St. Emlyn
MARCH 25, 2025
St.Emlyn's - Emergency Medicine #FOAMed Recorded at the London Trauma Conference 2024, Richard Lyon shares insights from his powerful presentation on the importance of detailed case learning and debriefing both in hospital and pre-hospital settings. The post Podcast – Excellence in Debriefing with Richard Lyon at LTC appeared first on St.Emlyn's.
Emergency Medicine Journal
MARCH 25, 2025
Background Traumatic brain injuries (TBIs) are a common cause of morbidity and mortality in war zones. Currently, the vast majority of reports on war-related TBIs concern soldiers, and little is known about this condition in civilians. Methods This is a retrospective observational study from the EMERGENCY NGO hospital for civilian war victims in Kabul, Afghanistan.
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Clinical Correlations
MARCH 25, 2025
By Matthew Ross Peer Reviewed In 1910, Ezra Hayman was on top of the world. The 26-year-old Nebraska native was a young ear, nose, and throat doctor studying abroad in Vienna, then one of the most prominent scientific and intellectual hubs in Europe. One.
Emergency Medicine Journal
MARCH 25, 2025
Background Ultrasound is now readily available in the prehospital setting and its use has been highlighted as one of the top research priorities in prehospital care. Clinical examination remains the standard care for diagnosing lung injury in the prehospital setting, yet this can be challenging and has poor diagnostic accuracy. This review evaluates the accuracy of prehospital ultrasound for the diagnoses of pneumothorax, haemothorax and pulmonary contusions in patients with trauma.
Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
Dr. Smith's ECG Blog
MARCH 25, 2025
Written by Willy Frick A woman in her 60s with very severe hyperlipidemia (LDL >200 mg/dL) presented with acute onset chest pain. Her symptoms began while getting off the bus. She described the pain as moderate in severity, and said it had come and gone several times over the next few hours before ultimately resolving. On day of presentation, the pain returned and was very severe with associated dyspnea and vomiting.
Emergency Medicine Journal
MARCH 25, 2025
Background Out-of-hospital cardiac arrest (OHCA) primarily affects older adults. Individuals in nursing homes are often elderly with significant comorbidities. Nursing homes are staffed by healthcare workers, able to respond immediately to cardiac arrest, including provision of bystander cardiopulmonary resuscitation (CPR). We aimed to describe the characteristics, treatments and outcome of individuals sustaining an OHCA in nursing and care home settings in England.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Emergency Medicine Journal
MARCH 25, 2025
Previous research has shown that many children with injuries consistent with the definition of major trauma are brought to the ED by their carers without activation of pre-hospital resources. Such children who ‘self-present’ may not be identified as promptly or receive trauma team activation (TTA) compared with those arriving by ambulance. 1 Relatively little is known about this patient group, the injuries that bring them to the ED or the severity of their injuries.
Sensible Medicine
MARCH 25, 2025
Stadiums packed with working-class Americans cheering for public health. Political leaders calling for war on our chronic disease crisis. An incoming NIH Director, Jay Bhattacharya M.D., Ph.D. committed to reform. Had someone painted this picture when I was a graduate student at the Johns Hopkins Bloomberg School of Public Health where the moto is “saving lives, millions at a time” it would have sounded like a dream come true.
Emergency Medicine Journal
MARCH 25, 2025
This month’s update is by the Emergency Department Team, Wexham Park Hospital, Slough, Frimley Health NHS Foundation Trust. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlighted the main findings, key limitations and clinical bottom line for each paper.
Emergency Medicine Journal
MARCH 25, 2025
‘8:42’ ‘They called it’ Moments earlier, a firefighter had stormed from outside the patient’s room to the ambulance bay, his face a dark cloud as he muttered profanities. Soon after, a nurse walked past as she tried, and failed, to hold back tears. It was less than an hour into my ride-along interview with a police officer.
Emergency Medicine Journal
MARCH 25, 2025
Warner et al 1 describe the use of oral tranexamic acid (TXA) as a novel treatment for remote or mass casualty incident (MCI) trauma. It should save lives with negligible risk of harm while being cheap, readily available and easy to administer. In other words, it could be the disaster equivalent of aspirin for acute coronary syndromes. It represents a realistic treatment anywhere the Gold Standard for haemorrhage (intravenous TXA) is not readily available and as such could be a viable approach t
Emergency Medicine Journal
MARCH 25, 2025
Background Appropriate dispatch of critical care teams to out-of-hospital cardiac arrest (OHCA) has been identified as a research priority emergency care in the UK. The study aimed to understand the criteria informing the decision to dispatch a critical care physician-paramedic prehospital team to OHCA in one UK region. Methods An invitation to participate in an anonymised online survey was sent by email to clinicians and non-clinicians working on the critical care (physician-paramedic) dispatch
Emergency Medicine Journal
MARCH 25, 2025
Welcome to the April 2025 issue of the Emergency Medicine Journal. This month’s edition of the journal has a timely focus on pre-hospital medicine and trauma. Starting with a thought-provoking commentary from Professor Karim Brohi, he highlights some of the challenges we face on a daily basis in trauma care across the healthcare system. He explores a relatively new approach; the concept of precision trauma and the need to tailor treatment to the individual, in direct contrast to the mantra
Emergency Medicine Journal
MARCH 25, 2025
A short cut review of the literature was carried out to examine whether a decision rule in conjunction with a D-dimer can be used to rule out aortic dissection. 117 unique papers were found of which three systematic reviews included data on patients relevant to the clinical question; these are discussed in the paper. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated.
