A 2014 introduction to cardiac troponin, built around common questions from the emergency department. The post introduces Rick Body and Iain Beardsell’s podcast on interpreting results, including causes of elevation, timing, changes between samples and the complications posed by renal failure.
Cardiac Troponin: The basics from St. Emlyn’s Read More
How do our beliefs and interpretations of evidence shape what we do for patients? Simon Carley introduces his SMACC Gold talk on deciding when to change practice, exploring the place of innovators and sceptics and linking to the debate that followed with Scott Weingart.
What to believe and when to change. St.Emlyn’s at SMACC Read More
What place should chronic disease risk factors have in emergency decision-making? Simon Carley introduces his SMACC Gold presentation, using that question to explore how clinicians’ assumptions, interpretations and beliefs influence their assessment of patients in the emergency department and resuscitation room.
Do risk factors factor in the ED? St.Emlyn’s at #SMACC Gold Read More
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.
Cardiology Case 04: An unusual ECG Read More
Rick Body introduces the original Manchester Acute Coronary Syndromes decision rule in this 2014 research report. He explains its derivation and external validation, how clinical features and biomarkers contribute to risk assessment, and the questions that still needed answering before routine use.
The MACS Rule: Immediate ‘rule in’ and ‘rule out’ for suspected cardiac chest pain Read More
Could online estimates of pre-test probability help clinicians choose investigations for pulmonary embolism and acute coronary syndromes? This initial 2013 discussion examines a trial of web-based decision support, exploring radiation exposure, gaps in the calculator’s data and unanswered questions about diagnostic safety.
JC: I’ll just ask Dr Google..for some PE/ACS investigation advice @ St.Emlyn’s Read More
A SMACC 2013 presentation on risk in emergency medicine, with a video and accompanying slides. Its deliberately provocative outline challenges how clinicians think about diagnosis, uncertainty and the risks they take in everyday practice.
Wrestling with Risk at SMACC 2013 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
