Tag: diagnosis

Is cMyC the new troponin?

Anyone who reads the news is likely to have seen the recent paper in Circulation evaluating a new biomarker of acute coronary syndromes: cardiac myosin binding protein C (cMyC) . This paper has been covered

N2O Laughing Matter

Everyone likes balloons, right?  Some people really like balloons, and more specifically the contents of them.  Having recently moved to East London, I can’t cycle to work and back (only about 15 minutes or so) without

Overconfidence in the ED

If you have ever worked as or with a doctor, you’ve probably encountered something called a multi-source feedback form, or a “360 appraisal”. It is part of the process for junior doctors to progress to

Getting your chest pain evaluation right: #UMECS16

Last week, while Iain was giving a keynote lecture in Austria, I was also heading for distant shores to speak about chest pain evaluation at a special conference set up by the legendary Amal Mattu:

Emergency medicine, a risky business part 7: Risk proximity

Risk proximity is an important concept. In simple terms it just describes the time from an event happening and the risk potentially occuring. It’s not something that we often think about in the emergency department,

JC: High sensitivity Troponin I on presentation. Is it enough to rule out ACS? St.Emlyn’s

As you surely know we love thinking about Troponin at St.Emlyn’s. We have our own world expert in Rick Body and there is loads of stuff here on the site about the use (and abuse)

JC: Are typical chest pain symptoms predictive of outcome? St.Emlyn’s

We love a bit of meta-cognition here at St.Emlyn’s. As time passes and we all become a little longer in the tooth it becomes increasingly apparent that it’s not just ‘what’ we know it’s how

The MACS rule: a new user-friendly version

This blog post is based on a paper we’ve just had published in the Emergency Medicine Journal entitled: ‘The Manchester Acute Coronary Syndromes (MACS) decision rule: validation with a new automated assay for heart-type fatty

JC: What’s the ‘best’ test for a broken chest? St.Emlyn’s

A 45 year old man comes off his motorbike on a country road. He is flagged up as major trauma and gets the full works, including WBCT. This reveals nothing other than 3 undisplaced rib

Is severe chest pain more likely to be a heart attack?

    Have you ever heard this sort of conversation in your ED? Junior ED doc: Can I run my patient by you, please? Senior ED doc: Sure Junior: I  have a 40 year old man with chest

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