Search St Emlyn’s

A patient’s chest pain has resolved and the emergency department ECG looks relatively reassuring. This teaching case asks what information might still be missing, using the contrast with an earlier ambulance tracing to explore dynamic ECG changes and the importance of clinical detective work.

A patient with ongoing chest pain has an ECG that does not fit a familiar STEMI pattern. This educational case from 2014 asks how the clinical history and shape of the ST segments should influence the next decision, before revealing the angiographic findings and outcome.

An illustrative chest-pain case challenges readers to interpret two ECGs alongside an early troponin result. This 2014 teaching post explores subtle high lateral STEMI, reciprocal changes and the risk of letting an initially unremarkable blood test distract from concerning ECG findings.

How seriously should we take ST depression when the patient is now pain-free? This hypothetical cardiology case explores dynamic ECG changes, serial troponin results and clinical context, then reviews the 2012 evidence on when patients with NSTEMI should undergo coronary intervention.

How do you act on an ECG suggesting STEMI when the rest of the presentation does not fit? This hypothetical cardiology case from 2012 combines altered consciousness, abdominal findings and no chest pain to explore competing diagnoses, bleeding risk and the urgency of reperfusion.

Rick Body explains what the fifth universal definition changes for emergency clinicians. The article covers the revised MI classification, sex-specific troponin thresholds, the role of imaging and the distinction between myocardial injury and infarction.

An imagined look back from 2038 asks how emergency medicine might recover from its current pressures. The piece explores virtual emergency departments, artificial intelligence, collaborative leadership and cultural change as parts of a possible future, rather than a record of events that have happened.

Could stellate ganglion block have a role during refractory cardiac arrest? This appraisal examines a scoping review of 32 reported cases, the rationale for the technique and why publication bias and other treatments make the apparent benefits difficult to interpret.

We are back at the TBS (The Big Sick) Conference in Zermatt, exploring key research papers that challenge critical care practices. Highlights include arterial blood pressure monitoring, intra-arrest DBP in cardiac arrest, SAPBs for rib fractures, the DanGer shock trial, and double sequential defibrillation timing.

This podcast reflects on four days at the London Trauma Conference 2024, from cardiac arrest and prehospital critical care to trauma in older patients. The discussion also considers clinician wellbeing, training and the human side of caring for injured patients.