Acute Medicine

The opening day of badEMfest 2018 puts equality, advocacy and African-led solutions at the centre of emergency care. This report brings together discussions of traditional medicine, respectful transgender care, point-of-care ultrasound and resuscitation, asking how local context and unequal access shape what clinicians can achieve.

The October 2017 podcast round-up revisits major incidents, thromboprophylaxis, oxygen in acute coronary syndromes and emerging cardiac biomarkers. It also reflects on the physical demands of EM training and the specialty’s annual scientific conference.

Could cardiac myosin binding protein C offer an alternative to troponin? This 2017 review examines promising diagnostic findings from APACE, while explaining why external validation, a practical assay and evidence of added clinical value were still needed.

Could troponin tell us more than whether a patient has had an infarction? This 2017 reflection explores increasingly sensitive assays, cardiovascular risk and personalised baseline measurements, while distinguishing exciting possibilities from clinical benefits that still needed to be demonstrated.

Does icatibant help ACE inhibitor-associated angioedema? This 2017 review contrasts an encouraging small trial with a larger placebo-controlled study that found no faster recovery, while explaining why its results cannot settle treatment for immediately life-threatening cases.

How should clinicians balance missed acute coronary syndrome against the harms of unnecessary investigation? In notes accompanying his UMECS 2016 talk, Rick Body explores the limits of symptoms and clinical judgement, acceptable risk and the importance of including patients in chest-pain decisions.