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Another angry drunk

It’s Friday night, a 19-year-old male who alleges he’s been assaulted is shouting / being aggressive in the waiting area. The triage nurse asks you to discharge him.
A 45-year-old man develops methemoglobinemia after an incidence of eating his own faeces.
Another faller presents to your ED Confused and smelling of alcohol. What will you do? How can you avoid missing the common pitfalls?
This blog looks at the challenges that patients with Autism Spectrum Condition face in the emergency setting and suggests some tips and tricks for clinical assessment and management.
This is the first of our public health series blogs. Keep your eyes peeled for a few more public health topics over the next few weeks.
A 56-year-old man presents to the ED 48 hours following an alcohol binge with chest pain and dyspnoea.
With a huge burden of mental and physical health needs carried by patients with eating disorders, ED clinicians need to be aware of how they can give the care needed.
A patient with acute behavioural disturbance is proving very hard to manage, you need to gain control but by what means and what powers do you have to achieve this?
A set of 10 Multiple choice questions to help you revise. The Questions have been selected at random covering the curriculum.
A set of 10 Multiple choice questions to help you revise. The Questions have been selected at random covering the curriculum.
A young lady presented with abdominal pain, lethargy, (Groin) bone pain, depression and headache.
A 13-year-old female collapses whilst running. How will you assess and manage this?
The unspoken disease of inflicted, non-accidental injury in children.
A 29-year-old woman attends your ED for medical clearance before further treatment by her Mental Health team. She has a seizure before you review her.
A young man presents with auditory hallucinations and paranoid delusions. Test your knowledge on assessment and management of a psychiatric patient.
A conducted energy device (CED) ‘taser’ was discharged into a patient’s shoulder. Before this patient is taken into police custody, you’ve been asked to assess them in your ED.
This month Susie and Rajesh talk about Emergency Physicians experience of stress during resuscitation and strategies for mitigating the effects of stress on performance.
The Police have brought a patient to your ED that has had a controlled energy device discharged into their upper back. You are called to assess this patient.
A 45-year-old man attends the department with a 48 hour history of nausea and vomiting. He also has a diffuse upper abdominal pain.
A set of 10 Multiple choice questions to help you revise. The Questions have been selected at random covering the curriculum.
A lady presents with decompensated liver disease and the CT reveals more than just ascites and cirrhosis.
A set of 10 Multiple choice questions to help you revise. The Questions have been selected at random covering the curriculum.
A set of 10 Multiple choice questions to help you revise. The Questions have been selected at random covering the curriculum.
A set of 10 Multiple choice questions to help you revise. The Questions have been selected at random covering the curriculum.
This session outlines a standardised approach to providing care for a haemodynamically normal patient presenting following rape or sexual assault.
This session outlines a standardised approach to providing care for a haemodynamically normal patient presenting following rape or sexual assault.
The aim of TERN Top Papers is to highlight the top emergency care related papers for emergency physicians, keeping them abreast of the latest practice-changing studies. 
Functional Seizures aren’t managed with benzodiazepines – but how do you tell functional seizures from epileptic ones?
From somewhere under the sea, sun... and food container.
Regular attender is brought to ED with low GCS with suspicion of intoxication in cold winter season.
What happens if your personality is disordered or disrupted by psychiatric illness? How can your ‘self’ then be accurately discerned from your personality disorder? Where does the condition end and you begin?
An interactive learning session covering the relevance of Inclusion Health to ED.
An interactive learning session covering the relevance of Inclusion Health to ED.
A 25-year-old male presents with a five day history of bilateral muscular leg pain.
This blog article aims to consolidate several resources and anecdotal practice around functional seizures.
This session covers important aspects of history taking, examination and investigation, alongside national guidelines and risk assessment tools, to help guide patient management.
The number of patients presenting to the ED with an eating disorder, or complications arising from an eating disorder, is increasing yearly.
A patient presents to the Emergency Department suspected of having illicit concealed drugs. This SAQ explores the clinical management, combined with the ethical and medicolegal aspects of their care.
How will you manage the absconding patient?
How will you manage your absconding patient with suicidal intent who has gone ‘absent without leave’?
Recognising the clinical features of acute behavioural disturbance (ABD)
Recognising the clinical features of acute behavioural disturbance (ABD)
Managing challenging and violent behaviour is an integral part of the workload of an Emergency Department.
Managing challenging and violent behaviour is an integral part of the workload of an Emergency Department.
How will you manage the absconding patient?
TERN Top Papers for November 2021. This month’s topic is Training and Wellbeing
A 22-year-old healthy male attends ED with sudden onset of headache. He reports taking 100 mg Sildenafil before the headache started. On examination there is right arm weakness.
