The St.Emlyn’s virtual hospital podcast

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August 1, 2020  

June and July 2020 Round Up St Emlyn’s

Our own version of Buy One Get One Free* this month, where you get a round up of two months of blog content.

 

Coronavirus continues to dominate the medical (and non-medical) headlines, and we discuss the two major results from the RECOVERY trial published recently, one positive and one not so (depending on who you talk to....). Simon also catches up with Roberto Cosentini, who you'll remember from the very powerful podcast at the beginning of the pandemic.

 

COVID isn't the only EBM circus in town though: we've reviewed HALT-IT and Simon has given a talk about the "Ten Top Trauma Papers" of the last year and Laura reviewed a paper looking at haloperidol for headaches.

 

We're having to think even harder about how we communicate in the ED, both for clinical care and to deliver education. Two ideas to help learning have been featured this month: The St Emlyn's Lesson Plans and "Background Learning". 

 

Good luck to all those starting in Emergency Medicine, and a huge thank you to all those who are moving to other areas of medicine or other departments. It's been a curious few months...

 

Take care,

 

Iain

*It's actually Get One Free Get Another Free, but whose ever heard of that?

 
 
May 15, 2020  

COVID-19 Journal Club #5

Welcome to our fifth webinar and journal club reviewing recent research and featuring COVID-19 updates, hosted by the University of Manchester, Manchester Royal Infirmary and Royal College of Emergency Medicine in collaboration with St Emlyn’s.

The live event took place on Tuesday 12th May at 11.00am BST (10.00am GMT). 

The COVID-19 Journal Club Panel

Today’s panel was hosted by Rick Body The panel includes Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynard (NIHR Clinical Research Fellow), Prof Dan HornerDr Anisa JafarProf Pam Vallely (Professor of Medical Virology), Prof Simon Carley and special guest Lauren Westafer (Attending in Emergency Medicine and Co-Creator of the Foamcast blog and podcast) and Ellie Hothershall (head of undergraduate medicine at the University of Dundee and an expert in Public Health) to discuss six papers about COVID-19 infection.

1. Lai S, Ruktanonchai NW, Zhou L, et al. Effect of non-pharmaceutical interventions to contain COVID-19 in China. Nature. May 2020. doi:10.1038/s41586-020-2293-x
2. Paranjpe I, Fuster V, Lala A, et al. Association of Treatment Dose Anticoagulation with In-Hospital Survival Among Hospitalized Patients with COVID-19. Journal of the American College of Cardiology. May 2020. doi:10.1016/j.jacc.2020.05.001
3. Thanh L, Andreadakis Z, Kumar A, et al. The COVID-19 vaccine development landscape. Nat Rev Drug Discov. 2020;19(5):305-306. doi:10.1038/d41573-020-00073-5
4. Bryan A, Pepper G, Wener MH, et al. Performance Characteristics of the Abbott Architect SARS-CoV-2 IgG Assay and Seroprevalence in Boise, Idaho. J Clin Microbiol. May 2020. doi:10.1128/jcm.00941-20
5. Treibel TA, Manisty C, Burton M, et al. COVID-19: PCR screening of asymptomatic health-care workers at London hospital. The Lancet. May 2020. doi:10.1016/s0140-6736(20)31100-4
6. Altmann S, Milsom L, Zillessen H, et al. Acceptability of app-based contact tracing for COVID-19: Cross-country survey evidence. May 2020. doi:10.1101/2020.05.05.20091587
 
Podcast edited from a live webinar by Izzy Carley
May 7, 2020  

COVID-19 Journal Club #4

Welcome to our fourth webinar and journal club reviewing recent research and featuring COVID-19 updates, hosted by the University of Manchester, Manchester Royal Infirmary and Royal College of Emergency Medicine in collaboration with St Emlyn's.

 

The live event tool place on Tuesday 5th May at 11.30am BST (10.30am GMT). 

 

The panel was again be hosted by Rick Body The panel includes Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynard (NIHR Clinical Research Fellow), Dr Anisa Jafar (Academic Clinical Lecturer), Prof Pam Vallely (Professor of Medical Virology), Prof Simon Carley and special guest Justin Morgenstern to discuss six papers about COVID-19 infection.

