Episodes

Monday Jun 02, 2014
Ep 1 - St.Emlyn's the podcast.
Monday Jun 02, 2014
Monday Jun 02, 2014
Welcome to the St.Emlyn's podcast. After a few years messing around with the blog at stemlynsblog.org the Choirmaster at St.Emlyn's has decided that some audio contributions are necessary. We will therefore be relaunching the podcast in a uniquely British way.

Wednesday Jun 04, 2014
Ep 2 - SMACC Chicago
Wednesday Jun 04, 2014
Wednesday Jun 04, 2014
The St.Emlyn's choirmaster has asked Iain and Simon to deliver a sermon on the importance of attending the SMACC Chicago conference in May 2015. After their pilgrimages to Australia in 2013 and 2014 they came back enthused and at times rather annoying about how jolly marvellous it all was.

Tuesday Jun 10, 2014
Ep 3 - Understanding diagnostics 1. SNout SpIn and Probability. St.Emlyn's
Tuesday Jun 10, 2014
Tuesday Jun 10, 2014
A podcast discussing sensitivity and specificity of diagnostic tests and how we can use this in our everyday medical care of patients.
This article from the Centre for Evidence Based Medicine is also useful.

Sunday Jun 15, 2014
Ep 4 - Diagnostics 2. Beyond simple yes vs no diagnostics. St.Emlyn's
Sunday Jun 15, 2014
Sunday Jun 15, 2014
Dear all,

Sunday Jun 22, 2014
Ep 5 - Understanding diagnostics 3. Why prevalence helps us stay in practice
Sunday Jun 22, 2014
Sunday Jun 22, 2014
Iain and Simon tackle the effect of prevalence on diagnostic performance. Mrs Trellis of North Wales makes a return appearance to discuss the delicate issues of sensitivity and Rick Body joins us by mail to raise concerns about the difficulties of missing patients with myocardial disease.
Listen and enjoy, visit the blog site and keep in touch.
Don't forget to subscribe to the podcast via iTunes, to subscribe to the blog site and to like us on facebook.
vb
S

Thursday Jun 26, 2014
Ep 6 - SMACC Back-Back on What to believe and when to change.
Thursday Jun 26, 2014
Thursday Jun 26, 2014
Hopefully you will have already seen and listened to my SMACC talk on 'What to believe and when to change'. If not then please whizz over to the site now and have a listen. I really enjoyed exploring the uncertainties that exist around when we decide to adopt or abandon therapies.
My belief is that it's really difficult to define the perfect moment and that it's only in retrospect that we can define it.
Since appearing on the ICN network and St.Emlyn's, Scott Weingart, one of the best and most innovative clinicians I know has come back and argued for early adoption. You can check out his rationale on his site and see what you think.
I actually agree with many of the things he tells us, although he has confined himself to one side of the argument. In terms of a defence of early adoption he makes a good case, but like all debates there needs to be another side to the story, so sit back and listen to why we must reflect hard on the decisions we make in deciding what we do, why we do it, and most importantly when.
vb
S

Sunday Jun 29, 2014
Sunday Jun 29, 2014
Iain and Simon chat about how we can start to translate research findings in to natural frequency summaries that help clinicians and patients alike understand the value of therapeutic interventions.
The NNT site we mention is just fantastic. Visit them here
Great revision page here by the amazing LITFL crew
The NNT for tranexamic acid is 67 not 50.
S

Tuesday Jul 08, 2014
Ep 8 - Trauma Team Leadership
Tuesday Jul 08, 2014
Tuesday Jul 08, 2014
Iain and Simon discuss the challenges of getting our trauma patients to the CT scanner within 30 minutes of arrival.
The 30 minute target is a UK standard, and we did not set it! All UK trauma centres are judged against the target and (rightly or wrongly) it has become a real issue for many centres.
We would be really be interested in what our International colleagues think about the target and the resultant strategies outlined by the team. There's more on this at the St.Emlyn's website.
As always, we'd love to hear your comments.
vb
S

