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Pacing in the ED

Our curriculum mentions pacing, and we all think that we know all about that as we’ve got ALS… right? Some of our brief discussions on twitter highlighted that pacing can be more complicated than ALS implies, and actually isn’t very common in ED.
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The Whole* of PEM, in One Blog

PEM Top Tips SLO5
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SLO6 – Practical Procedures

We thought we'd create this mini summary of the resources we've found here and elsewhere to enable you to get the background to proficiently deliver and teach emergency medicine skills.
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Digoxin Toxicity

Why digoxin? Digoxin has a narrow therapeutic index and digoxin toxicity can be a life-threatening condition.
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Non Invasive Ventilation

This guide is not intended for those who are experienced ITU types, however, if you are one of the millions of front-line staff looking to help during our latest respiratory pandemic with little experience in the use of NIV please read on.
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Malignant Spine Presentations

Here are two cases of oncological and palliative care emergencies that might present to the emergency department, that we should know how to treat.
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Neonate with blood in the nappy: look beyond the cracked nipples!

Rob, a 15-day old neonate has been brought to ED by his mum, Lucy, after she noticed some streaks of blood in his nappy. He was born at 39 weeks by spontaneous vaginal delivery after an uncomplicated pregnancy and has been exclusively breast fed since birth.
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Acting like a Boss

So you are thinking of acting up? CONGRATULATIONS - it means the end of your training is in sight. According to the RCEM guidance, you would need to have passed FRCEM and be in the final year of training, so you're nearly over the finish line.
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Inexpensive Teaching Models for Fascia Iliaca Blocks

Most of us are convinced that fascia iliac blocks for pain relief are fabulous. Models to teach and practice on can be expensive. Inspired by one of the ED registrars I work with, Dr Grace O’Connell, I am going to show how to make a simple model for simulating going through the fascial layers at the hip.
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DNA CPR in the ED

DNA CPR or “do not attempt resuscitation” decisions are confusing to many. If discussed sensitively and correctly, they make a huge huge huge immeasurable difference to the hospital stay of the patient, and their relatives.
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Hypnosis and EM

If we told you we knew of a medical practice that’s been around since the 18th century, with a strong evidence base, that can be utilised by any emergency physician, for the majority of patients (and colleagues), that’s free to deliver, costing only time, you’d probably think we were deluded. We're not... it's hypnosis.
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Ear me out!

Ear trauma is a common presentation to the Emergency Department. Whilst generally simple to manage, the consequences of ear trauma have the potential to impact patients’ day-to-day lives significantly
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Scurvy

If I mention scurvy to most people, they think of sea dogs, and Pirates, and archaic health complaints
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Communication in the ED

We become (mostly) emergency practitioners to reduce suffering of patients - not all suffering is pain, and both suffering and pain can be reduced by compassionate communication. 
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Male Urological Issues part 2 – Urethral Catheterisation

Part 2 of our urological problems in men blog - focussing on catheterisation and problems associated with it.
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Male Urological issues in the ED Part 1

Urology presentations are fairly common to the emergency department, and we hope this just in time reminder will emphasise some of the key management points.
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RCEM VSC 2020

I must admit, it felt a bit strange, taking a day off work as study leave to sit in my joggers in front of the laptop, but this is definitely The Way To Conference.
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Teaching the Basics: Blood Gases

Teaching is a huge part of emergency medicine. Whether you're preparing for the FRCEM OSCE or some shopfloor supervision of medical students, you need to be able to explain things to others that, for you, have now become second nature.
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It’s time to get this niggling pain off our chest… An approach to chest pain in Paediatric ED

Chest pain in children and young people is thankfully, in the most part, not too concerning. But explaining exactly what the cause of it is, can be tricky. And when do we need to worry?
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Email Management

Information overload is everywhere. With so many different methods of communicating, it is really easy for important facts to get lost in the noise. I think we all have a responsibility to make this better and easier, and I think we can make email work with a few changes
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Colles’ fracture

Colles' fractures are a common presentation to emergency departments across the globe. The eponymous fracture is a dorsally angulated extra-articular distal radial metaphyseal single segment fracture. Everything else is a distal radial fracture or a Smiths or a Bartons or a Chauffeur fracture or Galeazzi.
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Reflections from Online Education

A review of current practise and reflections from DFTB Illness and Injuries 2020
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Sun, Sea and Altitude Emergencies – Part 2

You move to your second base as some divers have surfaced and are getting ready to pack up. You notice one of them is swaying left and right and stops due to complaints of pain in his back. He has started to feel out of breath.
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Sun, Sea and Altitude Emergencies – Part 1

Big city medicine can sometimes be tricky to tick the box that says "Environmental Emergencies" in the RCEM curriculum. But a day in the life of a doctor living in more "outdoor" or seaside settings can help you get the mindset that is needed for these sort of pre-hospital jobs.

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