Emergency Medicine Cases – Where the Experts Keep You in the Know. For show notes, quizzes, videos and more learning tools please visit emergencymedicinecases.com
…
continue reading
Player FM - Internet Radio Done Right
99 subscribers
Checked 6d ago
추가했습니다 six 년 전
St Emlyn’s Blog and Podcast and St Emlyn’s Blog에서 제공하는 콘텐츠입니다. 에피소드, 그래픽, 팟캐스트 설명을 포함한 모든 팟캐스트 콘텐츠는 St Emlyn’s Blog and Podcast and St Emlyn’s Blog 또는 해당 팟캐스트 플랫폼 파트너가 직접 업로드하고 제공합니다. 누군가가 귀하의 허락 없이 귀하의 저작물을 사용하고 있다고 생각되는 경우 여기에 설명된 절차를 따르실 수 있습니다 https://ko.player.fm/legal.
Player FM -팟 캐스트 앱
Player FM 앱으로 오프라인으로 전환하세요!
Player FM 앱으로 오프라인으로 전환하세요!
들어볼 가치가 있는 팟캐스트
스폰서 후원
A
Advances in Care


1 Advancing Cardiology and Heart Surgery Through a History of Collaboration 20:13
20:13
나중에 재생
나중에 재생
리스트
좋아요
좋아요20:13
On this episode of Advances in Care , host Erin Welsh and Dr. Craig Smith, Chair of the Department of Surgery and Surgeon-in-Chief at NewYork-Presbyterian and Columbia discuss the highlights of Dr. Smith’s 40+ year career as a cardiac surgeon and how the culture of Columbia has been a catalyst for innovation in cardiac care. Dr. Smith describes the excitement of helping to pioneer the institution’s heart transplant program in the 1980s, when it was just one of only three hospitals in the country practicing heart transplantation. Dr. Smith also explains how a unique collaboration with Columbia’s cardiology team led to the first of several groundbreaking trials, called PARTNER (Placement of AoRTic TraNscatheteR Valve), which paved the way for a monumental treatment for aortic stenosis — the most common heart valve disease that is lethal if left untreated. During the trial, Dr. Smith worked closely with Dr. Martin B. Leon, Professor of Medicine at Columbia University Irving Medical Center and Chief Innovation Officer and the Director of the Cardiovascular Data Science Center for the Division of Cardiology. Their findings elevated TAVR, or transcatheter aortic valve replacement, to eventually become the gold-standard for aortic stenosis patients at all levels of illness severity and surgical risk. Today, an experienced team of specialists at Columbia treat TAVR patients with a combination of advancements including advanced replacement valve materials, three-dimensional and ECG imaging, and a personalized approach to cardiac care. Finally, Dr. Smith shares his thoughts on new frontiers of cardiac surgery, like the challenge of repairing the mitral and tricuspid valves, and the promising application of robotic surgery for complex, high-risk operations. He reflects on life after he retires from operating, and shares his observations of how NewYork-Presbyterian and Columbia have evolved in the decades since he began his residency. For more information visit nyp.org/Advances…
The St.Emlyn’s Podcast
모두 재생(하지 않음)으로 표시
Manage series 2485891
St Emlyn’s Blog and Podcast and St Emlyn’s Blog에서 제공하는 콘텐츠입니다. 에피소드, 그래픽, 팟캐스트 설명을 포함한 모든 팟캐스트 콘텐츠는 St Emlyn’s Blog and Podcast and St Emlyn’s Blog 또는 해당 팟캐스트 플랫폼 파트너가 직접 업로드하고 제공합니다. 누군가가 귀하의 허락 없이 귀하의 저작물을 사용하고 있다고 생각되는 경우 여기에 설명된 절차를 따르실 수 있습니다 https://ko.player.fm/legal.
A UK based Emergency Medicine podcast for anyone who works in emergency care. The St Emlyn ’s team are all passionate educators and clinicians who strive to bring you the best evidence based education. Our four pillars of learning are evidence-based medicine, clinical excellence, personal development and the philosophical overview of emergency care. We have a strong academic faculty and reputation for high quality education presented through multimedia platforms and articles. St Emlyn’s is a name given to a fictionalised emergency care system. This online clinical space is designed to allow clinical care to be discussed without compromising the safety or confidentiality of patients or clinicians.
…
continue reading
263 에피소드
모두 재생(하지 않음)으로 표시
Manage series 2485891
St Emlyn’s Blog and Podcast and St Emlyn’s Blog에서 제공하는 콘텐츠입니다. 에피소드, 그래픽, 팟캐스트 설명을 포함한 모든 팟캐스트 콘텐츠는 St Emlyn’s Blog and Podcast and St Emlyn’s Blog 또는 해당 팟캐스트 플랫폼 파트너가 직접 업로드하고 제공합니다. 누군가가 귀하의 허락 없이 귀하의 저작물을 사용하고 있다고 생각되는 경우 여기에 설명된 절차를 따르실 수 있습니다 https://ko.player.fm/legal.
A UK based Emergency Medicine podcast for anyone who works in emergency care. The St Emlyn ’s team are all passionate educators and clinicians who strive to bring you the best evidence based education. Our four pillars of learning are evidence-based medicine, clinical excellence, personal development and the philosophical overview of emergency care. We have a strong academic faculty and reputation for high quality education presented through multimedia platforms and articles. St Emlyn’s is a name given to a fictionalised emergency care system. This online clinical space is designed to allow clinical care to be discussed without compromising the safety or confidentiality of patients or clinicians.
…
continue reading
263 에피소드
모든 에피소드
×T
The St.Emlyn’s Podcast