 

There will be another COVID 19 Journal Club next week (Tuesday 12th May at 11am).

 

References

1. He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. Published online April 15, 2020. doi:10.1038/s41591-020-0869-5
 
2. Bahl P, Doolan C, de Silva C, Chughtai AA, Bourouiba L, MacIntyre CR. Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019? The Journal of Infectious Diseases. Published online April 16, 2020. doi:10.1093/infdis/jiaa189.
 
3. Wang Y, Zhang D, Du G, et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. The Lancet. Published online April 2020. doi:10.1016/s0140-6736(20)31022-9
 
4. Rajendran K, Narayanasamy K, Rangarajan J, Rathinam J, Natarajan M, Ramachandran A. Convalescent plasma transfusion for the treatment of COVID‐19: Systematic review. J Med Virol. Published online May 2020. doi:10.1002/jmv.25961
 
5. Tedeschi S, Giannella M, Bartoletti M, et al. Clinical impact of renin-angiotensin system inhibitors on in-hospital mortality of patients with hypertension hospitalized for COVID-19. Clinical Infectious Diseases. Published online April 27, 2020. doi:10.1093/cid/ciaa492
 
6. Docherty AB, Harrison EM, Green CA, et al. Features of 16,749 hospitalised UK patients with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol. Published online April 28, 2020. doi:10.1101/2020.04.23.20076042

 

Podcast edited from a live webinar by Izzy Carley 

May 3, 2020  

April 2020 podcast round up St Emlyn’s

 

It's been another busy month at St Emlyn's, with the publication of 15 blog posts and five podcasts, but there does seem to be an awful lot to talk about!

 

Of course there have been multiple posts and podcasts about COVID-19, and you can fiind all of these on our special St Emlyn's page. Highlights have included the three RCEM/St Emlyn's Webinars which we are delighted to host in podcast form.

 

It's not just been coronavirus though, we have also dipped out toes into exercise and nutrition, graphic design and horticulture!

 

Parts of the site have also undergone a bit of a redesign with the curriculum pages now easier to navigate to find that post to fioll an e-portfolio hole.

 

 

We hope you're finding all of our output useful. Please do subscribe to the website (in the top right hand corner) and rate our podcast on iTunes.

 

They'll be much more to come in May I am sure.

 

Take care

 

Iain

Podcast edited by Izzy Carley

 

April 25, 2020  

COVID-19 Journal Club #2

Welcome to our second webinar on recent research about COVID-19, hosted by the University of Manchester, Manchester Royal Infirmary and Royal College of Emergency Medicine in collaboration with St Emlyn’s.

The panel was hosted by Rick Body. The panel includes Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynard (NIHR Clinical Research Fellow), Prof Pam Vallely (Professor of Medical Virology), Dr Anisa Jafar (Academic Clinical Lecturer), Dr Casey Parker and Prof Simon Carley (you know him…) to discuss six papers about COVID-19 infection.

The live event took place on Tuesday 21st April 2020

References: 

Paper 1 (00:00) Tang W, Cao Z, Han M, et al. Hydroxychloroquine in patients with COVID-19: an open-label, randomized, controlled trial. April 2020. doi:10.1101/2020.04.10.20060558

Paper 2 (12:09) Bendavid E, Mulaney B, Sood N, et al. COVID-19 Antibody Seroprevalence in Santa Clara County, California. April 2020. doi:10.1101/2020.04.14.20062463
 
Paper 3 (16:40) Wölfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. April 2020. doi:10.1038/s41586-020-2196-x
 
Paper 4 (23:33) Favas C. Guidance for the Prevention of COVID-19 Infections among High-Risk Individuals in Camps and Camp-like Settings. London School of Hygiene and Tropical Medicine; 2020:1-15. https://www.lshtm.ac.uk/sites/default/files/2020-04/Guidance%20for%20the%20prevention%20of%20COVID-19%20infections%20among%20high-risk%20individuals%20in%20camps%20and%20camp-like%20settings.pdf. Accessed April 21, 2020.
 
