August 2020 Round Up St Emlyn’s

Welcome to our audio round up of everything on the blog during August. 

As the world continues to be in the grips of the Coronavirus pandemic there have been more papers looking at all aspects of this disease.

Simon reviewed the latest paper on Hydroxychloroquine and Charlie collated some of the top papers covering aspects from aerosol spread and use of CPAP to the effect on vulnerable groups and the effect on staff psychological health

It's not all COVID though. Sepsis is a condition we all want to be able to treat more effectively. Sadly there doesn't seem to be any encouraging news about the use of Vitamin C, Steroids and Thiamine in this latest RCT.

Many of the St Emlyn's group have special expertise in toxicology and Gareth wrote this incredibly informative post about the use of GBL. If you're not sure what "ChemSex" is then this post from a few years ago by Janos is worth a read.

The anonymously written "Look at what they make you give" post really struck a chord with readers, with an astonishing number of views. There are messages here for us all.

The numbers of Lesson Plans available continue to grow. We've had some great feedback following their use in induction. If tyou've not seen them yet, do have a look and let us know what you think.

Dexamethasone and COVID - Show us the Data!

St Emlyn's three professors, Carley, Body and Horner* critically appraise the Press Release regarding Dexamethasone in the treatment of COVID-19.

What does this mean for the future of Evidence Based Medicine? Can we really start using a medication when the trial hasn't been peer reviewed and the full dataset not released? 

The blog post by Josh Farkas, that is mentioned in the podcast, is here.

*Professor Simon Carley, Professor of Emergency Medicine at Manchester Metropolitan University and a Consultant in Adult and Paediatric Emergency Medicine at Manchester Foundation Trust, Professor Rick Body Professor of Emergency Medicine in Manchester and Honorary Consultant in Emergency Medicine at Manchester Foundation Trust. Professor Dan Horner, Professor of Emergency Medicine of the Royal College of Emergency Medicine and Consultant in Emergency Medicine and Intensive Care at Salford Royal NHS Foundation Trust.

COVID-19 Journal Club #7

Welcome to our seventh 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 26th May.

Today's panel will 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, Prof Pam Vallely (Professor of Medical Virology), Ellie Hothershall (Consultant in Public Health), Prof Simon Carley and special guest Kelly Ann Janssens (Emergency Physician in Ireland) to discuss five papers about COVID-19 infection.

This will be the last weekly journal club, but we will be back with more EBM goodness very soon. Do let us know what you like to be included at stemlyns@gmail.com

COVID-19 Journal Club #6

Welcome to our sixth COVID-19 Journal Club Podcast.

The panel was hosted by Rick Body and included Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynard (NIHR Clinical Research Fellow), Dr Anisa Jafar, Prof Pam Vallely (Professor of Medical Virology), Prof Simon Carley and special guest Liz Crowe (Advanced Clinician Social Worker and PhD candidate in health staff wellbeing in Brisbane) to discuss four papers about COVID-19 infection. We were especially pleased to welcome Liz this week, which enabled us to focus on the important topics of grief, loss and communication during the COVID-19 pandemic.

References

COVID-19 Journal Club #3

Welcome to our third 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 28th April at 11am BST (10am GMT).

The panel was hosted by Rick Body The panel includes Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynard (NIHR Clinical Research Fellow), Dr Dan Horner (RCEM Professor), Prof Pam Vallely (Professor of Medical Virology), Salim Rezaie (Emergency Physician and Founder of REBEL EM) and Prof Simon Carley (you know him…) to discuss five papers about COVID-19 infection. There will be another COVID 19 Journal Club next week (Tuesday 5th May at 11am).

Edited by Izzy Carley and Iain Beardsell

References

1. Helms J. High risk of thrombosis in patients in severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Medicine. April 2020:1-21. https://www.esicm.org/wp-content/uploads/2020/04/863_author_proof.pdf.
2. Caputo ND, Strayer RJ, Levitan R. Early Self‐Proning in Awake, Non‐intubated Patients in the Emergency Department: A Single ED’s Experience during the COVID‐19 Pandemic. Acad Emerg Med. April 2020. doi:10.1111/acem.13994
3. Garcia FP, Perez Tanoira R, Romanyk Cabrera JP, Arroyo Serrano T, Gomez Herruz P, Cuadros Gonzalez J. Rapid diagnosis of SARS-CoV-2 infection by detecting IgG and IgM antibodies with an immunochromatographic device: a prospective single-center study. April 2020. doi:10.1101/2020.04.11.20062158
4. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. April 2020. doi:10.1001/jama.2020.6775
5. Metzler B, Siostrzonek P, Binder R, Bauer A, Reinstadler S. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J. April 2020. doi:10.1093/eurheartj/ehaa314