Thursday Jul 17, 2014
Ep 9 - What can we do about targets in the ED?
Thursday Jul 17, 2014
Thursday Jul 17, 2014
It is a little known fact that to be successful as an emergency physician in the UK it is vital to take a three month rotation in Archery. Archery is a key skill for us all dating back to Medieval times when we introduced the longbow into warfare. This devastating tool could cause panic in opposing forces, scattering them into many wide and ineffective directions. In short they were an effective tool to cause and disruption inthe opposition ranks whilst the noble English armies of old strode forward with their visions of the future. Soldiers trained using targets to hone their skills and to focus on the aim - meeting the target.
Of course these days we do not have real bows and arrows in the emergency department, but archery remains alive and well. In the modern NHS we still train our troops in archery, or at least in the principle aim of archery - to meet the target.
With our long history of target setting and target hitting it is therefore no suprise that we are world leaders in standards/targets/indicators....., whichever term you prefer in fact and it has to be said that a target culture in the NHS has been criticised widely, even being blamed for the exodus of trainees to Southern climes, but there is arguably more to it than that.
In last weeks episode we touched on new targets around trauma care in the UK and that raised many questions and opened a debate on twitter. This week we want to take those thoughts further and ask what we, as the archiest of arch archers across the entire NHS can do with these externally set targets.
What we forgot to say in the podcast is the absolute need to work alongside a short stay admissions unit under the ED umbrella. Without that you would really struggle to deliver safe and efficient care. We both work in units with short stay admission units that allow us to deliver safe diagnostic and therapeutic interventions to our patients.
So, with some trepidation Iain and I ask whether all targets are a bad thing....
vb
S

Monday Jul 21, 2014
Ep 10 - Intro to EM: Staying safe in your first job
Monday Jul 21, 2014
Monday Jul 21, 2014
If you're starting out in EM then it can be a scary time. Iain and Simon talk through some of the initial anxieties and ask what you need to know to be safe, sensible and super.
- Respect those around you and value their opinion
- The History is everything
- There are 4 key treatments we give in the ED – think whether every patient you see needs any of these and you will save lives and relieve pain
- Oxygen
- Fluids
- Analgesia
- Antibiotics
- Think ‘What difference have I made to this patient?’. Always try to make a difference, however small (it may “just” be getting them an extra blanket)
- No patient (almost) wants to be in the ED. They really don’t. It wasn’t what they planned for their day.
- Spend twice as long with patients you don’t like or don’t get on with.
- Look the part. Be smart. Behave in the way you would expect anyone to behave towards you.
- Be on time. Always. Ansd leave on time if at all possible.
- Take your breaks – eat when you can and drink water when you can’t.
- Enjoy yourself…

