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Canal No.5

A 17-year-old man attends your ED having taken an unconventional shortcut on his way home. Check out this SAQ on Drowning.
This module focusses on the emergency department care of patients post-cardiac arrest i.e. after the return of spontaneous circulation.
This session focusses on the emergency department care of patients post-cardiac arrest i.e. after the return of spontaneous circulation.
A 67-year-old man presents with shortness of breath and fever. He has recently completed his first 2 week chemotherapy course for auricular Squamous Cell Carcinoma, administered via a PICC line.
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.
An update on the 2023 guidelines for management of pneumothorax.
Once you have heard the classic “croupy” cough, you won’t forget it.
A 76-year-old presents with abdominal pain. He is clinically shocked (hypotensive and tachycardic) with a known abdominal aortic aneurysm.
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.
This module covers the assessment and management of patients presenting with breathlessness to the ED.
Early recognition and treatment of sepsis in children is crucial as progression to organ failure and shock is often very rapid.
A set of 10 SBA sample questions to help you revise. The Questions have been selected at random covering the curriculum.
Abdominal wall bruising in a 9-year-old girl following a car vs car road traffic accident.
A 36-year-old male presents with a 5-day history of sore throat, fever and dehydration.
The child with decreased consciousness is a common problem with many possible diagnoses and potentially high mortality and morbidity.
The child with decreased consciousness is a common problem with many possible diagnoses and potentially high mortality and morbidity
Learning about lightning injuries
This module covers ACES scans which can provide crucial information in undifferentiated shocked patients.
A 47-year-old man presents to the ED after being thrown off his horse.
During Summer storms, lightning strikes can cause fatalities …but what happens to the survivors?
An 18-year-old female is brought into the ED following a head-on collision with another car with a combined speed of approximately 100mph.
This learning session focuses on the understanding, recognition and management of acute RHF.
This Reference focuses on the understanding, recognition and management of acute RHF.
You are assigned to perform an echo in life support on a 45-year-old patient with a witnessed out-of-hospital cardiac arrest.
This session concentrates on patients with actual or impending cardiopulmonary arrest.
A 4-year-old girl fell whilst playing in the playground on a metal slide and sustained a 3cm open wound to her left cheek and upper lip.
How will you manage haemodynamic instability in a patient following a calcium channel blocker drug overdose?
This session covers the assessment and management of primary, secondary and tension pneumothoraces.
This module covers the assessment and management of primary, secondary and tension pneumothoraces.
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.
A 3-day-old baby girl is brought to the emergency department by her distressed mother with complaints about the baby's shivering and lethargy.
Chest and abdominal x-rays are commonly requested in the emergency department.
The infant who nearly died in her parent’s arms.
A 4-year-old girl presents to the Emergency Department with a four-day history of fever and sore throat.
This session covers the diagnosis and initial management of a patient with acute aortic dissection.
This session covers the diagnosis and initial management of a patient with acute aortic dissection.
An unusual presentation of chest pain to the emergency department following substance abuse at a party.
Angioedema and Urticaria (hives) are part of a spectrum of allergic symptoms and occasionally have a non-allergic aetiology.
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.
A 35-year-old woman is brought to the ED after being involved in a road traffic collision.
This module deals with the assessment and management of bradycardias in the ED.
Ultrasound in shocked patients. This competency is specifically for Higher Specialty Trainees. It is also useful for interested Core Trainees.
You take handover for a patient in resus. They have presented with new onset of focal seizures. You start treatment but the convulsions are worsening. What will you do?
This session covers the assessment and management of broad complex tachycardia.
This module covers the assessment and management of broad complex tachycardia.
A 26-year-old Indian man presents to the ED after being unwell for 5 days complaining of weakness, fever and headache.
You receive a pre-alert for a 30-year-old female who had chest pain earlier that morning.
A 66-year-old man falls 6 feet from a step ladder on to concrete. On scene he is haemodynamically stable, his GCS is 15 and he is moving all 4 limbs.
A 30-year-old female attended the Emergency Department after vomiting, feeling weak and ‘not quite with it’.
The aim of this blog is to review management of adult medical cardiac arrests and look at interventions beyond the ALS algorithm.
An 80-year-old woman presented to the ED at 2am with acute chest pain and shortness of breath.
This month we have: outine head to pelvis CT post arrest, an RCEM ASC Interview Megamix and New Online,
A 46-year-old female presents with a three-month history of progressively worsening vaginal bleeding.
A 69-year-old man presents to the ED with a heart rate of 28bpm. He is hypotensive and clammy.
An 85-year-old lady is brought in after an unwitnessed fall in a care home complaining of right wrist pain. She has obvious facial bruising.
A young girl collapses suddenly at school and presents to your ED with an altered level of consciousness – what could have happened?
This month we discuss the SQUID protocol for DKA, Concussion Guidelines, The Physiologically Difficult Airway and New Online.
