How should we interpret survival improvements after changes to UK trauma services? This appraisal examines TARN data from 2008–2017, considering regional trauma networks alongside changing patient populations, case identification and missing data. It also highlights the challenge of recognising serious injury in older people.
Trauma in the UK, who cares? Read More
Preparing for Manchester’s 2018 festival season, this article explores the emergency consequences of MDMA and other recreational drugs, including hyperthermia and hyponatraemia. It connects clinical preparedness with harm reduction and the importance of responding to patients without judgement, rather than focusing only on the substances involved.
Party hard in the UK: Ecstasy and more in #Virchester. St Emlyn’s Read More
A sceptical 2017 appraisal of a systematic review of intravenous thrombolysis for acute stroke. The post examines functional outcomes, bleeding and mortality, showing how interpretation of benefits and harms fuels disagreement; it presents the author’s historical critique rather than current treatment guidance.
JC: Kicking against the prick: Systematic Review of stroke thrombolysis Read More
What makes emergency medicine trainees feel valued and supported? Reflecting on conversations with trainees in 2016, this post argues for meaningful feedback, supervisors who understand the curriculum, accessible consultant support and fairer rotas as investments in the specialty’s future.
Futureproofing EM: Why your trainees deserve it (and your nation needs it). St.Emlyn’s Read More
This 2016 teaching update explores fascia iliaca blocks for hip-fracture pain, combining anatomy, landmark and ultrasound approaches with discussion of local-anaesthetic safety and the supporting evidence. Videos and an infographic accompany the authors’ reflections on introducing regional analgesia into emergency department practice.
A St.Emlyn’s fascia iliaca block update. Read More
A critical response to NICE’s 2014 acute heart failure guidance, questioning whether varied presentations can be treated as one condition. The author examines the evidence behind diuretics, nitrates and non-invasive ventilation, and argues for clearer definitions and research that better reflects the sickest emergency department patients.
A 2013 response to reports of paramethoxyamphetamine, or PMA, in tablets sold as ecstasy. The post discusses changing patterns of recreational drug use, severe toxicity and hyperthermia, drawing on poisons information and the limited clinical evidence available at the time.
Something for the weekend, Sir? Read More
Alan Grayson describes volunteering with Festival Medical Services at Glastonbury in 2013. His account explores the planning, multidisciplinary teamwork and varied presentations behind festival healthcare, from minor injuries to critical illness, and the challenges of delivering emergency care in a field hospital.
What I do on my holidays, by Alan Grayson, aged 37 and a half. St.Emlyn’s Read More
