Category: Diagnosis
Taking a travel history in the ED by StEmlyns
Clinical scenario: A young man returns from Thailand where he spent two weeks in rural areas backpacking, rafting, mountain climbing before he starts university back home in Scotland. He has returned to the UK …
Are you PROcalcitonin? St.Emlyn’s goes bug-hunting.
At work the other day, someone mentioned that we could use procalcitonin to distinguish between viral and bacterial infections, particularly in the paediatric population. It was touted as the answer to that age-old question, “should …
Sugar and Spice…Not All Things Nice
The use of synthetic cannabinoids is on the rise. They are dangerous, don’t fit a particular toxidrome, and can require emergent intervention. They are a nasty phenomenon and this article will hopefully show you why. …
When is a Door Not a Door? Bias, Heuristics & Metacognition
This is an amended version of a talk on metacognition I gave at the Royal North Shore Hospital Grand Round. The clinical scenario has changed but the content remains the same. The purpose of this …
JC: Prevalence of PE in patients with syncope. St.Emlyn’s
There is a bit of a buzz on social media at the moment1 about an interesting paper in the NEJM2 on the prevalence of PE in patients with syncope3. We’re all familiar with the controversies …
It’s a Trap!
Not only do we have to battle with diagnostic uncertainty, a high intensity and stressful environment but we also have to contend with our own minds and the tricks and biases they play on us. …
Upper Gastro Intestinal Bleeding at St.Emlyn’s.
Earlier this week, Simon and Iain released a podcast on the management of acute upper gastrointestinal bleeding. Welcome to the blog post version, for all your textual needs. Around 60,000 people are admitted into hospital every year …
One high sensitivity troponin test to rule out acute myocardial infarction
This month I was honoured that a study I wrote with some terrific colleagues from Europe, Australia and the US has been published as the ‘Editor’s Choice’ in Academic Emergency Medicine. This was a secondary analysis …
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 …