A new paper on the challenging diagnosis of acute appendicitis has us wondering, can it be spotted with just a glance? The reality is never so simple. This episode we also discuss low-value overtesting, cardiac arrest trial consent, and patient discharge into police custody. As with many aspects of the ED, they each have a layer of legal pressure to consider.   Read the highlights: August 2025 primary survey   The EMJ podcast is hosted by: Prof. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

The NHS plans to set up mental health emergency departments throughout England. A survey discussed this episode highlights the importance of mental health assessments, finding that nearly a quarter of suicide deaths in a one year period had come after hospital or emergency department contact. Another survey raises the question, "How well is your ED prepared for a major incident?" and the statistics do not inspire confidence. Two more papers in this episode offer potential bulwarks against burnout of ED staff: global health outreach work, and self-rostered rotas. But there may be some downsides to watch out for too. Finally, a look at pulse oximetry for testicular torsion diagnosis. Read the highlights: July 2025 Primary Survey Contact with emergency departments and hospitals in England before suicide death: a retrospective cohort study Global health experience of staff working in UK emergency care: a reflexive thematic analysis A survey of major incident preparedness in English type 1 emergency departments In emergency settings, does the use of testicular pulse oximetry aid diagnosis of testicular torsions? Investigating the impact of self-rostering on EM trainee wellbeing and recovery: a national survey The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Can salbutamol be used be used to relieve pain in renal colic patients? Starting off this month's episode, a randomised trial seeks to find the answer. Then a topic of interest for anyone seeing patients with a phobia of needles, namely a study comparing coolant spray with topical anaesthetic cream for reducing pain from intravenous cannulation. Next, randomisation is a necessary tool for many trials, but what if you want something that's less high-tech, and more high-street? That's right, scratch cards! And finally, fear of not making the right decision dominates when it comes to  paramedic conveyance to the paediatric emergency department. "We just take them in," "parents know best," and "if only they could talk" are some of the revealing quotes found in the study wrapping up this month.   Read the highlights: June 2025 Primary Survey Salbutamol for analgesia in renal colic: a prospective, randomised, placebo-controlled phase II trial Comparison of the effects of vapocoolant spray and topical anaesthetic cream (lidocaine–prilocaine) on pain of intravenous cannulation: a randomised controlled trial Letter: Allocation concealment using scratchcards in an emergency department drug trial Factors influencing paramedic conveyance decisions when attending children with minor head injury: a qualitative study The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

