Do risk factors factor in the ED? St.Emlyn’s at #SMACC Gold

do risk factors factorWe’ve said it before but SMACC really is the best conference in the world for anyone involved in resuscitation, and it’s not just about the latest and greatest bits of kit, or the latest airway technique. There is plenty of science, encompassing cutting edge clinicians in emergency medicine, critical care, prehospital care and education.

At St.Emlyn’s we sometimes take a more philosophical view, taking pride in thinking deeply about what we do and why. I was delighted to get the opportunity to do two talks based on how we as clinicians think and practice. The first of these talks was released today and I’m delighted to share it in the true spirit of #FOAMed, that’s free, open access, medical and hopefully some education.

The talk is really about thinking about our thinking, meta-cognition if you prefer. As emergency physicians our practice is based on our ideas, interpretations and beliefs and in this presentation I hope that by talking through the importance of chronic health disease risk factors in emergency medicine it might give you pause to think and reflect on why we make the decisions that we do in the resus room and emergency department.

So, please watch, share and leave a comment. Look out for more in the next few weeks from myself, Iain, Nat, Rick and others from the UK and across the world. We are all one SMACC tribe here to share and learn together.


Here are the slides.

Here’s the audio.

Don’t forget to subscribe to the blog (use the follow us function on the right of screen), follow us on Facebook and to visit our new podcast on iTunes if you want to hear more from the St.Emlyn’s team.

Once you’ve done that then don’t forget that now is a great time to plan your trip to Chicago in 2015. Listen to Iain and myself tell you why here.




Cite this article as: Simon Carley, "Do risk factors factor in the ED? St.Emlyn’s at #SMACC Gold," in St.Emlyn's, June 17, 2014,

Posted by Simon Carley

Simon Carley MB ChB, PGDip, DipIMC (RCS Ed), FRCS (Ed)(1998), FHEA, FAcadMed, FRCEM, MPhil, MD, PhD is Creator, Webmaster, owner and Editor in Chief of the St Emlyn’s blog and podcast. He is visiting Professor at Manchester Metropolitan University and a Consultant in adult and paediatric Emergency Medicine at Manchester Foundation Trust. He is co-founder of BestBets, St.Emlyns and the MSc in emergency medicine at Manchester Metropolitan University. He is an Education Associate with the General Medical Council and is an Associate Editor for the Emergency Medicine Journal. His research interests include diagnostics, MedEd, Major incidents & Evidence based Emergency Medicine. He is verified on twitter as @EMManchester

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  6. Calculating risk is such a small part of the problem and every risk estimate we make has a rather broad confidence interval. What I lack in this discussion is the realization that we can’t think rationally about risk and neither can our patients. People are prepared to pay more to reduce the risk from 2% to 0 than to reduce it from 4% to 2%, not to mention from 66% to 64%. There is also the problem of weighing an imminent risk to a future one.

    To make better decisions we have to understand our own cognitive fallacies and stop assuming that we are smarter than everybody else. We can fight our instinct, but only if we make them visible to ourselves.


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