A 78-year-old man on clopidogrel presents after a fall with rib fractures, pulmonary contusion and haemothorax; ED erector spinae plane block has provided effective analgesia and improved oxygenation.
This month we have New in EM - Ibuprofen plus opiates in paediatric injury | Guidelines for EM - Sexual Assault in the ED | Maddy Dodds - Sexual Assault in the ED
This month we have New in EM - BP targets in spinal cord injury | Guidelines for EM - New Zealand Chest Wall Injury | Gender and assessment of abdominal pain with Charlotte Underwood.
A keen fisherman attends following a flu-like illness. He has a small head wound and is now jaundiced. One sign brings it all together, can you spot it?
A male presents with a large bulge to his bicep area after going to punch and then missing a punch bag in an arcade. Why does he now have such a big bicep?
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.
Most patients arrive with c-spine immobilisation, now called "restriction of c-spine movement or ROCSM", in situ. If they haven't, and they need it, there's a few steps to take.
A male in his twenties presents to the ED complaining of haemoptysis following blunt thoracic trauma in sport. After an abnormal Chest X-Ray, his CT Chest reveals an interesting finding which surprises the Emergency Medicine and Cardiothoracic teams.
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 month we have New in EM - Ruling out ACS in the ED | Guidelines for EM - AF (Part 1 of 2) | Interview with Matt Reed RE: Flagship Conference | New Online
This module aims to improve the standard of concussion care. It covers how to recognise a concussion, and provide appropriate management and discharge advice consistent with new national and international guidance.
This session aims to improve the standard of concussion care. It covers how to recognise a concussion, and provide appropriate management and discharge advice consistent with new national and international guidance.
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.
A 49-year-old female returns to the ED with post-traumatic elbow pain. She appears tearful. She was discharged a week ago after sustaining a fall, which was diagnosed as muscular back pain.
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.
A 30-year-old, 50kg, factory worker presents to your ED following a chemical burn injury. While operating a machine at the Royal Mint an accident sprayed chemical over his face, neck and upper chest.
This 32 year old has fallen off a ladder, and has hip pain. Their x-rays show a pubic ramus fracture, they’re able to mobilise, so can I send them home?
Here is a brief overview of three of our favourite and most satisfying PEM procedures. They epitomise ED practice - but can seem tricky to the PEM naive practitioner.
SBA session on the RCEM recommendations about the management of an aggressive patient with acute behavioural disturbance (ABD). How to keep your patient, your colleagues, and yourself safe!
This aims to provide the learner with an overview of common types of skin and soft tissue injuries, how best to accurately describe these, and considers the mechanism most likely to be responsible.
This module aims to provide the learner with an overview of common types of skin and soft tissue injuries, how best to accurately describe these, and considers the mechanism most likely to be responsible.
Poor old lumbar spine – it does a lot of the heavy lifting for the body but probably doesn’t get anywhere near the attention of the cervical spine when it comes to trauma.
Serratus anterior plane block can be used as multimodal analgesia for rib fractures in the trauma patient. This module outlines the ultrasound guided technique.
Best practice standards for safe procedural sedation. Includes choice of pharmacological agents and suggested doses. Sets out recommended staffing, competencies, monitoring, location, and discharge criteria.
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.
Serratus anterior plane block can be used as multimodal analgesia for rib fractures in the trauma patient. This session outlines the ultrasound guided technique.
This session describes the processes around Information Sharing to Tackle Community Violence. It also describes some of the responsibilities of emergency clinicians around confidentiality when looking after victims of violence.
This module describes the processes around Information Sharing to Tackle Community Violence. It also describes some of the responsibilities of emergency clinicians around confidentiality when looking after victims of violence.
In the past, paediatric lacerations requiring sutures often required admission and a general anaesthetic for wound closure. This blog looks at how we can provide timely, cost effective and acceptable management in the ED that avoids this paradigm.
This month we have: New in EM - Clonidine for pain, Guidelines for EM - NEXUS Chest CT Rule, an interview with Matt Reed, Coca cola for food boluses and New Online.
This session covers the practical aspects of safe insertion of chest drains using videos to provide guidance. It covers both the Seldinger technique and the open approach to chest drain insertion.
This mont we have POCUS for paediatric wrist fractures, NICE Guidelines on TLOC, Interview with GP Steve Taylor, Removing Penicillin Allergy labels & New Online
Walk into any Emergency Department in the country and you are bound to find at least one child waiting to be seen with a head injury - it's one of the commonest presenting complaints to EDs in the UK
This session presents a logical approach to the assessment, diagnosis and management of soft-tissue hand injuries in the ED, including suggested indications for early hand specialist referrals.