Paper 5 (30:30) Zeng J-H, Liu Y-X, Yuan J, et al. First case of COVID-19 complicated with fulminant myocarditis: a case report and insights. Infection. April 2020. doi:10.1007/s15010-020-01424-5
 
Paper 6 (35:02) Caruso D, Zerunian M, Polici M, et al. Chest CT Features of COVID-19 in Rome, Italy. Radiology. April 2020:201237. doi:10.1148/radiol.2020201237
 
Podcast edited by Izzy Carley and Iain Beardsell
April 22, 2020  

Beyond the ED: COVID-19 and Critical Care

In this podcast, Dan and Iain talk about the clinical journey of a COVID-19 patient, beyond the ED, with insights from the critical care unit. There are some concepts here that we don’t have time to do full justice to in the podcast, so there is a comprehensive set of "show notes" and all the references at www.stemlynsblog.org/covid-19-and-critical-care

April 5, 2020  

March 2020 Podcast St Emlyn’s round up

Iain and Simon discuss Covid19 and more in this review of the best of the blog from March 2020.

April 2, 2020  

Covid 19. Lessons from Sports and Exercise Medicine. St Emlyn’s

Simon interviews Dr John Rogers and Dr Nathan Lewis on respiratory infection prevention.

John a Sports and Exercise Medicine Consultant in Manchester. He is also Chief Medical Officer for British Triathlon and Visiting Professor in Sport & Exercise Medicine at Manchester Metropolitan University.

Nathan is lead performance nutrition scientist at the English Institute of Sport and at ORRECO.

These two academics take us through how sports science might be able to support our wellbeing during the Covid19 pandemic.

 

References

  1. Recommendations to maintain immune health in athletes https://www.tandfonline.com/loi/tejs20
  2. Probiotics https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006895.pub3/epdf/full 
  3. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials https://pubmed.ncbi.nlm.nih.gov/23840373/
  4. Vitamin C for prevention and treatment of pneumonia https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013134/full
  5. Vitamin C and common cold https://www.cochrane.org/CD000980/ARI_vitamin-c-for-preventing-and-treating-the-common-cold 
  6. Effect of Flavonoids on Upper Respiratory Tract Infections and Immune Function: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/27184276/
  7. Vitamin C and Infections https://pubmed.ncbi.nlm.nih.gov/28353648/
  8. Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage https://pubmed.ncbi.nlm.nih.gov/28515951/

 

 

 

February 12, 2020  

January 2020 podcast round up on St Emlyn’s

Iain is back on the podcast with Simon to talk through the best of the blog from January 2020.

October 6, 2019  

August 2019 round up podcast. St Emlyn’s

Our regular round up of the best and the brightest from the St Emlyn's blog. This is a round up of our August content.

September 10, 2019  
August 31, 2019  

The Future of Diagnostics with Rick Body

Prof. Rick Body is an internationally recognised expert in diagnostic testing. In this podcast he takes us through diagnostics today and also the near future which may change almost everything. 

You can read more and see the slides/video at http://www.stemlynsblog.com

July 14, 2019  
July 4, 2019  

Chris Gray on GI emergencies at #stemlynsLIVE

This is Chris's talk from #stemlynsLIVE on GI emergencies. Remember to check out the blog for the background, references and more.

 

June 21, 2019  
April 24, 2019  

March 2019 Podcast round up. St Emlyn’s

Here’s our regular monthly round up of the best of the blog from March 2019

 

April 13, 2019  

February 2019 Podcast round up St Emlyn’s

Our regular monthly round up of the best of the blog from Feb 2019.

February 23, 2019  

CAN 8 p-values

Part of the critical appraisal nuggets series. You can read more here https://www.stemlynsblog.org/cans-critical-appraisal-nuggets-st-emlyns/ 

Also mentioned in this podcast

1. Definition of p-values on the bottom line https://www.thebottomline.org.uk/blog/ebm/p-value/

2. Fragility index https://lifeinthefastlane.com/ccc/fragility-index/ 

3. Confidence interval https://en.wikipedia.org/wiki/Confidence_interval 

February 17, 2019  

January 2019 round up podcast from St Emlyn’s

The latest blog posts, ideas and thoughts from the St Emlyn's podcast. This month with Simon Carley and Rick Body,

January 30, 2019  

Can we use diagnostic probability to guide treatment thresholds in acute coronary syndromes.

