Simon Carley’s SMACC 2013 talk challenges the fear that can delay intervention when general emergency physicians treat critically ill children. The written introduction explains its provocative title, its focus on resuscitation skills and the fictional cases used to stimulate debate.
Children are just little adults. SMACC2013. St.Emlyn’s Read More
Does a missed diagnosis inevitably lead to serious harm? Part six of the Risky Business series explores the steps between diagnostic uncertainty and a poor outcome, including deterioration, return visits and opportunities to reconsider the diagnosis and intervene.
Emergency Medicine: A risky business part 6. How many steps to disaster? Read More
Making the right diagnosis does not guarantee that treatment will benefit an individual patient. Part five of Risky Business explores the links between testing, treatment and harm, and asks how diagnostic research can show whether patients actually do better.
How do you prepare for an emergency procedure you hope never to perform? In this 2013 reflection on perimortem caesarean delivery, Simon Carley explores advance planning, team roles, equipment and rehearsal for cardiac arrest in pregnancy.
Perimortem C-section at St.Emlyn’s Read More
Can a clinician’s gut feeling help identify serious infection in a child who otherwise seems well? This 2012 journal club examines a Belgian primary-care study, exploring diagnostic definitions, false alarms and the limits of transferring its findings to the emergency department.
JC: Gut feeling about serious paeds infections Read More
Why does a test’s sensitivity tell only part of the story about missed diagnoses? Part four of Risky Business uses pulmonary embolism and the PERC rule to illustrate how disease prevalence changes the numbers missed among all the patients investigated.
Emergency Medicine: A risky business Part 4 Read More
How much diagnostic uncertainty can clinicians and patients accept? Part three of Risky Business explores how percentages and natural frequencies shape risk perception, and why missed disease must be weighed alongside the harms of further testing and the patient’s perspective.
How much difference does an individual emergency physician make? Simon Carley uses the idea of a personal number needed to treat to explore teamwork, meaningful outcomes and professional worth, before proposing a more useful comparison: whether you are improving on your own previous practice.