A 43-year-old cyclist arrives after being struck by a car. He arrives with spinal immobilisation on a scoop stretcher with evidence of bruising to the right chest, abdomen, and pelvis.
For each life-threatening thoracic injury this session includes: a definition and context, Clinical assessment , treatment and Key learning points.
This session is the second one in the series dealing with thoracic injuries.
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.
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 previously healthy patient presents with a rapid onset illness, with fever, rash and tachycardia - what could be the culprit?
A Middle-aged man presents to the ED with Epigastric discomfort associated with multiple episodes of vomiting.
A 12-month-old diabetic girl presents generally unwell and vomiting.
A 63-year-old male walks into the Emergency Department with elbow and forearm pain and initially appears well.
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.
Everyone’s talking about sepsis lately, but do you know what to do?
A 76-year-old diabetic is referred with confusion and is being treated for a UTI. She is tachycardic and drowsy, is there more than sepsis?
A 54-year-old Jehovah witness man is pre alerted to resuscitation room with haematemesis and is hypotensive.
32-year-old presents to Resus with multiple stab wounds and breathlessness.
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 have: TXA in trauma revisited - the PATCH Trauma trial, Head injury, HALO procedures with Joseph Mathew and New Online.
This session covers the assessment, treatment and management of patients presenting to the ED with primary blast injuries.
This module covers the assessment, treatment and management of patients presenting to the ED with primary blast injuries.
EM/PHEM resuscitation during an observer shift
A patient having a large laceration sutured suddenly goes into cardiac arrest.
A 77-year-old man presents with haemoptysis and shortness of breath.
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?
Adult Trauma Call: Management of a 28-year-old male with a knife wound to the chest.
Management of Hypothermic Cardiac Arrest
An 81-year-old woman attends ED from a Nursing Home with a reduced GCS, tachycardia, tachypnoea, hypotension, hypothermia and hyperglycaemia.
A 71-year-old man with a history of chronic obstructive pulmonary disease, obesity, angina and ankylosing spondylitis presents to the ED acutely short of breath.
Management of Cardiac arrest in advanced pregnancy.
A 4-year-old child is brought into your resuscitation room with difficulty breathing.
This session describes the management of presentations of non-traumatic subarachnoid haemorrhage in the ED.
A 46-year-old gentleman with a known history of alcohol dependence re-attends to the ED with a reduced GCS. Is he just drunk?
A 52-year-old male complains of a mass at the base of his neck following a fall from his mountain bike.
Necrotising fasciitis is a rare but severe soft tissue infection that requires a high index of suspicion for diagnosis in the ED.
Necrotising fasciitis is a rare but severe soft tissue infection that requires a high index of suspicion for diagnosis in the ED.
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 9-week-old female infant presents to Paediatric A&E at 2200 hrs with a history of coughing, difficulty in breathing, lethargy and reduced feeding.
A patient presents with suspected aspiration but turns out to have something even more concerning.
An 8-month infant is brought into the ED following a collapsing episode as witnessed by his distress mother. What do you do next?
This month we have Liberal vs. restrictive fluids in sepsis, Management and investigation of results from the ED, GreenED and New Online.
A 40-year-old female presents to the Emergency Department feeling lethargic for 24 hours.
A 77-year-old gentleman presents to the ED five days after his endoscopic endonasal transsphenoid resection of his pituitary adenoma with a severe frontal headache, fever and multiple episodes of vomiting.
Another pain in the back SBA
A 2-year-old boy is brought to the ED at 2 am with noisy breathing and a barking cough.
Patient with Von Willebrand disease is brought to ED with per rectal bleeding.
A woman presents with 10/10 eye pain. Consider what could be going on, rule out the red flags and address her urgent concerns!
The physiological effects of hypothermia mean that the management of cardiac arrest requires an altered approach.
The physiological effects of hypothermia mean that the management of cardiac arrest requires an altered approach.
Cardiogenic Pulmonary Oedema
This session covers management of tachycardias in the Resuscitation Room. It builds on the Resuscitation Council UK ALS Guidelines (2021) using selected evidence.
Management of tachycardias in the Resuscitation Room.
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.
RCEM, Advanced Life Support, ALS, shockable rhythm, non- shockable rhythm, cardiac arrest, resuscitation, resus.
30 questions. 30 minutes. Test yourself against your colleagues!
This session explores how to use point-of-care ultrasound (POCUS) to assess patients presenting with shock to the Emergency Department.
A 21-year-old man is involved in a high speed RTC. He has a GCS of 6/15 at the scene and has an isolated head injury.
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.
A 72-year-old gentleman, who has not seen a doctor in decades, presents with dyspnoea and acidosis with increased work of breathing.
A patient with a bee sting complains of chest pain and has ECG changes, what are you thinking?
A 14-year-old boy has been brought to the ED with a headache that has been ongoing for the last few days.
A 67-year-old man is brought into the emergency department with collapse associated with chest pain
A stinging tale of paediatric anaphylaxis, with the added buzzzz of pre-hospital emergency care.
