How do emergency clinicians know whether they make good decisions? Simon Carley separates sound reasoning from lucky outcomes and argues for feedback on everyday practice, exploring patient follow-up, peer review and conversations that reveal how colleagues reached a clinical judgement.
Making good decisions in the ED. #RCEM15 #EuSEM15 Read More
What are the thromboembolic risks when prothrombin complex concentrate is used to reverse warfarin-associated intracranial bleeding? This 2015 appraisal examines a retrospective study, the importance of previous venous thromboembolism and the limitations of drawing conclusions from a different reversal regimen and clinical setting.
Nil nocere: do no harm reversing warfarin! Read More
Dan Horner’s 2015 RCEM masterclass asks how clinicians can investigate suspected venous thromboembolism without unnecessary testing or treatment. It explores pre-test probability, diagnostic tools and their limitations, then considers individual risks, patient preferences and the need to assess new approaches within local practice.
VTE masterclass with Dan Horner at #RCEM15 Read More
Can a trauma team leader’s early judgement predict which patients will need massive transfusion? Simon Carley examines a 2015 study comparing clinical gestalt with scoring systems, questioning the outcome definition, selection of patients and the limits of relying on a single early assessment.
Guess or Gestalt in Major Trauma at St.Emlyn’s Read More
Does more severe chest pain make a heart attack more likely? Rick Body describes a 2014 study of emergency department patients, showing the difference between a statistically significant association and a useful diagnostic test, and why mild discomfort alone cannot provide reassurance about the underlying cause.
Is severe chest pain more likely to be a heart attack? Read More
When clinicians rely on instinct, how do they recognise when their own judgement is becoming less reliable? Iain Beardsell reflects on fatigue, distraction, emotional reactions and time pressure, sharing personal strategies for protecting attention and asking colleagues for support when he is not at his best.
When we are the Diagnostic Test – Gestalt at St Emlyns Read More
What do clinicians mean when they talk about ‘gestalt’? Simon Carley introduces its origins in perception, uses visual examples to explain how patterns emerge from fragments, and considers how these ideas relate to bedside assessment, ECG interpretation, clinical judgement and information that is difficult to measure.
What is Gestalt? St.Emlyn’s Read More
Can experiencing physiological stress make blood gas results more meaningful to learners? This account describes an exercise-based teaching experiment using lactate measurements, then examines the value and limits of comparing healthy volunteers with critically ill patients. It also discusses consent, organisational approval and the absence of patient-outcome evidence.
How low can you go? Experiential learning at St.Emlyn’s Read More