Sunday Jul 27, 2014
Ep - 11 Understanding Troponin Part 1
Sunday Jul 27, 2014
Sunday Jul 27, 2014
Do you remember when it took three days to 'rule in' or 'rule out' an acute myocardial infarction (AMI)? When I was a medical student doing my first clinical attachments, I remember doing ward rounds on the CCU seeing patients with suspected AMI. The way they were managed is a million miles from what we do now. Back then, patients would have serial ECGs and then be admitted for cardiac enzyme evaluation over the course of the next 3 days. We'd measure CK, AST and LDH. 'CK' was the so-called 'early marker', which would rise early after the start of an AMI. Today we use CK as a marker of skeletal muscle damage (e.g. rhabdomyolysis). AST and LDH (today we think of these as liver function tests, I know) were the 'late markers' - and by late I really mean late - we might see a rise on days 2 and 3.
Could you imagine for a second, in today's world, ruling out AMI because their CK and LFTs were normal? It's completely unthinkable. That's how much cardiac troponin has changed our practice. We rely on it so completely to diagnose AMI. And yet, it's one of the most misunderstood tests in medicine. Given how much we use it, I guess we feel that we all should know lots about this test. But doctors still have so many questions. Here are just a few:
- What is cardiac troponin?
- Why is it a marker of AMI?
- What else causes a raised troponin and how?
- Should we be doing troponins at 3 hours, 6 hours, 12 hours? What's the difference and what's the evidence?
- What is a 'delta troponin'?
- What do you need to 'rule in' AMI?
- How do you use cardiac troponin in patients with renal failure?
This is just a brief list. With the research I do in this area and my experience developing protocols/guidelines, people get in touch to ask questions like this quite a lot. There are loads of questions that people ask - but there are lots of themes in common. We thought it was about time we produced a handy run down in the true spirit of #FOAMed.
Take a listen to Part 1 of our troponin podcast. While Simon and Iain have been prolifically churning out spectacular stuff for some time now, this is my debut on the St. Emlyn's podcast. I really enjoyed talking about troponin with Iain - and I hope we covered some useful stuff.
We'll cover more in part 2, when we'll move on to discussing high sensitivity troponins, what they are, how to use them and how to speak the troponin lingo. Please get in touch if there's anything we haven't covered that you'd like us to, or if there's anything you'd like us to elaborate on some more!
Rick

Friday Aug 01, 2014
Ep 12 - Intro to EM: The patient with headache
Friday Aug 01, 2014
Friday Aug 01, 2014
We've all had headaches, but not often severe enough to prompt us to seek help in an Emergency Department.
In our practice 10% of patients who do present to the ED with a primary presentation of headache will have serious pathology and our job as Emergency Physicians is to work out who these are. Key to this is actively ruling out the life-threatening and life-changing diagnoses:
- Subarachnoid Haemorrhage
- Meningitis
- Tumours and Space Occupying Lesions
- Temporal Arteritis
Listen to Simon and Iain discuss how to approach these patients here
Further Resources
Headaches at Life in the Fast Lane - a great summary from the LiTFL crew
NICE Guidelines (NCG150) - diagnosis and management of headaches; there's a flowchart and some red flags although you could read the St Emlyn's summary here!
Headache from the Flipped EM Classroom

Sunday Aug 03, 2014
Ep 13 - Intro to EM: The patient with shortness of breath
Sunday Aug 03, 2014
Sunday Aug 03, 2014
Breathless patients are a challenge in the ED. Shortness of breath can be a frightening presenting complaint for both patients and doctors. As always, think about the possible life threatening causes and actively rule them out. For breathless patients think especially about:
- Pneumonia
- Asthma/COPD
- Pulmonary Embolism
- Acute left ventricular failure
- Pneumothorax
Breathless Patients Podcast
In this podcast Iain and Simon discuss their approach to breathless patients in the ED which we hope will provide you with a good starting point.
For those of you who are more visual learners here is the video recorded a few years ago for SEMEP featuring our very own Iain Beardsell.
http://vimeo.com/35310564
Take Home Points
- Oxygen should be used in the patient with shortness of breath and the patient monitored closely. Hypoxia kills
- Always rule out life threatening causes first
- These patients are sick - do not be afraid to ask advice from a senior colleague early
- Look for clues - you don't have to wait until the penultimate page of the story to solve the mystery.
What have you learned about breathless patients?
Oxygen - or no oxygen??
Oxygen administration is rarely a problem in the immediate and acute
setting - and can save lives. So yes, when you first approach a patient
who is short of breath, get that oxygen on while you make your
assessment then think about the finer points of respiratory failure
afterwards.
Where do I begin?
A focused history, including asking the patient about previous conditions and whether they know what's going on!
And then - initial assessment and examination including vital signs
(especially respiratory rate), looking for clues as to the underlying
cause of their breathlessness, remembering the five common causes.
What treatments might be useful?
A small fluid bolus might help and carries relatively little risk;
think about the need for nebulised bronchodilators for patients with
asthma or COPD, and remember that antibiotics given early to patients
with sepsis save lives.
If the patient has pain we should definitely treat that too.
Which investigations might help me find out more?
- A chest x-ray is often useful in patients who are short of breath; your ED seniors might be able to use bedside ultrasound to further ascertain the underlying pathology, so get help early!
- ECGs are often useful in these patients
- Blood gases can also provide lots of useful information - think carefully about whether you need arterial gases and if so, please use local anaesthetic.
- If nothing makes sense - get a blood sugar, remembering that metabolic disease may cause an acidosis, presenting with an increased respiratory rate (although not often true dyspnoea).
- And GET SENIOR HELP (including getting your seniors to assess you for those all-important workplace-based assessments; definitely start those early)
Other resources
Chest Radiographs
One of the key investigations in patients with shortness of breath is the humble chest radiograph. There are some phenomenal FOAM resources for interpretation of CXRs (along with other XRs) at Radiology Masterclass. Well worth bookmarking for your ED shifts (but do ask a senior if you're unsure).
Chest X-Ray Anatomy - Chest X-Ray Abnormalities - Chest X-Ray Systematic Approach
Blood Gases
Think! Do you really need an ABG? If the answer is yes, please use local anaesthetic! Your patients will thank you...
Further Reading on Shortness of Breath
The Flipped EM Classroom - Shortness of Breath (with further links).
Natalie May

