Is paracetamol alone enough for pain after minor musculoskeletal injury? This 2017 review examines a randomised non-inferiority trial comparing paracetamol, diclofenac and their combination. It explores pain outcomes, trial design and exclusions, including why the findings cannot simply be extended to fractures or all painful injuries.
JC : Paracetamol, NSAID’s or both in MSK trauma. St.Emlyn’s Read More
How does repeated excess paracetamol taken for pain differ from other overdose presentations? This 2017 discussion explores therapeutic excess, risk assessment and the consequences for admission. It repeatedly stresses checking current TOXBASE or local toxicology guidance, rather than relying on the historical thresholds described in the post.
Management of paracetamol therapeutic excess in the ED. St.Emlyn’s. Read More
Natalie May continues her reflections on a year with Sydney HEMS, focusing on paediatric retrieval, drowning and airway care. These personal clinical lessons explore equipment, communication and the compromises involved in delivering critical care outside the hospital.
101 Reflective Lessons from a Year with Sydney HEMS. Part Four: More Clinical Read More
Does diazepam add anything to naproxen for acute low back pain? This 2017 trial appraisal examines the lack of additional benefit in a selected group without radicular symptoms, alongside questions about blinding, follow-up and how well the results fit everyday ED patients.
JC: Turn it Down to 11 – Benzos for Back Pain Read More
Does combining ketamine and propofol improve procedural sedation compared with propofol alone? This 2016 appraisal examines a systematic review’s complication findings, questioning how differences in patients, procedures and drug regimens—and limited information on sedation success—affect its relevance to emergency departments.
Is Ketofol the milk of human kindness for procedural sedation. St.Emlyn’s Read More
This 2016 teaching update explores fascia iliaca blocks for hip-fracture pain, combining anatomy, landmark and ultrasound approaches with discussion of local-anaesthetic safety and the supporting evidence. Videos and an infographic accompany the authors’ reflections on introducing regional analgesia into emergency department practice.
A St.Emlyn’s fascia iliaca block update. Read More
This 2015 induction post and podcast explore the assessment of back pain in the emergency department. Topics include recognising serious causes, taking a neurological history, documenting examination findings and seeking senior advice, alongside symptom relief, mobility and communication with primary care.
Back Pain in the Emergency Department Read More
Could patient-controlled analgesia improve ongoing pain relief after arrival in the emergency department? This 2015 journal club examines the two PASTIES trials, comparing abdominal pain and traumatic injury, and discusses their differing results, pragmatic design and the limitations of unblinded pain assessment.
JC: Pain free PASTIES in the ED. St.Emlyn’s Read More
