Acute Medicine

An April 2020 podcast and accompanying notes following patients with COVID-19 from the emergency department into critical care. Dan Horner discusses respiratory support, proning, ventilation physiology and equipment problems, alongside the practical and emotional pressures of working in intensive care during the first wave.

Ashley Liebig's January 2020 introduction to the novel coronavirus outbreak, written as cases began appearing beyond China. The article records the early questions facing clinicians and the information available at that point, offering a historical snapshot rather than an up-to-date account of COVID-19.

How do T-MACS, HEART, TIMI and EDACS compare with a troponin-only strategy for suspected cardiac chest pain? This review examines a multicentre study using one high-sensitivity troponin I assay, balancing diagnostic sensitivity and rule-out efficiency against missing data and limits to generalisability.

Can clinical probability guide D-dimer thresholds and reduce imaging for suspected pulmonary embolism? Dan Horner appraises the PEGeD management study, examining follow-up outcomes, assay units, possible selection bias and the limited evidence for moderate-risk patients, with a perspective on applying the findings in different settings.

Simon Carley selects papers from 2018–2019 for his RCEM conference talk, explaining why they might influence emergency medicine practice. Topics include paediatric seizures, cardiac arrest and pulmonary embolism in pregnancy, with links to fuller appraisals of the studies.

How do diagnostic decisions shape emergency care and hospital admission? This St Emlyn’s Live video and podcast introduces the future of diagnostics, placing the importance of making a diagnosis at the centre of the discussion.