Wednesday Aug 06, 2014
Ep 14 - Exeter CEM conference with Adam Reuben
Wednesday Aug 06, 2014
Wednesday Aug 06, 2014

#AWESOME ALERT - CLIFF REID WILL BE THERE - YOU HAVE TO BE TOO!!!!
I'll be there with many others from St.Emlyn's so if you see me say hi.
You can see the program here
vb
S

Thursday Aug 07, 2014
Ep 15 - Understanding Troponin Part 2
Thursday Aug 07, 2014
Thursday Aug 07, 2014
Recently we published part one of our series on cardiac troponins. If you haven't checked it out yet, you can find it here. In the second part, we're going to take a look at high sensitivity troponins and some of the more advanced areas around understanding cardiac troponin and its use in practice. We'll give you a quick run down on the troponin lingo - the language you need to be able to speak in order to fully understand how to use high sensitivity troponin in your practice, including terms like the limit of blank, limit of detection, co-efficient of variation and 99th percentile.
We'll also ask whether Joe Lex had a point when he stirred up controversy around these assays with this legendary tweet:
What if we called it "low specificity troponin" instead of "high sensitivity troponin?" Would that knock some sense into people?
— Joe Lex (@JoeLex5) October 9, 2012
So, check out the associated BLOG POST here and listen to the podcast. There is more on diagnostics and troponin to come very soon.
Hope you enjoy! Please keep the feedback, questions and comments coming. As always, we'd love to hear from you.
Rick
DOI: Much of my research work involves HsT. To help with this I have received reagents from companies who make HsT assays, but I not received any other financial benefit or gifts in kind as part of my work and have no financial ties to any companies.

Friday Aug 22, 2014
Friday Aug 22, 2014
This podcast is part of our induction series for new docs starting in UK emergency departments.
You can check out the full post and supporting materials over at the main St.Emlyn's website.
vb
S

Friday Sep 12, 2014
Ep 17 - Diffuse Axonal Injury with John Hell
Friday Sep 12, 2014
Friday Sep 12, 2014
John Hell is a Neurointensivist at University Hospital Southampton and very kindly gave up an afternoon to record his thoughts and share his considerable wisdom about Diffuse Axonal Injury.
I also managed to get him to discuss some other topics including the choice of induction agents and intravenous fluids in patients with head injury.
Please listen, enjoy and comment. We'd love to hear from you, and don't forget to visit the blog site for additional information, slides and content.
vb
Iain Beardsell