A new survey has found that less than one third of end-of-life patients in Irish emergency departments have their own room. This is only one of the shortcomings found in end-of-life care, explored in two papers to start this episode. Following on from that is a comparison of video and direct laryngosocopy for intubation outcomes. There's also a "Best Evidence" review of the use of nasal clips for stopping nosebleeds, an approach which appears likely to offer advantages over the hands or inventive tongue-depressor contraptions. The finish up this month's episode, there's a return to a topic previously visited one year ago - the RCEM guidelines on cannabinoid hyperemesis syndrome. A study from Wales follows up on the adherence to this guidance. Read the highlights: May 2025 Primary Survey Dying matters in the emergency department Emergency clinician perceptions of end-of-life care in Irish emergency departments: a cross-sectional survey Video laryngoscopy may improve the intubation outcomes in critically ill patients: a systematic review and meta-analysis of randomised controlled trials Use of nasal clips as first aid for anterior epistaxis Awareness and management of cannabinoid hyperemesis syndrome among staff in emergency departments in Wales The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Trauma and paediatrics are the themes for this month's collection of papers. Starting off is a review of the effectiveness of prehospital ultrasound in detecting lung injury, with some surprising statistics. Next is a letter on the topic of self-presentation by paediatric patients with major trauma, which is thankfully a rare occurrence. The third paper looks at prehospital testing of trauma patients for  low fibrinogen levels, a condition which can lead to worse bleeding, increased transfusions, and higher mortality. The final paper discusses the worrying topic of delayed presentation with testicular pain, a phenomenon which leads to significantly lower salvage rates. This can arise from lack of information or embarrassment, particularly in younger males.   Read the highlights: April 2025 Primary Survey   Diagnostic accuracy of prehospital ultrasound in detecting lung injury in patients with trauma: a systematic review and meta-analysis Identifying the walk-in wounded: paediatric major trauma patients self-presenting to a paediatric major trauma centre Comparison between point-of-care international normalised ratio, COAST, TICCS and truncated FibAT scores to rule in clinically significant hypofibrinogenaemia in the prehospital setting Experiences and perceptions of acute testicular pain, with a focus on reasons for delayed presentation to hospital: a qualitative evidence synthesis   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Advance clinical practitioners (ACPs) can have a big role to play in the emergency department, but their career paths are not always well understood. This episode features three papers from the journal which begin to address that - a census survey of over 1000 ACPs, a qualitative study on their experiences in emergency care, and a commentary on how to improve ACP training. There is also a paper from Canada discussing considerations to be made for patients living with dementia, as well as their care partners who may be accompanying them to the hospital. A bit of a curveball to close out, with a review on hidradenitis suppurativa, a challenging skin condition which can take years for a diagnosis.   Read the highlights: March 2025 Primary Survey   Care for older adults living with dementia in the emergency department: a systematic review and meta-synthesis of care partner roles and perspectives Emergency medicine advanced clinical practitioners: an English workforce census A qualitative study exploring the experiences of advanced clinical practitioner training in emergency care in the South West of England, United Kingdom How can we improve on advanced clinical practitioner training? Diagnosis and management of hidradenitis suppurativa: a review for the emergency clinician   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Another packed issue of the journal this month, and a podcast to match. Starting off with the Editor's Choice paper, on the important topic of sex and gender disaggregation in emergency medicine trials. Sex and Gender Equity Reporting (SAGER) guidelines were introduced in 2016 but poor adherence is still found in current publications. Next is a paper with high seasonal relevance, addressing the sensitivity and specificity of multiplex lateral flow tests for Flu A, Flu B and COVID 19. There's also a randomised controlled trial on nebulised corticosteroids for asthma exacerbation, and to finish, a question few might think to ask - can intradermal injection of sterile water offer pain relief to renal colic patients?   Read the highlights: February 2025 Primary Survey   Sex and gender reporting in UK emergency medicine trials from 2010 to 2023: a systematic review Sex and gender reporting in scientific papers now strongly recommended by the Emergency Medicine Journal Multiplex lateral flow test sensitivity and specificity in detecting influenza A, B and SARS-CoV-2 in adult patients in a UK emergency department  Nebulised high-dose corticosteroids as add-on therapy for adults with asthma exacerbation: a randomised controlled trial Best evidence topic report: can intradermal sterile water injections provide effective pain relief in patients with renal colic?   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

A special bonus podcast this time, on the perennial issue of crowding. Rick and Sarah are joined by Royal College of Emergency Medicine president Dr. Adrian Boyle, and EMJ's editor-in-chief Prof. Ellen Weber. They address recent evidence for crowding's harmful impact, the arm-twisting needed to shape policy, how it shapes patient confidence, and what the future of crowding looks like.   Links: Association between delays to patient admission from the emergency department and all-cause 30-day mortality Being a patient in a crowded emergency department: a qualitative service evaluation   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