A 16-year-old is brought in by ambulance to your resuscitation room with a reduced level of consciousness and then starts to see monkeys everywhere. What’s going on?
FII is a broad term to describe a group of behaviours by parents or carers which cause harm to children.
A 19-year-old man presents to emergency department with paranoid delusions.
Describe a safe environment for assessing disturbed or psychiatric patients in the ED.
Describe a safe environment for assessing disturbed or psychiatric patients in the emergency department
A healthy 25-year-old presents to the emergency department complaining she cannot text on her phone
A man with a history of mental health problems, pancreatitis, alcohol excess and type 2 diabetes presents with anxiety.
This month we discuss Guidelines in EM: Mental health | Ondansetron take home in paeds gastroenteritis | Diarrhea and rehydration
Patients with mental health problems often present to the Emergency Department (ED). They will commonly be assessed and then treated, initially, by junior doctors.
A young male has concerning symptoms with a background history of G6PD deficiency…
All our Current COVID-19 information collated together in one handy iBook alongside amazing content from St Emlyn's and Don't forget the bubbles
RCEMLearning Coronavirus, COVID19, tips and resources
Why is this a hot topic? It is a sign of serious distress. It is common. It is strongly associated with suicide. Suicide is one of commonest causes death in young people. 200% increase in self harm 1985-1995. If ever you have the opportunity to save a young persons life - it is now.
It is Monday morning 09.00hrs and you are checking your email inbox. You have received the following email from the StR who has just finished weekend nights
"Toni is a 35 year old lady who attends the emergency department regularly with chest pain. Nothing seems to make it better, and her troponin is always normal. You wonder if there is a potential cause. Read on to find out that there is more to IBS than abdominal pain."
It's Friday evening and you're at work in the ED (where else would you rather be??). Jack is a 15 year old boy who has taken an overdose of paracetamol a couple of hours ago. He texted his girlfriend soon after and she called an ambulance
Alcohol withdrawal is a common presentation to UK EDs and patients can present significant management challenges to clinicians.
Approximately 10% of all admissions to the Emergency Department (ED) are related to patients having a mental health crisis.  With the ever increasing numbers of patients requiring mental health input, it is important that we understand the law that underpins our treatment (RCEM, 2018)
Alcohol use disorder (AUD) is defined by the World Health Organisation as consuming more than 40g/day of alcohol for males and 30mg/day of alcohol for females
Working in the emergency department, you are guaranteed to see and treat patients from all specialties of medicine and surgery. Most will prove to be interesting but also challenging at the same time.
It's your second day on the 'shop floor' and your next patient is handed over as a 51 year old man who has been brought in by ambulance with sudden onset generalised abdominal pain and vomiting
The relative tranquillity of the night shift thus was about to be broken. I swallowed my apprehension and walked outside.
January 2018
The December 2017 Podcast
So the TOXABSE guidelines for staggered paracetamol overdose last night. We bring you an up to date podcast on paracetamol overdose management recorded at the recent RCEM scientific conference with James Dear
The RCEMLearning podcast for November 2017
The new podcast for October 2017
Alcohol abuse is undoubtedly a huge social problem in the UK. It is responsible for many unnecessary attendances to Emergency departments (ED) and is an enormous burden on the NHS, which must treat the complications of alcohol abuse
The 2017 RCEM CPD conference was held in central London in April 2017. There was a great selection of speakers and we had the good fortune to capture a few interviews with some of the speakers
Welcome to the new format podcast. From now on you'll be getting a monthly podcast with lots of different segments to try and cover as much as we possibly can
Today we have an interview with Cian McDermott, an Irish trained EP working in Australia and an old friend of mine
This is the fifth in a series of Emergency Casebooks from the virtual hospital CFN General, with key learning points for staff working in an Emergency Department
One of the CEM General regular attenders was in the other day, a young woman with lower abdominal symptoms. She was needing more analgesia, and was not happy with the protocol we have for her
James Harding, Consultant at UHCW in Interventional Radiology, gives an overview of his talk from the Trauma Care Conference in Telford on Interventional Radiology (IR) in Trauma
Top 10 Trauma Papers 2014-15
Is there a role for the Impedance Threshold Device in hypotensive, spontaneously breathing, trauma patients?
This is the first in a series of Emergency Casebooks from the virtual hospital CFN General, with key learning points for staff working in an Emergency Department
Struggling to find a resource on how to approach the IDU, check out this podcast
Class A drug in the UK - illegal to possess, give away or sell. Possession can be punished with 7 years in jail
A 19-year-old man attends the ED complaining of a change in his sense of smell and taste, together with a feeling of pressure behind the eyes.