Revisit Cliff Reid’s 2013 talk on why emergency medicine can be a great job. In this 2024 reflection, a difficult clinical case prompts Simon Carley to return to the talk and the meaning found in caring for patients and their families.
EM is a great job. After 11 years is Cliff Reid still right? Read More
A Central Australian case series explores adrenaline infusions for shock in remote settings with limited resources. This appraisal examines the observational evidence, gaps in the safety data and practical concerns about labelling, flow control and supervision before considering wider use of the technique.
The Dirty Adrenaline (Epi) drip. Read More
When is the right moment to perform a high-stakes emergency procedure? This reflection uses the Goldilocks analogy to explore the harm of acting too early or too late, the uncertainty between those extremes and how training and peer review might develop judgement.
Optimal Timing for Life-Saving Procedures in Critical Care: Finding the Goldilocks Moment Read More
How feasible is a definitive trial of lidocaine patches for older patients with rib fractures? This appraisal examines recruitment, treatment crossover and follow-up in a randomised feasibility study, explaining why its clinical findings cannot establish whether patches improve pain or recovery.
Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study Read More
This 2024 article reviews intercollegiate guidance on non-fatal strangulation in adults and adolescents. It covers assessment, red flags and imaging alongside safeguarding and sensitive communication, emphasising the importance of considering both physical injury and the patient’s continuing safety.
Non-fatal strangulation Read More
How well do MACS, T-MACS and HE-MACS perform in emergency department patients with suspected cardiac chest pain? This appraisal examines a systematic review of their diagnostic accuracy, differences between study populations and the importance of external validation, while acknowledging the St Emlyn’s team’s involvement in developing the scores.
Systematic review of the Manchester Acute Coronary Scores. Read More
Does the interval between two shocks matter in double sequential external defibrillation? This appraisal examines a secondary analysis in refractory out-of-hospital cardiac arrest, including the distinction between terminating ventricular fibrillation and improving survival.
Is persistent ventricular fibrillation the same as a rhythm that returns after a successful shock? This appraisal examines a secondary analysis of DOSE-VF, comparing outcomes in shock-refractory and recurrent VF and considering the implications for defibrillation strategy.
Does the outcome from refractory VF differ from recurrent VF in DOSE-VF patients? Read More
