A 44-year-old male collapses and is subsequently brought into Resus. He presents with sudden-onset chest tightness and sweating, preceded by progressive shortness of breath over the past 24 hours.
Tuberculosis can feel like a disease from a different era. The truth is, it is still very much with us and in a busy urban ED you will see it. The real question is whether you think of it before the patient leaves the department, or three months later when they’re back worse.
This module provides an overview of neuroprognostication following cardiac arrest, beginning with the current prevalence of cardiac arrest and the Chain of Survival framework. It explores the key factors influencing survival to hospital discharge as well as multimodal evaluation techniques and the clinical criteria used in brain stem death determination.
You are met with a patient who, you believe, is suffering an anaphylactic reaction, however the adrenaline is not having the desired effect. Why might this be and what would you do?
An 18-month old boy is brought in to the ED with a cough, mild constitutional upset and increasing stridor for approximately 12 hours. He is previously well and immunised up to date.
1 in 300 people will experience anaphylaxis at some point in their lives. RCUK anaphylaxis guidelines provide an updated consensus for the recognition and management of anaphylaxis in all age groups.
A 48-year-old man on carbamazepine developed acute ataxia and vomiting after starting clarithromycin for cellulitis, with toxic carbamazepine levels, highlighting a preventable drug–drug interaction.
This session covers the recognition and management of potentially difficult airway scenarios, including appropriate equipment preparation and strategy development for failed intubation.
This module covers the recognition and management of potentially difficult airway scenarios, including appropriate equipment preparation and strategy development for failed intubation.
An elderly lady is brought to your ED by ambulance after falling at home. She is hypotensive, tachypnoeic and agitated. She has a wound on her right shin with no active bleeding.
An 18-year-old male is brought into the ED by ambulance. He was performing a BMX stunt off a ramp approximately 6 feet in the air when he lost his balance and fell to the floor landing on his right hand side, and then rolling onto his front.
You are working on a rapid response vehicle (RRV) as a part of a PHEM-rotation and attend a ‘red’ call: “3-year-old cardiac arrest. Unsupervised child fallen into outdoor pond. Not breathing. Not responsive”.
A motorcyclist presents after a high speed collision, appearing stable with minor signs. But is everything as it seems? Would you trust the vitals or investigate further?
This module focuses on the knowledge, skills, facilities and equipment required to perform safe procedural sedation. Commonly used sedation agents and some of their qualities are described.
Your receive a pre-alert call from the air ambulance team who are bringing a 32-year-old man, who has sustained a single stab wound to the epigastrium whilst outside a pub.
Anaphylaxis is a severe, life-threatening, generalised or systemic hypersensitivity reaction characterised by rapidly developing life threatening airway, breathing and/or circulation problems usually associated with skin and mucosal changes
The biggest cause of spinal injuries in children is road traffic collisions, particularly those with high speed, a rollover or an ejection from the vehicle, with second place going to falls in younger children and sporting injuries in older children.
This month we have Parental concern and critical illness in children | Acute behavioural disturbance in the ED (Part Two) | Clearing paediatric C-spine with CT imaging only | New Online.
FAST involves assessment of the peritoneal cavity, pleural cavity and pericardial space. Learning that free fluid is present facilitates the most appropriate management plan.
Tracheostomy emergencies are rare in the ED but are associated with high mortality and morbidity. It is therefore essential that ED practitioners are competent in assessing and stabilising patients with complications arising from tracheostomies.
This module focuses on the treatment of adult patients with previously diagnosed asthma that present to the ED with an acute episode of breathlessness.
A 45-year-old male, with unresolved cyanosis despite oxygen, presents with pleuritic chest pain and recent PE history. Arterial blood gas was performed to assess underlying hypoxemia.
Emergency Physicians must be confident managing the post-cardiac arrest patient with return of spontaneous circulation (ROSC) to continue high quality care once initial resuscitation succeeds.
Transfusion reactions range from mild to life threatening, and it is, therefore, important for clinicians to be able to assess, investigate and manage these presentations.
Sedation is a routine aspect of emergency care. The aim is clear: make the procedural experience as comfortable as possible for your patient, whilst ensuring that your practice is safe.
Guideline summary
30-word description of the Guideline How to diagnose and manage adults with severe sore throat, including life-threatening supraglottitis / epiglottitis
Children commonly present in the ED with stridor. Stridor is a sign of upper airway obstruction. An ED physician must be able to diagnose, initiate treatment, appropriately investigate, anticipate and manage complications.
Children commonly present in the ED with stridor - a sign of upper airway obstruction. An ED physician must be able to diagnose, initiate treatment, appropriately investigate, anticipate and manage complications.
Transfusion reactions range from mild to life threatening, and it is, therefore, important for clinicians to be able to assess, investigate and manage these presentations.
Patients with airway compromise need prompt recognition and correction using basic airway techniques. These are essential skills for emergency physicians and will be covered in this session.
This session covers indications for Propofol sedation identifying suitable patients and those at higher risk of adverse events, a standardised procedure for Propofol sedation (protocol), strategies for addressing adverse events and all relevant governance issues.
This module covers indications for Propofol sedation identifying suitable patients and those at higher risk of adverse events, a standardised procedure for Propofol sedation (protocol), strategies for addressing adverse events and all relevant governance issues.
This month we are discussing paed nail bed repair, Sickle Cell Disease, James Lind Alliance Priority Setting Partnership for Major Trauma and New Online.
