bmj.com/content/40/8/539 The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK ( @richardbody ) Dr. ...
Aug 01, 2023•29 min•Ep. 94
A summary of some of the best paper we published in the July 2023 issue of the Emergency Medicine Journal. Rick and Sarah talk through topics on Pre Hospital assessment of chest pain, management of pain in the emergency department and some thoughts on improving the experience for the waiting patient. Read the highlights: https://emj.bmj.com/content/40/7/471 The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK ( @richardbody ) Dr. Sarah Edwards, EMJ Soci...
Jul 03, 2023•30 min•Ep. 93
A summary of some of the best paper we published in the June 2023 issue of the Emergency Medicine Journal. Rick and Sarah talk through topics including home pulse oximetry, out of hospital cardiac arrest, the perils of correctly calculating respiratory rate in the ED and even cross-cultural adaptation of patient communication material. Read the highlights: https://emj.bmj.com/content/40/6/393 You can subscribe to the EMJ podcast via all podcast platforms, including Apple Podcasts, Google Podcast...
Jun 02, 2023•31 min•Ep. 92
Rick Body, University of Manchester and Manchester University NHS Foundation Trust, and Sarah Edwards, University Hospitals of Derby NHS Foundation Trust, cover the pick of the papers from EMJ's May 2023 issue. In this edition, we cover papers on shoulder dislocation, blunt chest trauma, uterine bleeding, medical errors, benign paroxysmal position vertigo, and calcium and QTc interval. Read the highlights: https://emj.bmj.com/content/40/5/317 You can subscribe to the EMJ podcast via all podcast ...
Apr 26, 2023•29 min•Ep. 91
A summary of some of the best paper we published in the April 2023 issue of the Emergency Medicine Journal. Rick and Sarah talk through topics including the impact of emergency physician gender on the outcomes of patients with early pregnancy loss; major trauma centre care for patients with low velocity trauma; the development of a new checklist for emergency paediatric intubation; the effect of head-up position on intubation success in the Emergency Department; and spiking by injection in the E...
Mar 29, 2023•32 min•Ep. 90
A summary of some of the best papers we published in the March 2023 issue of the Emergency Medicine Journal. EMJ's deputy editor Rick Body and social media editor Sarah Edwards talk through topics including biomarkers of traumatic brain injury, the limping child, hypothermia and sepsis in infants and the importance of avoiding secondary insults in patients intubated for traumatic brain injury in the prehospital environment. Read the highlights: https://emj.bmj.com/content/40/3/157 You can subscr...
Feb 27, 2023•29 min•Ep. 89