It's a celebration of qualitative research to start the new year, with a collection of papers offering new perspectives on emergency department issues. First is a pair of papers centred on the theme of pre-alerts to the emergency department. Setting the scene for a patient's arrival is a vital process, yet it can generate fear of criticism for getting the balance wrong, when it comes to over- and under-alerting. Following on is a paper taking a look at the human experience of working in the emergency department, and the war-like atmosphere that can be found there. This leads to the final paper on well-being interventions in the ED, with interviews having found real limitations to current approaches.   Read the issue highlights: January 2025 Primary Survey   How do emergency departments respond to ambulance pre-alert calls? A qualitative exploration of the management of pre-alerts in UK emergency departments What influences ambulance clinician decisions to pre-alert emergency departments: a qualitative exploration of pre-alert practice in UK ambulance services and emergency departments  It’s a battlefield! A thematic analysis of narratives shared in Cape Town emergency departments Well-being interventions for emergency department staff: ‘necessary’ but ‘inadequate’ – a phenomenographic study   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Subarachnoid haemorrhage is a diagnosis that can't be missed, but it is not a simple process to detect it. The first paper for discussion this month questions if a CT scan within 6 hours is sufficient for exclusion in patients with acute headache. Then there is a large-scale analysis of over 400 million ED visits in the USA, focussing in on the significant issue of self-harm in the homeless population. Next is a paper on a decision tool for suspected acute aortic syndrome, and to finish, a discussion on the change in ED culture around safety since the COVID pandemic.   Read the issue highlights: December 2024 Primary Survey   Articles discussed in this episode: Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study Suicide and self-injury-related emergency department visits and homelessness among adults 25–64 years old from 2016 to 2021 in the USA  Decision analytical modelling of strategies for investigating suspected acute aortic syndrome  Culture of safety in an adult and paediatric emergency department before and after the COVID-19 pandemic   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Upper limb injuries make up about three-quarters of the limb injuries to children seen in the emergency department. But when it comes to the elbow, just how good are clinicians at diagnosing based on radiography? The first paper this month is a study putting over 300 global participants to the test. There's also a practice review highlighting the concept of shared decision making with frail elderly patients, a discussion of biomarkers for aortic dissection detection, more on telephone triage, and an interesting questionnaire on patient experience. Read the issue highlights: November 2024 Primary Survey Articles discussed in this episode: Black and white: how good are clinicians at diagnosing elbow injuries from paediatric elbow radiographs alone? Person-centred decisions in emergency care for older people living with frailty: principles and practice Use of emergency departments by children and young people following telephone triage: a large database study The wisdom of elders: a new patient experience survey for older patients could tell us how to fix our emergency departments for everyone Psychometric validation of a patient-reported experience measure for older adults attending the emergency department: the PREM-ED 65 study Diagnostic accuracy of alternative biomarkers for acute aortic syndrome: a systematic review Links: Understanding escalation area and corridor care in UK emergency departments (UNCORKED) The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.  

There's a whole pile of blocks in this month's papers, with the first being a trial of Erector-Spinae Plane (ESP) blocks, not for rib fractures as you might expect but Hepato-Pancreato-Biliary (HPB) pain instead. Following on from that is a retrospective study comparing the resource utilisation of haematoma blocks, Bier’s blocks and procedural sedation for patients with forearm fractures. The next paper sets the performance of unassisted radiographers against those armed with artificial intelligence algorithms when diagnosing pneumothorax, and the results show an interesting demographic trend. Concluding the discussion topics this month is a letter regarding "on-scene time" for ambulances when assessing patients for suspected stroke - a situation where every minute counts. Read the issue highlights: October 2024 Primary SurveyArticles discussed in this episode: EASIER trial (Erector-spinAe analgeSia for hepatopancreaticobiliary pain In the Emergency Room) Haematoma block is the most efficient technique for closed forearm fracture reduction: a retrospective cohort study Evaluation of the impact of artificial intelligence-assisted image interpretation on the diagnostic performance of clinicians in identifying pneumothoraces on plain chest X-ray: a multi-case multi-reader study  On-scene times during ambulance assessment of suspected stroke patients across England from December 2021 to November 2022 The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Being fallible was one of the most valued characteristics in a consultant, according to new doctors going through their induction - that's the subject of the first paper this month. Next up is a study on the impact of noise on hospital staff, which includes some simple interventions with measurable impact. There's also a discussion on pain relief for rib fractures, and how frailty scores are linked to 30-day mortality in patients. Read the issue highlights: September 2024 Primary SurveyArticles discussed in this episode: Qualitative study of new doctor induction and socialisation Reduced noise in the emergency department: the impact on staff well-being and room acoustics The RELIEF feasibility trial: topical lidocaine patches in older adults with rib fractures Frailty is associated with 30-day mortality: a multicentre study of Swedish emergency departmentsThe EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