Tuesday Sep 23, 2014
Ep 18 - Victoria Brazil on great presentations with St.Emlyn's
Tuesday Sep 23, 2014
Tuesday Sep 23, 2014
Vic Brazil of #FOAMed and #SMACC fame came to talk to the St.Emlyn's team in Virchester.
Listen in for top tips on looking great and sounding super.
vb
S

Tuesday Sep 30, 2014
Ep19 - In Situ and Guerrilla Sim in the ED
Tuesday Sep 30, 2014
Tuesday Sep 30, 2014
Iain and Simon talk through the practicalities of in situ sim in the ED. How do we make it happen in a way that works and helps individuals, teams and departments learn together.

Thursday Oct 23, 2014
Ep 20 - Understanding Troponin Part 3: The NICE guidance.
Thursday Oct 23, 2014
Thursday Oct 23, 2014
Rick and Iain explore how the latest guidance about the use of high sensitivity troponin was developed and how far we can be assured that it is evidence based.
The NICE guidance is available here. http://www.nice.org.uk/guidance/dg15
vb
S

Tuesday Oct 28, 2014
Ep 21 - Code for Cash and Credibility
Tuesday Oct 28, 2014
Tuesday Oct 28, 2014
Simon and Iain discuss what might appear to be a rather dull subject, but it's not. Coding is a key to developing your department and also to secure the functions of UK emergency departments.
A great primer for everyone coming up to FCEM and to anyone interested in how Emergency Departments are funded in the UK.
Follow this link to the associated blog post http://stemlynsblog.org/show-money/
vb
S

Friday Oct 31, 2014
Ep 22 - Button Battery ingestion in children
Friday Oct 31, 2014
Friday Oct 31, 2014
Simon and Nat with a linked podcast to the blog post on the ingestion of button batteries by children.
http://stemlynsblog.org/button-batteries/
S

Friday Oct 31, 2014
Ep 23 - Smacc Chicago update
Friday Oct 31, 2014
Friday Oct 31, 2014
Iain and Simon talk about the upcoming SMACC conference in Chicago and do their very best to persuade you to come to the best conference in the world

Wednesday Nov 12, 2014
Ep 24 - Getting started in Emergency Medicine Research
Wednesday Nov 12, 2014
Wednesday Nov 12, 2014
The Challenge and Value of Research in Emergency Medicine: at DGINA 2014
Rick Body's talk from DGINA on the need for research in EM.
Check out the associated blog post at http://stemlynsblog.org

Monday Nov 24, 2014
Ep 26 - Intro to EM: The ED approach to the child with shortness of breath
Monday Nov 24, 2014
Monday Nov 24, 2014
Iain Beardsell and Natalie May talk you through a wise and safe approach to the child with moderate shortness of breath. Listen and learn from the St.Emlyn's team.

Saturday Nov 29, 2014
Ep 27 - Intro to EM: The patient with chest pain
Saturday Nov 29, 2014
Saturday Nov 29, 2014
Iain and Simon discuss the dilemmas of dealing with the patient presenting with chest pain to the ED.
Blog post link here

Wednesday Dec 03, 2014
Ep 28 - Iain and Nat preview the amazing London Trauma Conference.
Wednesday Dec 03, 2014
Wednesday Dec 03, 2014
Next week Iain and Nat will be in London for the best trauma conference in the world. Join them in person, online, on the podcast and on twitter.
Check out the program here, it's amazing.
http://www.londontraumaconference.com/
Have fun :-)
S

Tuesday Dec 09, 2014
Ep 29 - London Trauma Conference: Day one round up.
Tuesday Dec 09, 2014
Tuesday Dec 09, 2014
Whilst I remain in Virchester healing the sick and injured, Nat and Iain are sharing the #FOAMed love at the London Trauma Conference. This is the first round up from day 1 with many highlights and a few tasters for some more podcasts to come.
vb
S

Wednesday Dec 10, 2014
Ep 30 - London Trauma Conference: Day two round up.
Wednesday Dec 10, 2014
Wednesday Dec 10, 2014
Old, young, pregnant, social, airways, cricoid and dogmalysis. There is loads to catch up on from #LTC2014.
Iain and Nat take you through the day.
vb
S

Thursday Dec 11, 2014
Ep 31 - London Trauma Conference: Day three round up.
Thursday Dec 11, 2014
Thursday Dec 11, 2014
It's prehospital and helicopter day at #LTC2014! Iain and guest podcaster Caroline Leech chat through the key points of the day.

