The St.Emlyn’s virtual hospital podcast

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June 22, 2014  

Understanding diagnostics 3. Why prevalence helps us stay in practice. St.Emlyn’s

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.



June 10, 2014  

Understanding diagnostics 1. SNout SpIn and Probability. St.Emlyn’s

Dear all, 

Mr S. Pecifity the Verger has asked for clarification on whether or not the pipes in the organ need replacing. He was most dissapointed at the report from OrgansRUs which stated that the answer depended on how sure Mr Pecificity was that they needed replacing before they were asked. 
I agree that this answer clearly makes no sense at all and so I have decided to investigate the matter further. 
As I understand it, the best analogies to explain the answer lie in the realm of medicine and so it is to Dr Beardsell and Prof Carley that we must turn.
I have the honour to be your most worshipful servant etc.
The Choirmaster of St.Emlyn's
June 4, 2014  

SMACC Chicago. St.Emlyn’s

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. 

We felt that it was important for them to share their thoughts and to ask if anyone wishes to join them on their planned trip to the Northern Americas next year. AS Choirmaster at St.Emlyn's I have reluctantly decided to give them some air time.
I have the honour to be, as always, your most dutiful servants.
Yours etc.
The St.Emlyn's Choirmaster
May 25, 2014  

Marginal Gains in the ED. St.Emlyn’s

A short podcast on the reasons why it's the little things that matter. Sure, we all love the latest shiny kit, but that's not what always matters and it's not how to move a system to excellence. In this short podcast we talk about why it's good to sweat the small stuff.

See the related blog post here.

April 21, 2014  
April 21, 2014  

Balanced sedation in the ED

A short version from the blog post on balanced sedation on the St.Emlyn's blog. Link here


In summary, if you are going to be good at procedural sedation you need to evaluate the needs of the patient assess their needs and then select the appropriate drugs to tailor their effects to what the patient requires.


  1. Analgesia
  2. Sedation
  3. Anxiolysis
  4. Amnesia
October 27, 2012  

Sample Size: The basics

This podcast links to the blog post on the main St.Emlyn's website. It's a bit old now but hopefully will help you grasp the basics of sample size calculation. It should be very helpful to anyone considering the critical appraisal component of the FCEM exam.



July 17, 2012  

Ring removal trick

Visit for more information.

This is the undertakers trick. If you have arrived here then don't forget to visit the StEmlyns blog as well for more posts on EM topics.

2 caveats about this....I say that I've never cut a ring off. Sort of true as others have done it for me in two circumstances. 1. If there is a deep wound to the finger distal to the ring this is not a great method 2. If the ring did not come off before the injury due to bony (i.e. fixed) enlargement distally then clearly this won't work. However, if they were able to get the ring off that morning, and now they cannot because of soft tissue swelling, and they can tolerate the discomfort of the procedure then this is a great technique.

Check out the better explanation here

And obviously, this is best done by someone who knows what they are doing, and you try it at your own risk.



November 3, 2011  

Statistics 2

More on basic interpretation of statistics for the critical appraiser. No maths, no formulas, no hard calculations. Just the tools to make the interpretation of results easier.

This week we look at relative risk (RR), absolute risk reduction (ARR) and number needed to treat (NNT). Are they different or the same?

You'll find that NNT is much more useful for the reader, things like relative risk have their place for statisticians and researchers who are seeking to understand their data. However, for clinicians and readers we would be better served by expressing data as NNT (or NNH).


November 3, 2011  

Statistics 1

This is not a stats lecture!

What I want to get across is that with very little knowledge you can have a really good go at interpreting the stats in the papers you read. No calculators, no maths, no hard sums, just an appreciation of whether it looks as though the authors did the right sort of thing.

In this podcast we look at different types of data, what p-values are and how do we define confidence intervals.

October 27, 2011  

Study design: Diagnostic tests

A short podcast on the basics of diagnostic test design. Hope you like it.

You may find these links useful.