The recovery of laceration repair patients is the topic of this month's first paper, looking at behavioural disturbances in children following these difficult medical procedures. The second paper deals with pre-hospital use of tranexamic acid for trauma, and surfaces some demographic discrimination in its rates of application. Next there is an observational study which has developed a score for indirect signs of appendicitis on ultrasounds where the appendix is not visualised. Finishing off the episode is a "Best Evidence" report, dealing with the appropriate usage of CT scans on patients first presenting with a seizure.   Read the issue highlights: August 2024 Primary Survey   Articles discussed in this episode: Paediatric laceration repair in the emergency department: post-discharge pain and maladaptive behavioural changes Evaluation of the prehospital administration of tranexamic acid for injured patients: a state-wide observational study with sex and age-disaggregated analysis Predictive values of indirect ultrasound signs for low risk of acute appendicitis in paediatric patients without visualisation of the appendix on ultrasound Best Evidence Topic report: Is a CT head required for patients who present to the emergency department with a first seizure?    The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

What might yawning and sneezing be signs of in a patient? This month's podcast features new RCEM and NPIS guidance on acute opioid toxicity, outlining a number of symptoms to stay alert to. Before getting to that there's a paper on bypassing hospitals for patients needing mechanical thrombectomy, a study on how austerity affected emergency admissions across a range of UK local authorities, and some research on the immune-related adverse affects that can arise in the ED amongst oncological patients. Read the issue highlights: July 2024 Primary Survey Articles discussed in this episode: Healthcare professional views about a prehospital redirection pathway for stroke thrombectomy: a multiphase deductive qualitative study. Day J, Simmonds RL, Shaw L, et al Are local public expenditure reductions associated with increases in inequality in emergency hospitalisation? Time-series analysis of English local authorities from 2010 to 2017. Castro-Ávila AC, Cookson R, Doran T, et al Management and outcome of oncological patients under immune checkpoint inhibitors presenting at the emergency department. Pini F, Grigoriu B, Lieveke A, et al Joint RCEM and NPIS best practice guideline: assessment and management of acute opioid toxicity in adults in the emergency department. Blundell M, Gill R, Thanacoody R, et al   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

How well do patients in the emergency department judge the severity of their situation? Some may fear the worst for any hospital visit, and others not realise that their lives are in danger. This month's first paper is a review of the accuracy of self-prognostication and its relation to admission, severity, and length of stay. Then there's a trio of publications on the challenges of pain in various forms. Starting with a study on the links between red flags in headache assessment, and serious secondary headaches. Next there is a letter, questioning how well pain management is done in the ED. To finish, a new scale has been developed to assess ultrasound-guided fascia iliaca block. Read the issue highlights: June 2024 Primary Survey Articles discussed in this episode:Can acutely ill patients predict their outcomes? A scoping review. Mols EM, Haak H, Holland M Safer@Home Research Consortium, et al Predictive performance of the common red flags in emergency department headache patients: a HEAD and HEAD-Colombia study. Chu K, Kelly A, Kuan WS HEAD and HEAD-Colombia study groups, et al Pain in the ED: does anyone manage it well? Wilson S, Dainty J, Quinlan J, et al Development and validation of an assessment tool for adult simulated ultrasound-guided fascia iliaca block: a prospective monocentric study. Guyader F, Violeau M, Guenezan J, et al The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.  

Should we be bringing preventative medicine into the emergency department, or is it just using up valuable time? Our first paper this month looks at the "Cessation of Smoking Trial in the Emergency Department (COSTED)" trial, which presents the case for opportunistic smoking cessation intervention. Next up is a topical research paper on interpreting CT scans with artificial intelligence, and how machine assessment measures up against experienced physicians. Then there's a trio of troponin papers, discussing high-sensitivity testing. The final paper this time is not a paper but a guideline from the Royal College of Emergency Medicine, setting out best practices for dealing with suspected cannabinoid hyperemesis syndrome.Articles discussed in this episode:Cessation of Smoking Trial in the Emergency Department (COSTED): a multicentre randomised controlled trial. Pope I, Clark LV, Clark A, et al Using an artificial intelligence software improves emergency medicine physician intracranial haemorrhage detection to radiologist levels. Warman P, Warman A, Warman R, et al External validation of a rapid algorithm using high-sensitivity troponin assay results for evaluating patients with suspected acute myocardial infarction. Cullen L, Greenslade JH, Stephensen L 2022 SAMIE study group, et al High-sensitivity troponin testing at the point of care for the diagnosis of myocardial infarction: a prospective emergency department clinical evaluation. Curran JM, Mergo A, White S, et al Determination of a whole-blood single-test low-risk threshold for a point-of-care high-sensitivity troponin assay. Pickering JW, Hamill L, Aldous S, et al RCEM best practice guideline: suspected cannabinoid hyperemesis syndrome in emergency departments. Humphries C, Gillings M   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

