Dan Horner reviews outpatient pulmonary embolism care in this article supporting his 2019 RCEM CPD talk. It examines patient selection, follow-up and British Thoracic Society guidance, alongside conflicting evidence about investigating suspected pulmonary embolism in pregnancy.
JC: Pulmonary embolism, ambulatory care and the goddess of the hunt Read More
What does ‘massive’ pulmonary embolism really tell us about a patient’s risk? In this case-based 2018 review, Dan Horner examines physiology, clot burden, clinical trajectory and bleeding risk, arguing for a fuller assessment and shared decisions rather than reliance on a single blood-pressure threshold.
Pulmonary Embolism – We call it massiiiiiiivve Read More
What can emergency clinicians learn from an audit of perioperative anaphylaxis? Chris Gray reviews NAP6, focusing on recognition, cardiovascular collapse and reactions associated with antibiotics, muscle relaxants and chlorhexidine. This 2018 discussion considers how findings from anaesthetic practice relate to the emergency department.
St.Emlyn’s takes a NAP. The NAP4 anaesthesia audit. Read More
Preparing a critically ill patient for transfer brings challenges that can be less obvious at the bedside. In this third Sydney HEMS reflection, Natalie May explores sedation, ventilation, physiological preparation and contingency planning through lessons from interhospital retrievals.
101 Reflective Lessons from a Year with Sydney HEMS. Part Three: Clinical Read More
Anand Swaminathan revisits his SMACCDub argument for considering thrombolysis in selected patients with submassive pulmonary embolism. This 2017 opinion piece weighs possible functional benefits against major bleeding, emphasising patient selection, shared decisions and the uncertainty in the evidence available then.
Could bedside ultrasound improve the assessment of patients with acute breathlessness? This 2014 journal club examines a randomised trial, separating improved diagnostic accuracy from evidence of better patient outcomes and considering how patient selection and reliance on a single ultrasound operator limit the findings.
JC: POCUS for the breathless patient. St.Emlyn’s Read More
To explore the discomfort of arterial blood gas sampling, an emergency clinician volunteers to have the procedure filmed without local anaesthetic. This personal account accompanies a video made for NHS Change Day 2014, supporting a pledge to pay closer attention to procedural pain.
Self Experimentation in Medical Education – LA for ABGs Read More
A 2013 journal club examines a randomised trial comparing GlideScope video laryngoscopy with direct laryngoscopy in trauma patients. It considers survival, uncertainty around a small head-injury subgroup and whether results from a specialist trauma centre apply across emergency medicine.
JC: Video Layngoscopy – Did Video kill the Laryngoscope star? Read More
