Acute Medicine

Getting your chest pain evaluation right: #UMECS16

Last week, while Iain was giving a keynote lecture in Austria, I was also heading for distant shores to speak about chest pain evaluation at a special conference set up by the legendary Amal Mattu: the University of Maryland Emergency…
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Taking a sexual history in ED

Emergency physicians often feel that taking a sexual history in EDs is something medical school and specialty training have not prepared them very well for. This comes as no surprise as it differs significantly from ordinary medical history taking.  Personal,…
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The MACS rule: a new user-friendly version

This blog post is based on a paper we’ve just had published in the Emergency Medicine Journal entitled: ‘The Manchester Acute Coronary Syndromes (MACS) decision rule: validation with a new automated assay for heart-type fatty acid binding protein’.  You can…
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Get the NOAC Knowhow: Novel Oral Anticoagulants Part 1

Where would we be without warfarin?  The good old rat poison has served us brilliantly for decades, allowing us to anticoagulate patients to treat and prevent venous thromboembolism, prevent stroke in AF, and so much more.  As a House Officer,…
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Is severe chest pain more likely to be a heart attack?

    Have you ever heard this sort of conversation in your ED? Junior ED doc: Can I run my patient by you, please? Senior ED doc: Sure Junior: I  have a 40 year old man with chest pain.  I don’t think it’s…
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New NICE high sensitivity troponin guidance: 3 hours and done?

The National Institute for Health and Care Excellence (NICE) from the UK has just published new recommendations for the use of high sensitivity troponin to rule out NSTEMI in the Emergency Department.  You can find it at this link.  I…
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The Heart Under Stress – St. Emlyn’s at SMACC Gold

  Chris Nickson (@precordialthump) is a genius in many ways. Not only does he organise arguably the best healthcare conference in the world right now, but he’s also a very clever chap when it comes to thinking of imaginative titles…
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JC: Should we use Heimlich Valves for ambulatory pneumothorax management? St. Emlyn’s

Here at St. Emlyn’s we have been managing patients with pneumothoraces as out patients for many years. The approach in the UK has been ‘guided’ by the BritishThoracic Society guidelines. For many PNXs we simply aspirate, and if successful we…
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