Tuesday Dec 23, 2014
Ep 32 - The Christmas review podcast 2014
Tuesday Dec 23, 2014
Tuesday Dec 23, 2014
A Christmas review of the world of EM, CC and resuscitation #FOAMed.
This review is no way exclusive and focuses on sites that people may not be familiar with. Take it as read that EMCRIT, LITFL, PHARM, ICN, SGEM, EMLitofNote, ALiEM, Resus.me, KI docs, etc. are already known to be awesome. Check them out and follow the many excellent #FOAMed sites around the world.
Check out the big hitters here http://www.aliem.com/social-media-index/
There are also so many other sites that we have not mentioned, but which we regularly visit and listen to.
vb
S

Tuesday Jan 06, 2015
Ep 33 - Impact Brain Apnoea with Gareth Davies from London HEMS (LTC 2014)
Tuesday Jan 06, 2015
Tuesday Jan 06, 2015
First of our podcasts from the London Trauma Conference.
A fantastic episode with Iain talking to Gareth Davies (from London HEMS) talking about Impact Brain Apnoea.
vb
St.Emlyn's

Wednesday Jan 14, 2015
Ep 34 - Intro to EM: Problems in Early Pregnancy
Wednesday Jan 14, 2015
Wednesday Jan 14, 2015
The number of patients seen in each ED with problems relating to early pregnancy in the UK is very variable - some hospitals have rapid referral pathways for patients who know they are pregnant. It's still worth thinking about early pregnancy problems though as all EDs see young women and many of these may not yet know that they are pregnant.
Our induction podcast covers our approach to women presenting to the ED
Nat and Iain :-)

Sunday Jan 18, 2015
Sunday Jan 18, 2015
Rick Body and Kerstin de Wit discuss the role of NOACs in clinical management. Part 1 addresses the basics, stuff you should know if you are prescribing these drugs.
Part 1 tells us the good stuff, don't forget to listen to 2 and 3 in the next few weeks as not everything is perfect ;-)
Check out the BLOG POST HERE
vb
R

Saturday Jan 24, 2015
Ep 36 - The GoodSAM app with Mark Wilson (LTC 2014)
Saturday Jan 24, 2015
Saturday Jan 24, 2015
Live from the London Trauma Conference 2014. Iain Beardsell interviews Mark Wilson on the need for rapid response, digital technology and the GoodSAM app.

Monday Feb 02, 2015
Ep 37 - Karim Brohi at LTC (LTC 2014)
Monday Feb 02, 2015
Monday Feb 02, 2015
Karim Brohi joins the St.Emlyn's team at the London Trauma Conference to talk on vascular injury and arterial dissection. A whole range of diagnoses that you should not miss, but which is easy to miss.
Tricky!
Check out the blog post that accompanies this podcast here.
S

Tuesday Feb 10, 2015
Tuesday Feb 10, 2015
Rick and Kirstin delve deeper into the world of Novel Oral Anti Coagulants.

