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Free open access medical education from St Emlyn’s: clinical discussions, research appraisals, podcasts and reflections on learning and working in emergency care.

Belgian EM at BeSEDiM 2018.

10 min read

Belgium’s 2018 BeSEDiM symposium brought together decision-making, simulation, wellbeing and clinical debate. This report explores hierarchy and feedback in teams, practical toxicology cases and discussions of advanced resuscitation, while reflecting on the growth of emergency medicine and the value of a connected professional community.

JC: The End of the ‘Roid? ADRENAL

15 min read

Did hydrocortisone improve outcomes in septic shock in the ADRENAL trial? This 2018 appraisal examines the absence of a demonstrated 90-day mortality benefit alongside secondary findings on shock resolution and time in intensive care. It explores trial design, patient selection and the limits of subgroup interpretation.

JC: CRYOSTAT-2 with Ross Davenport

5 min read

This 2018 introduction explains the question behind CRYOSTAT-2: could early cryoprecipitate improve survival after major traumatic bleeding? It outlines the rationale for fibrinogen replacement, the planned randomised trial, eligibility criteria and patient-centred outcomes. This is a preview of the study, before its results became available.

JC: Can I safely discharge dizzy patients from the ED?

11 min read

Distinguishing peripheral dizziness from posterior circulation stroke can be difficult in the emergency department. This 2018 review discusses bedside assessment, including nystagmus, HINTS, neurological examination and gait. It emphasises the knowledge and practice needed to use these techniques, rather than offering a simple discharge rule.

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