Category: Acute Medicine

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

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

The Heart Under Stress – St. Emlyn’s at SMACC Gold

  Chris Nickson (@precordialthump) is a genius in many ways. Not only does he organise arguably the best healthcare conference in the world right now, but he’s also a very clever chap when it comes

JC: Should we use Heimlich Valves for ambulatory pneumothorax management? St. Emlyn’s

Here at St. Emlyn’s we have been managing patients with pneumothoraces as out patients for many years. The approach in the UK has been ‘guided’ by the BritishThoracic Society guidelines. For many PNXs we simply

JC: Milk for refractory migraines?

Every day is a school day in Virchester! When you thought you had heard everything about Propofol with recent media cover over the unfortunate event involving a pop star, a paper from Iran suggest that

Are you sure that’s allergic?? Angioedema in Scarbrough

A guest blog from an old friend and colleague from the the other side of the Pennines. Andy Volans is consultant in Emergency Medicine in the seaside town of Scarborough, Yorkshire. A lovely part of

NICE on headaches

  Everyday is a school day!   NICE (the National Institute for Healthcare and Clinical Excellence) have recently issued their new recommendation on the management of headaches in young people and adults. For those colleagues

Is this what we mean by critical care? Feedback at St.Emlyn’s

  Over the years we’ve been building up a profile of our virtual hospital, St. Emlyn’s.  Here, let’s explore the way we reflect on cases in Emergency Medicine, and take a look at what might go on at a ‘St.

Ay, There’s The Rub – The Mental Capacity Act in the ED

A clinical case of overdose who declines treatment. How to assess capacity and interpret the Mental Capacity Act in the emergency setting.

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Glasgow Blatchford Score 2 – The case for an RCT!

Thanks for a great post, Gareth.  If you’ve landed here without reading that post, hit the link – this is a follow on, a ‘deep dive’ in the words of Smart EM – to be taken

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