Sunday Feb 22, 2015
Ep 39 - Prof. Tim Harris on Shock Assessment (LTC 2014)
Sunday Feb 22, 2015
Sunday Feb 22, 2015
Do you think you're awesome at assessing shock?
Think again!
The stupendous Prof Tim Harris (who St.Emlyn's loves) tells us that all is not quite as it seems.....
Listen, learn, be awesome.
vb
S

Friday Feb 27, 2015
Ep 40 - Opiate overdose in the ED
Friday Feb 27, 2015
Friday Feb 27, 2015
Simon and Iain debate how the management of opiate OD has changed in the ED.
Surely you're not still giving massive doses of naloxone IV and IM are you? Really? Maybe this will make you think again.
vb
S

Sunday Mar 15, 2015
Ep 41 - Is trauma an elite sport? with Tom Evens (LTC 2014)
Sunday Mar 15, 2015
Sunday Mar 15, 2015

Sunday Mar 22, 2015
Ep 42 - Paediatric Major Trauma with Ross Fisher (LTC 2014)
Sunday Mar 22, 2015
Sunday Mar 22, 2015

In this podcast he gives us a paediatric perspective on how we should approach the seriously injured child.
Great stuff, controversial in places, challenging to adult dogma and always excellent.
S
PS. If you ever get to hear him speak.... then do, he's awesome. Check this out.

Thursday Mar 26, 2015
Ep 43 - APLS 2015 updates for the management of the serious injured child
Thursday Mar 26, 2015
Thursday Mar 26, 2015
A short podcast updating the UK Advanced Paediatric Life Support (APLS) course guidelines for the management of trauma in children.
Don't forget to read the blog post here. APLS Updates: New kids on the block,
vb
S

Saturday Apr 18, 2015
Ep 44 - Tim Draycott on Obstetric Trauma (LTC 2014)
Saturday Apr 18, 2015
Saturday Apr 18, 2015
Iain interviews the wonderful Tim Draycott on the management of the Obstetric patient with trauma.Tim is a consultant Obstetrician from Bristol and is a great speaker on this rather terrifying topic!

Monday Apr 27, 2015
Ep 45 - Top 10 trauma papers 2014-2015.
Monday Apr 27, 2015
Monday Apr 27, 2015
A first podcast with Simon Laing from the RCEMFOAMed team. We look back at influential trauma related papers from 2014-2015.

Wednesday May 06, 2015
Ep 46 - Intro to EM: The patient with asthma
Wednesday May 06, 2015
Wednesday May 06, 2015
Iain and Simon discuss the initial management of severe and life threatening asthma in the resus room.
Another podcast in the induction series aimed at new starters in Emergency Medicine.
vb
S

Friday May 22, 2015
Ep 47 - Barbra Backus on Risk scores in Acute Coronary syndromes
Friday May 22, 2015
Friday May 22, 2015
Barbra Backus joins Rick Body to discuss the origin, development and future of risk scores for ED patients with possible acute coronary syndromes. Two researchers at the top of their game, and authors of the HEART and MACS scores.

Thursday Jun 04, 2015
Ep 48 - Intro to EM: The patient with back pain.
Thursday Jun 04, 2015
Thursday Jun 04, 2015
Another induction podcast on a common condition in the ED. Back pain in the ED - it's not all musculoskeletal and there are some really risky diagnoses out there that you need to think about.
Don't forget to listen to Iain's talk on chronic pain link here. https://vimeo.com/97811644
Red flag symptoms and analgesia advice below.


Wednesday Jun 24, 2015
Ep 49 - SMACC Workshops Review and Pearls
Wednesday Jun 24, 2015
Wednesday Jun 24, 2015
Recorded in Chicago at the SMACC US Conference, Nat, Rick, Simon and Iain discuss the day of workshops and look forward to the main conference.

Wednesday Jun 24, 2015
Ep 50 - All in a day's work (SMACC 2015)
Wednesday Jun 24, 2015
Wednesday Jun 24, 2015
Iain and Simon discuss Iain's SMACC talk and how we deal with difficult cases in the ED.

Thursday Jun 25, 2015
Ep 51 - Day One Round Up (SMACCUS)
Thursday Jun 25, 2015
Thursday Jun 25, 2015
The first day of #smacc15 was amazing. An incredible introduction and an amazing program.