COVID-19 Journal Club

Professor Rick Body is joined by Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynolds (NIHR Clinical Research Fellow), Prof Pam Vallely (Professor of Medical Virology), Dr Anisa Jafar (Academic Clinical Lecturer) and Prof Simon Carley (you know him...) to discuss six papers about COVID-19 infection. 

03:10 - Paper 1 – Guan et al. Clinical characteristics of Coronavirus disease 2019 in China. NEJM Feb 28 2020

https://www.nejm.org/doi/full/10.1056/NEJMoa2002032

16:54 Paper 2 – Zou et al. Single Cell RNA-SEQ Data Analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-NCOV infection. Frontiers of Medicine. Mar 12 2020.

https://link.springer.com/content/pdf/10.1007/s11684-020-0754-0.pdf

21:43 Paper 3 – Gautret et al. Hydroxychloroquine and azithromycin treatment of COVID-19: Results of an open-label non-randomised clinical trial. International Journal of Antimicrobial Agents. 20 Mar 2020

https://www.sciencedirect.com/science/article/pii/S0924857920300996?via%3Dihub

25:25 Paper 4 – Cao et al. A trial of Lopinavir-Ritonavir in adults hospitalized with severe COVID-19. NEJM Mar 18 2020

https://www.nejm.org/doi/pdf/10.1056/NEJMoa2001282

29:35 Paper 5 – Cui et al. Prevalence of venous thromboembolism in patients with severe Coronavirus pneumonia. Journal of Thrombosis and Haemostasis. Apr 9 2020 doi:10.1111/jth.14830

https://onlinelibrary.wiley.com/doi/epdf/10.1111/jth.14830

34:14 Paper 6 – Lynarts et al. Prediction models for diagnosis and prognosis of COVID-19 infection: systematic review and critical appraisal. BMJ. Apr 7 2020 BMJ 2020;369:m1328

https://www.bmj.com/content/bmj/369/bmj.m1328.full.pdf

Covid 19 update and February review 2020. St Emlyn’s

Iain and Simon chat about the current Corona pandemic and the blog in Feb 2020.

Iain remains positive, but Simon thinks the glass is half full. Time will tell who is right (though in truth there is a lot of common ground).

S

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.

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.

July 2019 round up podcast. St Emlyn’s

The best from the blog and podcast in July 2019. 

JC: Clot’s the Problem? Vena Cava filters in trauma patients. St Emlyn’s

Psychological performance in the resus room. Ashley Liebig at #stemlynsLIVE

JC: The Resuscitative Care Unit. St Emlyn’s

The great day paradox. St.Emlyn’s

All you need to know about Listeria. St Emlyn’s.

GI Emergencies – Chris Gray at #StEmlynsLIVE

Similar challenges, different approaches – Mass Casualty Incident training lessons from Pakistan. St Emlyn’s

June 2019 Podcast round up. St Emlyn’s

Here's our regular round up of the blog and podcast from June 2019.

Beyond ATLS https://www.stemlynsblog.org/beyond-atls-with-alan-grayson-at-stemlynslive-st-emlyns/

Traumatic Cardiac Arrest https://www.stemlynsblog.org/traumatic-cardiac-arrest-tca-podcast-with-prof-jason-smith-rn-st-emlyns/

The psychological impact of emergency medicine https://www.stemlynsblog.org/how-events-in-emergency-medicine-impact-doctors-psychological-well-being-st-emlyns/

Can we use IO aspirate for analysis https://www.stemlynsblog.org/jc-can-we-really-use-io-blood-for-analysis-st-emlyns/

Don't forget the Bubbles conference and site https://dontforgetthebubbles.com/ 

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.

May 2019 Podcast round up. St Emlyn’s

Our regular monthly round up, this month with Ian and Simon chatting through the best of the blog.