1 Ep 261 - Moral Injury with Caroline Leech at Tactical Trauma 24 15:41
15:41
나중에 재생
나중에 재생
리스트
좋아요
좋아요15:41
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe welcome back Caroline Leech, a emergency medicine consultant with extensive pre-hospital care experience. Caroline discusses the concept of moral injury, delving into its distinction from moral distress. She introduces three mechanisms of moral injury: acts of commission, acts of omission, and betrayal. Caroline provides insightful examples from emergency medicine to illustrate these concepts, emphasizing the importance of identifying and addressing moral injury to support healthcare professionals. The discussion highlights the emotional and cognitive distress faced by emergency responders and the necessity for professional psychological support when moral distress accumulates into moral injury. 00:00 Introduction and Welcome 00:23 Introducing Caroline Leech 01:10 Defining Moral Injury and Distress 03:42 Acts of Commission 07:12 Acts of Omission 12:30 Betrayal in Healthcare 15:00 Conclusion and Final Thoughts The Guest - Caroline Leech Caroline Leech is Deputy Clinical Lead of The Air Ambulance Service and has 25 years of prehospital clinical experience. She is a Consultant in Emergency Medicine at University Hospital Coventry, the West Midlands Trauma Network Director, and the Trauma Lead for the Institute for Applied & Translational Technologies in Surgery (IATTS). Caroline is currently undertaking a NIHR funded Clinical Research Scholarship with Warwick University. Her research interests include maternal out-of-hospital cardiac arrest, calcium in traumatic haemorrhage, and frailty in major trauma. She is committed to improving equality and diversity in PHEM, and promoting strategies for supporting the wellbeing and psychosocial care of prehospital responders.…
T
The St.Emlyn’s Podcast

1 Ep 260 - Monthly Round Up December 2024 - Chest trauma, IO access, AI and more 20:35
20:35
나중에 재생
나중에 재생
리스트
좋아요
좋아요20:35
In this season-ending episode of the St Emlyn's podcast, Iain Beardsell and Simon Carley come together in Zermatt, Switzerland, to discuss recent studies and updates. They highlight a randomized control trial on early exercise in blunt chest wall trauma, revealing its limited impact on recovery outcomes. Additionally, they explore the long-term safety of intraosseous access based on new evidence from Denmark. The episode also provides insights into updated imaging guidelines for paediatric trauma and broad considerations on the growing role of AI in healthcare, especially in emergency settings. There are closing remarks on recent blog posts about toxic alcohol poisoning and the Difficult Airway Society meeting, while looking forward to upcoming conferences in Spain and Vienna. 00:00 Welcome to St Emlyn's Podcast 00:31 Exploring the Big Sick Conference in Zermatt 01:25 Evidence-Based Medicine: Early Exercise in Blunt Chest Wall Trauma 04:30 Intraosseous Access: Long-Term Complications 06:37 Imaging Decisions in Pediatric Trauma 09:17 The Promise and Perils of Artificial Intelligence in Healthcare 13:10 Toxic Alcohol Poisoning: A Critical Review 16:17 Conference Highlights and Future Events 19:19 Season 11 Finale and Looking Ahead to Season 12…
T
The St.Emlyn’s Podcast