This session provides training in chest drain insertion. It looks at the indications for carrying out this procedure, as well as how to prepare for it, and shows a chest drain being inserted. Post-procedure management and complex cases are also covered
This module provides training in chest drain insertion. It looks at the indications for carrying out this procedure, as well as how to prepare for it, and shows a chest drain being inserted. Post-procedure management and complex cases are also covered.
This session provides an introduction to Brief Unexplained Resolved Events. It covers the definition, differential diagnoses, how to stratify patients into low or high risk and the subsequent management.
This session provides an introduction to Brief Unexplained Resolved Events. It covers the definition, differential diagnoses, how to stratify patients into low or high risk and the subsequent management.
Dyspnoea is an overall term used to describe an unpleasant awareness of increased respiratory effort and will be used synonymously with "breathlessness" in this session.
In the first podcast of 2024 we have Aortic Dissection in the ED, Invasive Procedures in the ED, Noninvasive airway management in comatose poisoned patients and New Online.
This blog looks at RSI from the eyes of the “assistant” - this might be the resus nurse, the ED FY2, or a non-airway trained ED registrar. Please send your thoughts, feedback and comments.
This module is part one of two dealing with thoracic injuries. It is pitched at FRCEM examination standard and you are expected to be competent at leading a trauma response.
We’ve talked a lot in RCEMLearning blogs about how to recognise death in ED and how to break bad news, but we haven’t really focused on how to legally “declare” someone as dead, and complete the relevant paperwork. It is through researching updates to my trust’s policy, together with making sure our international medical graduates were aware of the UK rules, that this blog post was born.
This session looks at disorders of potassium metabolism, in particular the presentation of hypokalaemia and hyperkalaemia in the ED. It also covers the investigation and management of these conditions.
This module looks at disorders of potassium metabolism, in particular the presentation of hypokalaemia and hyperkalaemia in the ED. It also covers the investigation and management of these conditions.
Tracheostomy emergencies are a relatively common and often alarming occurrence – do you know how to manage a patient presenting with a tracheostomy emergency?
This month we discuss Bystander cardiopulmonary resuscitation and cardiac rhythm change over time in patients with out-of-hospital cardiac arrest, Spiking and Blunt chest wall trauma.
A 78-year-old gentleman is wondering if he needs antibiotics for his worsening shortness of breath. His only past medical history is a maxillofacial tumour that was surgically resected a year ago. Is this a simple chest infection?
The aim of this session is to have a quick recap of Brugada syndrome, identify key ECG features for diagnosis and learn about managing patients with the condition.
The aim of this session is to have a quick recap of Brugada syndrome, identify key ECG features for diagnosis and learn about managing patients with the condition.
A patient books in stating that his “heart is beating fast”. Your receptionist thinks he ‘doesn’t look right’ and brings him through to you in the main department.
This session is an overview of Sudden Unexpected Death in Infancy and Childhood (SUDIC); the risk factors associated with SUDIC, our role in the ED and the investigative process thereafter.
This session is an overview of Sudden Unexpected Death in Infancy and Childhood (SUDIC); the risk factors associated with SUDIC, our role in the ED and the investigative process thereafter.
A 45-year-old female attends with grossly swollen lips. She has some important information about her symptoms, can you understand it?
моє обличчя опухло!
If not, it’s time to use some clinical acumen!
A 16-day-old baby, who has had an uneventful antenatal period, presents with coryza, with some blood streaking in this. His symptoms progress over the coming days to uncover another more subtle diagnosis that may not be considered without a thorough and detailed assessment.
This month we discuss Fluids in RSI, Learning Disabilities, New Online material and we have highlights from the Thames Valley Cardiac Arrest Symposium (Part 1)
This session provides an overview of neuroprognostication following cardiac arrest, beginning with the current prevalence of cardiac arrest and the Chain of Survival framework. It explores the key factors influencing survival to hospital discharge as well as multimodal evaluation techniques and the clinical criteria used in brain stem death determination.
Imagine it's 2am and the Red Phone rings…. “A 26-year-old male, fallen off motorcycle, in traumatic cardiac arrest”. Your heart races, you’re excited, but you feel way out of your depth. You know there’s loads to prepare and often there isn’t much notice. What do you do?
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.
This month we have part B of our recordings from the Annual Scientific Conference. We discuss End of life and escalation with Dr Calvin Lightbody, Organ donation in EM with Dr Katja Empson and TBI in ED with Dr Virginia Newcombe
A third of deaths from food anaphylaxis occur despite appropriate early management. Consequently, the RCUK have recognised a need for standardised algorithms for ongoing resuscitation in cases of refractory anaphylaxis.
A 2-year-old boy is brought to the Emergency Department with a barking cough and noisy breathing. Can you diagnose and treat him before he deteriorates?
This learning module covers the basics of what an LVAD is, the common complications an emergency medical team may have to deal with, and the management of a collapsed LVAD patient.
This learning module covers the basics of what an LVAD is, the common complications an emergency medical team may have to deal with, and the management of a collapsed LVAD patient.
Andrew and Graham discuss Projected paediatric cervical spine imaging rates with application of NEXUS, Canadian C-spine and PECARN clinical decision rules in a prospective Australian cohort
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.
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.
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.
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.
This month we have split the podcast into two sections. The first has New in EM WBCT for cardiac arrest and Critical care update Part 1. The 2nd part is a complete feature on COVID19
This session is about achieving a diagnosis in a patient presenting with chest pain
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