Welcome to Virchester, home of St Emlyn’s virtual hospital. This tongue-in-cheek introduction explains its imagined setting, staff and services, using a fictional emergency department to reflect familiar challenges in clinical care, teaching and hospital life.
What, where and who is St.Emlyn’s? Read More
This 2013 journal club examines the Cochrane review of colloids versus crystalloids, with a particular interest in sepsis. Simon Carley explores mortality findings, numbers needed to harm and why differences between trial populations matter when interpreting a meta-analysis.
JC The end of the road for colloids in sepsis??? St.Emlyn’s Read More
Making the right diagnosis does not guarantee that treatment will benefit an individual patient. Part five of Risky Business explores the links between testing, treatment and harm, and asks how diagnostic research can show whether patients actually do better.
How do you prepare for an emergency procedure you hope never to perform? In this 2013 reflection on perimortem caesarean delivery, Simon Carley explores advance planning, team roles, equipment and rehearsal for cardiac arrest in pregnancy.
Perimortem C-section at St.Emlyn’s Read More
A hypothetical case of severe self-inflicted eye injury explores the emergency department’s role in coordinating ophthalmic and psychiatric care. The discussion considers patient safety, the impact on relatives and staff, and the value of following up with the team afterwards.
Case of the week: Oedipism at St.Emlyn’s Read More
Simon Carley offers an early emergency department response to the Surviving Sepsis guidance discussed in 2013. He highlights its resuscitation targets, antibiotic priorities and three- and six-hour bundles, while questioning how closely the recommendations reflected evolving practice at the time.
New Surviving Sepsis Guidelines – What’s new? St.Emlyn’s Read More
Does seeing fewer patients mean a doctor is performing poorly? Simon Carley examines the limits of productivity figures and league tables, arguing for supervision that explores case mix, quality and individual difficulties without putting pressure on trainees to sacrifice safety for speed.
Can you get the doctors to work faster? Read More
This short January 2013 post introduces a conversation with Matthew Harris about PACE and graded assertiveness in pre-hospital care. It links to a discussion of paramedic practice, learning and the forthcoming SMACC and SimWars events.
PACE with @HarrisCPD Read More
