Category: Diagnosis

How to prepare your ED for a MERS-CoV outbreak

Following a successful local collaborative Ebola campaign preparation last year, the team at Virchester ED have started preparing for the next outbreak of infectious disease that threatens our quiet shores: the Middle-East Respiratory Syndrome (MERS).

JC: Are typical chest pain symptoms predictive of outcome? St.Emlyn’s

We love a bit of meta-cognition here at St.Emlyn’s. As time passes and we all become a little longer in the tooth it becomes increasingly apparent that it’s not just ‘what’ we know it’s how

The MACS rule: a new user-friendly version

This blog post is based on a paper we’ve just had published in the Emergency Medicine Journal entitled: ‘The Manchester Acute Coronary Syndromes (MACS) decision rule: validation with a new automated assay for heart-type fatty

JC: What’s the ‘best’ test for a broken chest? St.Emlyn’s

A 45 year old man comes off his motorbike on a country road. He is flagged up as major trauma and gets the full works, including WBCT. This reveals nothing other than 3 undisplaced rib

Is severe chest pain more likely to be a heart attack?

    Have you ever heard this sort of conversation in your ED? Junior ED doc: Can I run my patient by you, please? Senior ED doc: Sure Junior: I  have a 40 year old man with chest

When we are the Diagnostic Test – Gestalt at St Emlyns

There are many reasons why I enjoy being part of the St Emlyn’s team, not least the chance to share ideas and beliefs about EM with some of the most thoughtful physicians I’ve ever met.

Induction – Chest Pain in the ED

Chest pain is the archetypal ED presentation: one which presents frequently and usually has a benign cause, but could, just could, be the result of life threatening pathology. As Emergency Physicians we must look after

What is Gestalt? St.Emlyn’s

If you’re a #FOAMed fan then you will have come across the term Gestalt quite a lot in recent months. Many conversations about clinical decisions hinge around this elusive, slippery and somewhat obscure term. Perhaps

New NICE high sensitivity troponin guidance: 3 hours and done?

The National Institute for Health and Care Excellence (NICE) from the UK has just published new recommendations for the use of high sensitivity troponin to rule out NSTEMI in the Emergency Department.  You can find

JC: Should USS be first investigation for renal colic? St.Emlyn’s

A few years ago I was asked to see a patient in the rapid assessment unit with severe pain in the flank. She looked as though she had renal colic and we instituted the usual


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