Emergency Medicine

Vic Brazil and Sandra Viggers join St.Emlyn's for a review of the international medical simulation conference in San Diego, California.

This 2016 teaching update explores fascia iliaca blocks for hip-fracture pain, combining anatomy, landmark and ultrasound approaches with discussion of local-anaesthetic safety and the supporting evidence. Videos and an infographic accompany the authors’ reflections on introducing regional analgesia into emergency department practice.

Why might the immediate fear of a missed diagnosis outweigh the less visible harms of unnecessary testing? Simon Carley explores ‘risk proximity’, distinguishing risks to patients from risks to clinicians and asking how their timing can distort decisions in the emergency department.

Could inhaling vapour from an isopropyl-alcohol wipe reduce nausea in the emergency department? This 2016 appraisal examines a small randomised trial, weighing its short-term symptom findings against concerns about blinding, patient selection and the lack of a direct comparison with other antiemetics.

Ross Fisher, consultant paediatric surgeon from Sheffield UK explains why paediatric surgeons may not be best placed to lead paediatric trauma teams.

When might an early CT scan change the need for lumbar puncture in suspected subarachnoid haemorrhage? This 2016 discussion reviews the evidence available then, scanner and reporting requirements, and conversations with patients about uncertainty, further investigation and the risks of testing.