Latest posts

Can short-term targets distract us from the purpose of healthcare? Craig Ferguson uses finite and infinite game theory to explore the tension between measurable performance and lasting quality, including how targets can distort priorities, consume resources and produce unintended consequences in emergency medicine.

Does tamsulosin help patients with renal colic pass their stone? Simon Carley reviews a 2018 randomised trial in adults with CT-confirmed stones under 9 mm, examining patient-reported passage, follow-up imaging and subgroup uncertainty. He considers why the findings challenged routine medical expulsive therapy in this ED population.

In part two of his personal PTSD series, Rusty Carroll asks how clinicians might recognise distress in themselves or colleagues. He reflects on changes in sleep, behaviour and emotional responses, and on the difficulty of acknowledging that coping alone may no longer be enough.

Heidi Edmundson describes bringing Forum Theatre into the emergency department to explore communication, power and staff wellbeing. By replaying difficult situations with audience members trying alternative responses, the project gave colleagues a way to examine everyday tensions together and consider how interactions might change.

Simon Carley shares highlights from the 2018 BASICS North West conference, spanning prehospital care, sepsis, stroke research and support for clinicians. The report ends with his torso trauma discussion, covering changing interventions, paediatric injuries, assessment of shock and the challenges of care across the patient journey.

Does the speed or composition of intravenous rehydration affect neurological outcomes in children with DKA? This review examines the 2018 PECARN trial, its four fluid regimens and the limits of its findings. Simon Carley explains why challenging established assumptions does not remove the need for careful fluid management.