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
A report from the first two days of the Intensive Care Society’s 2017 State of the Art meeting in Liverpool. Topics include trauma, early mobilisation, transfusion, pulmonary embolism and tracheostomy care, alongside debates about service standards, robotics and translating evidence into everyday critical care.
Dan does part of State of the Art #ICSSOA2017. St.Emlyn’s Read More
When emergency-department pressures affect morale, how can colleagues make the working day more supportive? Janos Baombe shares experience-based ideas about gratitude, helping others, explaining plans and choosing words carefully. He also reflects on emotional responses to difficult cases and the value of acknowledging them within the team.
Tough Times in the Emergency Department. St.Emlyn’s Read More
Can the Ottawa subarachnoid haemorrhage rule reduce unnecessary investigation without missing serious disease? This 2017 appraisal examines its prospective validation, patient selection and the tradeoff between sensitivity and specificity. Natalie May considers testing burden, clinician interpretation and why careful documentation of headache onset matters.
JC: Subarachnoid Haemorrhage, Decision Rules & Overtesting Headaches Read More
Could routine HIV testing make emergency care a stronger public-health opportunity? This 2017 discussion examines the rationale behind NICE’s 2016 guidance, including local prevalence, consent and follow-up. It considers how ED screening might reach people who do not attend sexual-health services and reduce barriers to diagnosis.
HIV screening in the ED. When, who and why. St.Emlyn’s Read More
How do we make decisions when time is short and information incomplete? This introduction to St Emlyn’s first e-book brings together risk, probability and metacognition, explaining why thinking about our thinking matters in emergency medicine.
Risk, probability and decisions in Emergency Medicine. St.Emlyn’s Read More
How much does delay matter when giving tranexamic acid? This 2017 journal club examines individual patient data from CRASH-2 and WOMAN, exploring the relationship between treatment timing and bleeding deaths, the size of the benefit and the analysis’s limitations.
JC: Does earlier TXA save lives? St.Emlyn’s Read More
A year with Sydney HEMS offers lessons beyond clinical practice. The final instalment explores facing fears, recognising fatigue, responding to frustration and making time for the people who matter, alongside the value of humility and reflection.
101 Reflective Lessons from a Year with Sydney HEMS. Part Seven: Life Lessons Read More