This module presents a logical approach to the assessment, diagnosis and management of soft-tissue hand injuries in the ED, including suggested indications for early hand specialist referrals.
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 month we discuss: The STANDING Protocol for Vertigo, Head Injury (Part 2 of 2), A History of A&E Performance with Steve Black, TTA Topical Anaesthetics for Corneal Abrasion and New Online.
Understanding mechanism of injury is a crucial aspect of managing patients who have suffered traumatic injuries. This module aims to provide an overview on attaining this information and its translation into patient care.
Understanding mechanism of injury is a crucial aspect of managing patients who have suffered traumatic injuries. This session aims to provide an overview on attaining this information and its translation into patient care.
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.
This month we’ve got two New in EM segments: which shoulder relocation technique is best & the use of TXA in haemoptysis.
We also speak with Tessa Davis of Don't Forget The Bubbles fame and her top tips for delivering teaching online. We then speak to Evan Bayton about the RCEM Coat of Arms and what on earth it all means, and then end the podcast with New Online.
This month Graham talks to our very own Rob Hirst about establishing the research priorities of emergency medicine trainees, patients and carers across the UK and Ireland: the TERN Delphi study. Then Susie Roy discusses Cervical spine movements during laryngoscopy and orotracheal intubation: a systematic review and meta-analysis.
Nikki Abela and Liz Herrieven have treated themselves to the RCEM PEM Conference in Manchester on 21/3/2023 – World Down Syndrome Day. Put on your #LotsOfSocks for the day and have a read to see what they learned.
A young lady presents with shoulder pain, for which there are multiple differential diagnoses. How do you differentiate between them in order to manage her effectively?
The use of FI blocks in the emergency department has been shown to provide effective pain relief in the acute setting and to reduce the use of opiate analgesia.
The use of FI blocks in the emergency department has been shown to provide effective pain relief in the acute setting and to reduce the use of opiate analgesia.
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.
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.
Local anaesthetics are amongst the most widely used drugs in any emergency department. It is, therefore, essential that emergency medicine clinicians can use these drugs safely and effectively.
This month we discuss Laryngospasm in paediatric sedation, Case Based Discussions, Use of Non-Sterile Gloves for Wound Closure, and new online material from RCEMLearning
It's safe to say you will likely see a few of these, as minor injuries are a very common occurrence in childhood with around 20-30% of all paediatric attendances to the Emergency Department involving minor injuries or trauma
Paediatric injuries can be very different from those sustained in adults in many respects. This session discusses why this is the case and outlines the general principles of treating paediatric injuries.
Paediatric injuries can be very different from those sustained in adults in many respects. This session discusses why this is the case and outlines the general principles of treating paediatric injuries.
A young man presents with superficial wounds on his forearm from a dog bite. You know what you have to do. Clean the wound, give a tetanus shot and prescribe antibiotics…. Right?
Cervical spine injuries are rare but potentially devastating. Immobilisation of the cervical spine on the slightest suspicion of injury is recommended by most resuscitation courses.
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.
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.
Effect of tranexamic acid on intracranial haemorrhage and infarction in patients with traumatic brain injury: a pre-planned substudy in a sample of CRASH-3 trial patients
This session deals with the critical appraisal of a key randomised controlled trial. The study concerns two treatments for the management of hand lacerations
Fracture of the neck of the femur is a common injury and the incidence is increasing although it is not always easy to diagnose. The majority of fractures are caused by falls in the elderly and the fracture usually occurs through osteoporotic bone
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
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.
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
Every year, at the Royal College of Emergency Medicine Annual Scientific Conference, the Rod Little prize is held to celebrate trainee research and recognise the outstanding work of the winner
Each year at the Royal College of Emergency Medicine (RCEM) Annual Scientific Conference, the prestigious Elizabeth Molyneux Prize is awarded. The prize, named in honour of Professor Elizabeth Molyneux, recognises outstanding work in the field of Paediatric Emergency Medicine (PEM).
The January 2020 podcast is hosted by Chris Connolly and features New in EM currency in EM intubation, ASC 2019: Govind Oliver - Clinical Gestalt vs TMAC scoring, New in EM early antibiotic in sepsis, ASC 2019: Gordon Fuller AHEAD-2
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