Emergency Medicine Journal
MARCH 25, 2025
Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.
Emergency Medicine Journal
MARCH 25, 2025
Burnout and stress are terms that are likely to resonate with those working in EDs across the UK and internationally. For many years, ED staff have dealt with high levels of stress with obvious contributing factors being crowding, shift work, emotional strain and understaffing. These challenges were further compounded by the COVID-19 pandemic, thrusting the mental health needs of healthcare professionals into the spotlight.
Emergency Medicine Journal
MARCH 25, 2025
Clinical Introduction Diagnosing anorectal abscesses can be challenging in patients who present with non-specific symptoms or lack external signs such as redness and swelling. We present a case of a perirectal abscess where point-of-care ultrasound facilitated a rapid diagnosis. A 56-year-old man presented to the ED with a 2-day history of intermittent lower back pain and urinary frequency.
Emergency Medicine Journal
MARCH 25, 2025
The early administration of tranexamic acid is recognised as significantly reducing mortality in traumatically injured patients with major haemorrhage, typically given via intravenous or intramuscular routes. In the context of mass casualty events, there may exist multiple traumatically injured casualties that would benefit from tranexamic acid, however, it's administration may be delayed through the need to establish intravenous access.
Emergency Medicine Journal
MARCH 25, 2025
Background The annual incidence of testicular torsion is approximately 1 in 4000 males under the age of 25. Despite the 97% testicular salvage rate when surgical intervention is within 6 hours of onset, orchidectomy is required in 40% of cases. These comparatively poor outcomes are driven by delays to intervention, the majority of which take place prior to presentation to healthcare.
Emergency Medicine Journal
MARCH 25, 2025
While much research tracks patient contacts across healthcare systems, relatively few studies ask the patient about their experience over the 24 hours before presentation to the emergency department (ED).We undertook a patient survey during the busiest weeks ever recorded at our standalone inner-city ED. As attendances approached 1400 patients per week, we attempted to understand each patient’s journey prior to arrival at our ED.
Emergency Medicine Journal
MARCH 25, 2025
Clinical introduction A woman in her 30s with a history of inhaled opioid and marijuana use presented with 3 days of increasing atraumatic left arm pain that began in her shoulder. Her partner was sent away from the ED because he was carrying a pet rat. Vital signs were normal. No skin changes, redness or swelling were noted. The patient was unable to move her shoulder and elbow due to severe pain.
Emergency Medicine Journal
MARCH 25, 2025
Vital sign parameters are components of emergency medical services (EMS) protocols, guide treatment and interventions, and activate hospital processes such as trauma teams or other expedited care. The appropriate interpretation of vital sign parameters is recognised as an important prehospital paediatric priority. 1 We recently developed two sets of age-based vital sign parameters based on an outcome of prehospital life-saving interventions 2 3 , one with higher sensitivity and another with high
Emergency Medicine Journal
MARCH 25, 2025
Traumatic haemothoraces are managed with large bore chest drains to reduce the risk of infection from blood in the sterile pleural space. 1 The benefits or harms of invasive pleural interventions in a contemporary trauma population are unknown, and there is a lack of high-quality evidence to guide decision-making. A 2021 systematic review of observation versus chest drain in small haemothoraces could not produce a recommendation due to low-quality evidence in the two studies identified. 2 One re
Emergency Medicine Journal
MARCH 25, 2025
Background Hypofibrinogenaemia on ED arrival and in the prehospital setting has been associated with both increased mortality and increased blood transfusions. The timely administration of fibrinogen-rich products on arrival to hospital is difficult to achieve and there is no clinical benefit with early, in-hospital empirical fibrinogen supplementation.
Emergency Medicine Journal
MARCH 25, 2025
Clinical introduction A 24-year-old man presented to the ED following a scooter collision. He had multiple abrasion wounds on his extremities and complained of right hip pain. Physical examination revealed mild limitation of the right hip joint and difficulty walking. Plain film radiography was performed ( figure 1 ). Question What abnormality can be observed?
Emergency Medicine Journal
MARCH 25, 2025
A short systematic review of the literature was undertaken to assess whether tranexamic acid (TXA) administration in the ED for neck of femur fractures was associated with improved outcomes for patients undergoing surgery. MEDLINE, EMBASE, Cochrane and Google Scholar databases were searched. Four relevant papers were identified by our search strategy.
Emergency Medicine Journal
MARCH 25, 2025
Trauma care has long been characterised by empiric, protocol-driven interventions. While these approaches provide a broad framework, there is a growing recognition that treatment should be tailored to each patient’s unique physiology and injury profile. In contrast, fields such as oncology have embraced diagnostic precision and targeted therapies with demonstrable benefits.
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