This is a really important concept developed by Charlie Reynard and Rick Body here in Manchester. There is an accompanying paper in the EMJ that you can read via this link https://emj.bmj.com/content/34/12/A870 

This concept could radically change how we make probabilistic prescribing decisions in the ED. Have a listen and look out for a blog post on St Emlyn's soon.

December 23, 2018  

November round up podcast 2018. St Emlyn’s

 

November was a busy month for the St Emlyn's team with a variety of blogs on conferences, EBM, philosophy and education. Here's the podcast and the links to the blogs mentioned in November.

 

FeminEM part 2 with Natalie May https://www.stemlynsblog.org/fix18-part-two/ 

 

 

Dan Horner on the POLAR trial of hypothermia in brain injury https://www.stemlynsblog.org/jc-hypothermia-in-brain-injury-the-polar-trial-st-emlyns/ 

 

 

 

Claire Bromley on her experience on elective in Cape Town https://www.stemlynsblog.org/south-africa-as-a-medical-student-elective-claire-bromley/ 

 

Natalie May on why resuscitation is not sexy https://www.stemlynsblog.org/so-unsexy/ 

 

 

Salim Rezaie on Advanced ACLS - beyonfd the guidelines https://www.stemlynsblog.org/beyond-acls-salim-rezaie-at-stemlynslive/ 

 

November 28, 2018  

Beyond ALS with Salim Rezaie at #stemlynsLIVE

Salim Rezaie from the REBEL EM podcast takes us through the optimal management of cardiac arrest and also explores some of the controversies and difficulties that make the difference to our patients. 

You can read a lot more about the background to this talk, see the evidence and watch the video on the St Emlyn's site. Just follow this link. https://www.stemlynsblog.org/beyond-acls-salim-rezaie-at-stemlynslive/ 

November 13, 2018  

St Emlyn’s October 2018 round up

Here's our round up of the best of the blog from October 2018.

In Pursuit of Excellence with Natalie May from #stemlynsLIVE https://www.stemlynsblog.org/in-pursuit-of-excellence/

A FeminEM in NY with Natalie May Part 1. https://www.stemlynsblog.org/fix18-part-one/

JC: Cricoid Pressure, Do we still need it? Simon Carley https://www.stemlynsblog.org/jc-cricoid-pressure-and-rsi-do-we-still-need-it-st-emlyns/

Teaching and Learning in Stretched Environments with Simon Carley https://www.stemlynsblog.org/teaching-and-learning-in-stretched-environments-rsm-2018-st-emlyns/

Five free strategies to improve your resuscitations Simon Carley https://www.stemlynsblog.org/stemlynslive-five-free-strategies-to-improve-your-resuscitation-practice-st-emlyns/

PTSD and me, EMDR therapy with Rusty Carroll https://www.stemlynsblog.org/ptsd-and-me-part-3-emdr-therapy-st-emlyns/

 

April 24, 2018  

St Emlyn’s February 2018 blog and podcast round up.

Iain and Simon review the best of the blog from February 2018.

Simon Carley

December 27, 2017  

HEMS, reflections and St.Emlyn’s e-books.

Natalie and Simon discuss reflections, e-books and life at Sydney HEMS. This week we have added Lorikeets in the background (Nat recorded at Coogee Bay in NSW). We think they sound cute so we've kept them in (or rather we could not edit them out).

S

October 21, 2017  

St Emlyn’s in Review October 2017

Simon (@EMManchester) and Iain (@docib) review some of the articles from the St Emlyns blog site (http://stemlynsblog.org/) from recent weeks and chat about the current state of Emergency Medicine in the UK.

