When does confidence in the emergency department become overconfidence? Prompted by personal feedback, this reflection explores diagnostic uncertainty, missed opportunities to learn from patient outcomes and practical ways to seek advice, follow up decisions and invite honest feedback from colleagues.
Overconfidence in the ED Read More
Could platelet transfusion worsen outcomes after spontaneous intracerebral haemorrhage in patients taking antiplatelet drugs? This 2016 appraisal examines the PATCH trial’s unexpected findings, functional outcomes and limitations, asking why a biologically plausible treatment might fail to help the patients it was intended to benefit.
JC: Platelets for Intracranial Haemorrhage. St.Emlyn’s Read More
A historical review of the 2016 RCEM guidance on acute behavioural disturbance in the emergency department. The post discusses de-escalation, the risks of restraint, sedation, assessment for underlying illness and early senior involvement when severe agitation accompanies physiological instability.
Managing Acute Behavioural Disturbance Read More
How can clinicians support a bleeding trauma patient while definitive haemorrhage control is being arranged? This 2016 discussion explores resuscitation physiology, fluids, vasopressors and treatment endpoints, setting out the authors’ perspective while acknowledging limited evidence and the importance of the wider trauma system.
Can we buy time in bleeding trauma. St.Emlyn’s. Read More
A patient’s chest pain has resolved and the emergency department ECG looks relatively reassuring. This teaching case asks what information might still be missing, using the contrast with an earlier ambulance tracing to explore dynamic ECG changes and the importance of clinical detective work.
Cardiology Case 05: Detective work Read More
Does hypertonic saline offer better outcomes than mannitol after traumatic brain injury? This 2016 appraisal explores the limited comparative evidence, distinguishes changes in intracranial pressure from outcomes that matter to patients and considers the uncertainty surrounding temporary treatment before definitive care.
JC: Salt or Sugar? Hypertonic saline for head injury at St.Emlyn’s. Read More
Small changes can make an emergency department visit feel less frightening for a child. Inspired by ICEM 2016, this reflection explores welcoming children, involving caregivers, using play, listening carefully and respecting dignity, with children’s rights at the centre of the encounter.
Making ED Visits Easier for Children Read More
Following Prince’s death in 2016, Rick Body reflects on what clinicians might learn from his response to a rain-soaked performance. The post connects resilience, humour and hope with the emotional tone we bring to patients and colleagues during difficult times in healthcare.
Dancing in the purple rain: lessons for clinicians from Prince Read More
