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Authors: Andy Neill, Chris Connolly, Nikki Abela / Code: IP3, SLO1, SLO11, SLO2, SLO3 / Published: 20/09/2016

Hello and welcome to the first of our daily podcast summaries from not-so-sunny Bournemouth for the RCEM annual scientific meeting.

We hope to give you a brief sense and feel of what’s been happening. Though the best way to experience an RCEM conference is to be there in person.

The morning kicked off after an address by outgoing RCEM president Cliff Mann, who handed over his presidential role to Taj Hassan after the AGM at the end of the day.

Mervyn Singer: Sepsis 3.0

 

Intensive Care professor Mervyn Singer warned about  there being an extreme amount of hype around sepsis and the risk harming people who don’t need aggressive treatment. The third international consensus definitions on sepsis use qSOFA as a risk assessment tool and should not be confused with a definition of sepsis, he pointed out.

There is much FOAMed out there on the new sepsis definitions and NICE guidance, including our very own  podcast published last week. Here are some others:

Troponins

Rick Body and the St Emlyns team have a number of blogs and podcasts on Troponin, which will bring you up to speed with the latest update and Jodd Hollander’s review article on troponin is also a good one to look at. Rick warned against “Troponinitis” – where too many people were being diagnosed with ACS simply due to a false positive troponin rise.

The three things Rick recommended to ward against this were to:

  1. Interpret the clinical context
  2. Consider the patient’s baseline
  3. Work out the rise and fall of troponin using absolute delta (ie. Troponin 2- Troponin 1)

Edd Carlton followed with a talk on “TIMI- time to say goodbye”.

If low-risk chest pain scores are not your thing, I do not blame you, because there are so many decision rules out there, that it feels like the search continues:

One Clinical Decision ToolToRULEthem all

Free papers

The afternoon session had academic presentations which hit a tune on twitter. One talked about SAAP (selective aortic arch perfusion), which if you have not heard about it, I don’t blame you, but EMCrit has a great post which will get you up to speed.

The Big Debate

This debate closed the day with the twitter audience deciding in absolute majority that we should not be treating patients as customers, or as Olly, from South London put it:

Are you being served?

We will leave you with some of the other thoughts from the audience:

Screen Shot 2016-09-20 at 16.18.57

https://twitter.com/PJay1707/status/778250831854465024

https://twitter.com/BrianFlavin2/status/778249913582907392