Emergency Medicine

Who should be seen next when the emergency department cannot see everyone immediately? Rick Body uses hypothetical triage dilemmas to explore fairness, waiting time, clinical urgency and suffering, asking how fast-tracking, staffing decisions and performance targets affect the balance between individual patients and the wider department.

In this 2014 guest post, Mark Wilson explains the origins of GoodSAM: connecting nearby trained responders with emergencies before an ambulance arrives. He describes the thinking behind the app, its early defibrillator mapping and questions about responder participation, registration and indemnity during the project’s development.

Does a lack of evidence for benefit mean paramedic trauma training does not work? This 2014 critique of a Cochrane review examines its small, dated and methodologically limited evidence base, distinguishing uncertainty about educational interventions from a justification for withdrawing investment in training.

Louise Cullen and Rick Body debate whether high-sensitivity troponin is friend or foe at SMACC Gold 2014. This post brings together the recording, both speakers’ slides and background resources on troponin interpretation, including why a raised concentration does not always mean acute myocardial infarction.

A 2014 induction guide and podcast on assessing syncope in the emergency department. Simon Carley and Iain Beardsell discuss establishing what happened, gathering a witness history and using the ECG, then connect possible causes with the physiology of cerebral perfusion to structure further assessment.

Can CT measurements identify which older patients with acute subdural haematoma need neurosurgical referral? This 2014 journal club examines a proposed decision tool, questioning selection bias, measurement reliability and how a ‘surgical’ bleed was defined, and explaining why promising retrospective findings still need validation.