1:00 - How to declare a Major Incident - http://stemlynsblog.org/how-to-declare-a-major-incident-st-emlyns/

3:10 -  RCEM ASC 2017 – Update on the TiLLI study - http://stemlynsblog.org/rcem-asc-2017-update-on-the-tilli-study/

6:03 - The rise and SURPRISE of the DOACs - http://stemlynsblog.org/the-rise-and-surprise-of-the-doacs/

8:08 - Life as an EM Trainee in South Africa -  https://itunes.apple.com/gb/podcast/the-st-emlyns-virtual-hospital-podcast/id547326956?mt=2&i=1000393179333

9:26 - Rheum for Improvement? The physical challenge of EM training - http://stemlynsblog.org/rheum-for-improvement-st-emlyns/ Harriet's website is here  - https://www.rheumforimprovement.com/

10:47 - JC: Oxygen in ACS. A fuss about nothing? The DETO2X Trial - http://stemlynsblog.org/oxygen-in-acs-a-fuss-about-nothing/. Paper is here - http://www.nejm.org/doi/full/10.1056/NEJMoa1706222

11:57 - Is cMyC the new troponin? - http://stemlynsblog.org/cmyc-new-troponin/

13:00 - Who gets a Tetanus? You get a Tetanus! - http://stemlynsblog.org/tetanus-in-the-ed/

14:22 - Mass Casualty Incidents: Lessons from AAST - http://stemlynsblog.org/mass-casualty-incidents-lessons-aast-st-emlyns/

15:00 - The Annual Scientific Conference and the State of EM

March 22, 2017  

Top Ten Trauma Papers 2016

Iain and Simon chat through our top ten trauma papers for 2016. Lots here for anyone who is interested in trauma including whole body CT, traumatic cardiac arrest, neurosurgery in severe head injury and much more. As ever we'd suggest you read the original papers, references for which along with a blogpost can all be found here http://stemlynsblog.org/top-10-trauma-papers-2016-st-emlyns/

 

 

March 5, 2017  

St Emlyn’s In Review - March 2017

In a new podcast format Simon (@EMManchester) and Iain (@docib) discuss the month's offerings from the St Emlyn's blog and podcast (www.stemlynsblog.org).

 

It's been a month full of interesting posts on subjects as diverse as Thrombolysis in Stroke (Alan Grayson), The Future of Emergency Medicine in the Social Age (Simon), Cardiac Arrest Centres (Simon), Love in Critical Care (Liz Crowe), Transfers (Nat and Simon), Thrombolysis in PE (a guest post from FOAMed legend Anand Swarminathan) and Benzos in Back Pain (Janos). Head to the website for the articles themselves and all the references and links you need.

 

We're aiminig to make this a regular monthly podcast - let us know if it's useful and enjoyable and how we could make it even more educational.

September 15, 2016  

CAN 3 - Selection Bias

Prof Rick Body and Niall Morris, Clinical Research Fellow, discuss selection bias and how it can affect clinical research.

This podcast is the third in the St Emlyn's series "Clinical Appraisal Nuggets".

August 24, 2016  

CAN 2 Blinding and Masking in clinical trials

Rick and Simon talk blinding (and masking) for your critical appraisal delight.

See more at http://stemlynsblog.org/cans-critical-appraisal-nuggets-st-emlyns/

August 10, 2016  

CAN1 - Randomisation

Our series on critical appraisal nuggets in 5-10 mins. This week it's Randomisation. Great if you are revising for an exam in critical appraisal (e.g. FRCEM).

January 18, 2015  

New (or are they really new) Oral Anticoagulants and the Emergency Physician PART 1

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

December 23, 2014  

The Christmas review podcast with Iain and Simon from St.Emlyn’s

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

October 23, 2014  

Understanding Troponin Part 3: The NICE guidance.

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

June 26, 2014  

SMACC Back-Back on What to believe and when to change.

spockkirk.jpegHopefully 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

June 15, 2014  

Diagnostics 2. Beyond simple yes vs no diagnostics. St.Emlyn’s

Dear all,

It would appear that the organ member was correct and we cannot be certain about the organ pipes. Apparently there are doubts about whether they are safe or need replacing. 
We will once again turn to Dr Beardsell and Prof. Carley to see if there is anything more that we can do. As I am due to allocate funds for repairs to musical instruments this year then we must ensure that these are spent wisely. 
If there is a less than 2% chance of failure we will wait. If there is a greater than 50% chance of failure then we should spend the money. 
The situation is uncertain and we need help.
I have the honour to be et. etc. etc.
The Choirmaster at St.Emlyn's

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