This session is about the assessment and complex management of patients with pelvic injury in the emergency department.
This session is about the assessment and complex management of patients with pelvic injury in the ED.
This module focuses on community acquired pneumonia (CAP) which is by far the commonest form of pneumonia seen in the Emergency Department.
This session covers community-acquired pneumonia (CAP), which is by far the commonest form of pneumonia seen in the ED.
A 14-year-old girl is haemodynamically unstable following an RTC.
This session covers how to diagnose, assess and manage a patient with chronic obstructive pulmonary disease (COPD).
This module covers how to diagnose, assess and manage a patient with chronic obstructive pulmonary disease (COPD).
Hyperosmolar hyperglycaemic State is a common presentation to the ED which can mimic many other disease processes.
Hyperosmolar hyperglycaemic State is a common presentation to the ED which can mimic many other disease processes.
A 35-year-old previously healthy male presents to the ED complaining of chest pain and breathlessness following an unknown bite.
This month we discuss IV Paracetamol, Sedation, Highlights from the Thames Valley Cardiac Arrest Symposium & New online material from RCEMLearning.
An 18-month old boy is brought in to the ED by his grandmother with a cough, mild constitutional upset and increasing stridor for approximately 12 hours. He is previously well and immunised up to date
A 21-year-old man presents with a chainsaw injury to his neck on the left side.
A 52-year-old male electrician presents in the ED with a complaint of abdominal pain.
A 54-year-old driver of a pick-up truck is involved in a head on collision with a stationary vehicle at approximately 30mph.
This session covers the assessment and management of lower gastrointestinal (GI) haemorrhage.
This session covers the assessment and management of lower GI haemorrhage.
Preparing for exams and trying to find an SBA on organ donation? The law around organ donation has changed; refresh your knowledge with this SBA.
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)
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 next?
A 5-year-old girl presents with acute shortness of breath and wheeze.
A 68-year-old man attends the ED one evening with a painful right knee.
In United Kingdom, approximately 76,000 patients sustain Cardiac Arrest following a non-traumatic cause in an inpatients and out-of-hospital settings
The medical professionals have a great responsibility of ensuring the survivals of Cardiac Arrest have an excellent quality of life.
An unconscious male presents to the ED after being pulled from a burning building.
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, a section on advanced procedural sedation and all relevant governance issues.
Palpitations in a young woman for the last week. Her GP says probably a panic attack. Can you stream her to the in-house GP?
Struggling to negotiate CT imaging requests for your paediatric patients? Let the guiding principles of ALARA come to your rescue!
You are asked to see a 51-year-old lady who has been taken to the resus room. The ambulance crew tell you she has taken an overdose 5 hours previously.
A 20-year old female presents to the ED with reduced GCS and profuse vomiting following a night out.
A previously fit and well, fully immunised 10-month-old is brought into your ED with a 3 hour history of drowsiness.
A 55-year-old woman, who is usually fit and well, is brought in on a spinal board having fallen off her bicycle whilst going downhill at high speed.
The aim of TERN Top Papers is to highlight the top emergency care related papers for emergency physicians. This month’s topic is critical care.
This session reviews the transfer of oxygen from the atmosphere to the body's tissues.
Trauma Pre-alert for a 35-year-old gentleman who sustained injury to head and back after diving into the shallow end of a swimming pool.
Could this be a BRUE? A Brief, Resolved, Unexplained Event
A 65-year-old man with a neck of femur fracture becomes acutely unwell after a fascia iliaca block.
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. 
This session describes the pathophysiology, diagnosis and management of endocarditis.
Management of Heat Stroke in the ED
Globally, climate change is recognised as one of the leading determinants of health with health outcomes predicted to worsen as the globe continues to warm. But how does this affect me, in the UK? And how will this affect my patients, and the care they receive? And what can I do about it?
A 30-year-old male presents with worsening shortness of breath.
Trauma Pre-alert for a 35-year-old gentleman who sustained injury to head and back after diving into the shallow end of a swimming pool.
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?
Life-threatening asthma and a difficult airway in a previously well patient.
There’s a lot to know about PEM. Can you answer our questions on some of the more common PEM?
Diving-related problems can present in many ways and their appropriate and timely management is essential for good outcomes and patient safety.
Hypoxia is common in patients presenting to the ED and can be life-threatening. The differentials are wide and include cardiac, respiratory and haematological causes
Methaemoglobinaemia is a life-threatening cause of hypoxia and death but is reversible with early recognition and treatment.
A 6-month-old boy brought in because he can’t breathe.
A 52-year-old male presents with a 2-day history of lethargy, vomiting and feeling generally unwell.
This month we discuss Comparison of Q SOFA and hospital early warning scores for prognosis in suspected sepsis in ED patients: A systematic review.
This is the case about clinical diagnosis of Anaphylaxis and life threatening and non-life threatening mimics of Anaphylaxis
A patient is bradycardic. They might need pacing. They might not.
Penetrating neck wounds – how do you manage the stable patient?