“Social distancing is a privilege,” is the core message underlying the first paper brought by Sarah to this month’s roundup, as it unpacks the stark differences in COVID-19 outcomes across the spectrum of racial and ethnic groups in the United States. A second paper examines the returning rates of COVID patients across a large group of emergency departments in Canada, and the factors at play there. The final topic is one of Rick’s favourites, focusing on troponin testing in ambulances. Articles discussed in this episode: Pandemic phase-related racial and ethnic disparities in COVID-19 positivity and outcomes among patients presenting to emergency departments during the first two pandemic waves in the USA. Khosla S, Del Rios M, Chisolm-Straker M, et al.  Characteristics and outcomes of patients with COVID-19 who return to the emergency department: a multicentre observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). Rosychuk RJ, Khangura JK, Ortiz SS, et al.  Perceived barriers and opportunities to improve working conditions and staff retention in emergency departments: a qualitative study. Daniels J, Robinson E, Jenkinson E, et al. Prehospital T-MACS and HEART scores in the prediction of myocardial infarction: a prospective evaluation. Cooper JG, Donaldson LA, Coutts AJ, et al.   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

A feast of aortic papers this month, including a study on missed aortic dissection diagnoses and an analysis of coroners' reports. Rick runs through the findings of an interesting study from the Trainee Emergency Research Network (TERN), and Sarah finishes off with a paper on predicting adverse outcomes in elderly patients with orthopaedic trauma. Articles discussed in this episode: Ohle R, Savage DW, Caswell J, et al. Mortality and risk factors associated with misdiagnosis of acute aortic syndrome in Ontario, Canada: a population-based study. Hodgson S, O'Mahony K, Nicholson J, et al. Thematic analysis of ‘Prevention of Future Deaths’ reports related to emergency departments in England and Wales 2013–2022.  McLatchie R, Reed MJ, Freeman N on behalf of the DAShED investigators, et al. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. Isaac CJ, Moore L, Bérubé M, et al. Predictors of adverse outcomes in elders hospitalised for isolated orthopaedic trauma: a multicentre cohort study.   Related links: RCEM Learning: Aortic Dissection podcast. Trainee Emergency Research Network.   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

There's a lot of drugs to be talked about this month, and a heap of randomised control trials to be covered too. Rick and Sarah talk though the combining of nitrous oxide and fentanyl for sedation, the environmental impact of analgesics, the efficacy of acute heart failure treatment with high-dose and low-dose nitrates, and more newly published work from the latest issue of the journal.   Articles discussed in this episode: Safety and efficacy of a nitrous oxide procedural sedation programme in a paediatric emergency department: a decade of outcomeshttps://emj.bmj.com/content/41/2/76 Environmental impact of low-dose methoxyflurane versus nitrous oxide for analgesia: how green is the ‘green whistle’?https://emj.bmj.com/content/41/2/69 High-dose versus low-dose intravenous nitroglycerine for sympathetic crashing acute pulmonary edema: a randomised controlled trialhttps://emj.bmj.com/content/41/2/96Trip-killers: a concerning practice associated with psychedelic drug usehttps://emj.bmj.com/content/41/2/112 Effect of intranasal sufentanil on acute post-traumatic pain in the emergency department: a randomised controlled trialhttps://emj.bmj.com/content/41/2/83   The EMJ podcast is hosted by: Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.