The power of peer review: https://www.stemlynsblog.org/smacc2019-the-power-of-peer-review/

Virtual reality in PED: https://www.stemlynsblog.org/jc-virtual-reality-for-distraction-from-paediatric-procedural-pain/

Wellbeing for the broken: https://www.stemlynsblog.org/wellbeing-for-the-broken-part-3-the-podcast-st-emlyns/ 

Traumatic cardiac arrest https://www.stemlynsblog.org/wellbeing-for-the-broken-part-3-the-podcast-st-emlhttps://www.stemlynsblog.org/jc-should-we-use-chest-compressions-in-traumatic-cardiac-arrest-st-emlyns/

Should we cardiovert AF in the ED or wait? https://www.stemlynsblog.org/should-we-rapidly-cardiovert-af-in-the-ed-st-emlyns/ 

Prolonged field care in the ED https://www.stemlynsblog.org/prolonged-field-care-in-the-ed/

Keppra or Phenytoin for status epilepticus in kids https://www.stemlynsblog.org/jc-enter-sandman-which-agent-as-second-line-in-paediatric-status-epilepticus/ 

April 2019 round up podcast.

Here is the latest from the St Emlyn's team

March 2019 Podcast round up. St Emlyn’s

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

February 2019 Podcast round up St Emlyn’s

Our regular monthly round up of the best of the blog from Feb 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,

December round up podcast 2018. St Emlyn’s

This is the monthly round up of blogs from the St Emlyn's team

Tribalism with Ross Fisher https://www.stemlynsblog.org/breaking-down-tribalism-onetribeemta-st-emlyns/

Conservative management of chest trauma https://www.stemlynsblog.org/jc-conservative-management-of-chest-trauma-st-emlyns/

ICS SOA day 1 https://www.stemlynsblog.org/st-emlyns-on-tour-icssoa2018/ 

Handover principles https://www.stemlynsblog.org/handover-process-practice-and-controversy-icssoa2018-st-emlyns/ 

ICS SOA day 2 https://www.stemlynsblog.org/icssoa2018-day-2-st-emlyns-on-tour/ 

ICS SOA day 3 https://www.stemlynsblog.org/icssoa2018-day-3-st-emlyns-on-tour/ 

FeminEM part 4 https://www.stemlynsblog.org/fix18-part-four/ 

PEP, PEPSE and HIV https://www.stemlynsblog.org/pep-prep-and-all-things-hiv-st-emlyns/ 

Game of Thrones https://www.stemlynsblog.org/ste-journal-club-a-christmas-games-of-thrones-issue/ 

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.

St Emlyn’s September 2018 Round Up

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

The following blogs are discussed.

OOHCA and airway management. Do we need a tube?  http://www.stemlynsblog.org/jc-oohca-and-airway-management-do-we-need-a-tube-st-emlyns/

The Zero Point Survey. Optimising resuscitation teams in the ED. https://www.stemlynsblog.org/jc-the-zero-point-survey-optimising-resuscitation-teams-in-the-ed-st-emlyns/

Subacute and massive PE management https://www.stemlynsblog.org/we-call-it-massiiiiiiivve-pe-at-st-emlyns/

EMS Gathering and podcast https://www.stemlynsblog.org/ems-gathering-review-and-podcast-st-emlyns/

ResusTO: A simulation/resuscitation conference like no other https://www.stemlynsblog.org/resusto-a-simulation-resuscitation-conference-like-no-other/

Monkeypox has arrived https://www.stemlynsblog.org/monkeypox-has-arrived-is-the-panic-justified-st-emlyns/

Micro Machines: Sick neonates at RATH18 https://www.stemlynsblog.org/micromachines/

Equality and Diversity in EM. What I learned as a recovering racist. https://www.stemlynsblog.org/equality-and-global-health-what-i-learned-from-being-a-recovering-racist/

StEmlyn's at EusEM (Four posts)

• https://www.stemlynsblog.org/st-emlyns-at-eusem18-day-4/
• https://www.stemlynsblog.org/st-emlyns-at-eusem18-day-3/
• https://www.stemlynsblog.org/st-emlyns-at-eusem18-day-2/
• https://www.stemlynsblog.org/st-emlyns-at-eusem18-day-1/

Moral Injury in emergency and prehospital care

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/