1 Ep 259 - Skills Fade with Nathalie Pattyn at Tactical Trauma 24 16:22
16:22
나중에 재생
나중에 재생
리스트
좋아요
좋아요16:22
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe talk with Nathalie Pattyn at TacTrauma24 in Sweden about the phenomenon of skills fade amongst emergency physicians. Nathalie discusses her extensive background in medicine, psychology, and neuroscience, and shares insights from her research on how skills can deteriorate during low workload deployments, such as her 15-month clinical stint in Antarctica. They delve into the lack of systemic measures to address returning to practice after long absences, how cognitive and psychomotor skills are affected by skill fade, and the contrast between teaching technical skills and ensuring they become automatic and stress-resilient. The conversation highlights the need for evidence-based guidelines to ensure healthcare professionals maintain their proficiency, which ultimately benefits patient care and the healthcare system. 00:00 Introduction and Guest Introduction 00:13 Natalie's Background and Expertise 00:38 Skills Fade in Emergency Medicine 01:01 Personal Experience with Skills Fade 02:14 Regulations and Policies on Skills Maintenance 04:19 Imposter Syndrome vs. De-skilling 06:42 Aviation vs. Medical Field: Skills Certification 08:27 Aging and Cognitive Decline in Medical Skills 09:57 Teaching vs. Training in Medical Education 12:42 Future Directions and Systemic Solutions 14:31 Conclusion and Contact Information The Guest Nathalie Pattyn, MD, MPsy, PhD, received a degree in medicine from the Université Libre de Bruxelles (magna cum laude, 2001), a Master in Clinical Psychology from the Vrije Universiteit Brussel (cum laude, 2004), a PhD in Psychological Sciences from the Vrije Universiteit Brussel (2007) and a PhD in Social and Military Sciences from the Royal Military Academy (2007). She also holds a postgraduate degree in Aerospace Medicine; a postgraduate degree in Emergency Medicine; a postgraduate degree in General Practice ; a postgraduate degree in Disaster Medicine ;and a Master in Global and Remote Healthcare. She completed her Junior Officer Course with the Belgian Defense College in 2005, and her Staff Officer Course in 2008. She has a mixed clinical, research and operational background, having been deployed as a medical officer in various Middle Eastern and African countries, and having completed missions in Antarctica for a total duration of more than two years. Her longest deployment was 15 months to the Halley VI Research Station in Antarctica, where she worked as the station physician while setting up a new biomedical research laboratory for the European Space Agency. She is currently still working as an emergency physician and a flight surgeon. Her research interests include the psychophysiological measures of performance in elite populations; and Human Factors approach to isolated and confined environments, ranging from space to submarines. In 2010, she founded a research unit within the Royal Military Academy, dedicated to the multidisciplinary study of human performance in operational environments. This led her to be the project manager for designing a tailored Human Performance Program for the tier one unit of the SOF community in Belgium. She is currently an Associate Professor in Physiopathology at the Vrije Universiteit Brussel and in Human Performance at the Royal Military Academy. You can read Nathalie's excellent book "Handbook of Mental Performace" for free here .…
T
The St.Emlyn’s Podcast

1 Ep 258 - Compassionate Resuscitation with Matt Hooper at LTC 24:57
24:57
나중에 재생
나중에 재생
리스트
좋아요
좋아요24:57
Welcome to our first episode recorded at the London Trauma Conference 2024. In this episode, hosts Iain Beardsell and Natalie May are joined by Matt Hooper from Adelaide to discuss his unique career path, from emergency medicine to pre-hospital and retrieval medicine, intensive care, and more recently, palliative and end-of-life care. The conversation centres around the principles of end-of-life care, particularly in acute and traumatic scenarios, and how these can be integrated with life-saving efforts. Key points include the challenges of shifting focus from survival to quality of death, the importance of recognizing and supporting witnesses and caregivers, and the concept of 'compassionate resuscitation.' Practical tools such as the 'pause' are also explored, aiming to humanize highly charged medical environments and potentially prevent burnout and PTSD among healthcare providers. 00:00 Introduction and Guest Welcome 01:00 Key Messages on Death and Palliative Care 02:12 Challenges in End-of-Life Care 03:20 Improving Quality of Death and Relationships 04:32 Emotional Impact on Care Providers 06:41 Navigating End-of-Life Conversations 12:17 Practical Applications in Intensive Care 16:41 The Pause: A Tool for Reflection 21:58 Conclusion and Final Thoughts The Guest - Matt Hooper Matt is an accomplished intensive care specialist with a diverse background in emergency medicine, prehospital & retrieval medicine, and palliative care. Notable for his leadership in developing critical care service models, he founded South Australia’s MedSTAR Emergency Medical Retrieval Service. He has also co-authored a highly regarded case-based text book and held key teaching and examining roles nationally and internationally in prehospital and retrieval medicine. With a strong focus on high-performance teams working within high acuity, high consequence environments, Matt's expertise has also extended to human factors in healthcare, cardiothoracic intensive care, ECMO, and clinical ultrasound. More recently however, he has pivoted towards palliative and end of life care, pursuing a Master's degree at Cardiff University and consulting at Mary Potter Hospice in Adelaide. He is passionate about exploring new and innovative ways to prevent potentially avoidable suffering and enhance end of life outcomes for patients in acute care clinical environments.…
T
The St.Emlyn’s Podcast

1 Ep 257 - Ten Second Triage with Sean Brayford Harris at Tactical Trauma 24 19:46
19:46
나중에 재생
나중에 재생
리스트
좋아요
좋아요19:46
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe speak with Sean Brayford Harris, a paramedic and interoperability development officer with the London Ambulance Service, about the development of the 10 second triage tool—a new, streamlined method for triaging casualties in high-stress environments like major incidents. They discuss its creation and implementation, including collaboration with the Metropolitan Police and other emergency services. Key points include the shortcomings of the previous 'sieve and sort' system, the challenges of developing a simplified tool, and the benefits of this new approach for non-medical first responders. The episode emphasizes the importance of cross-team collaboration in emergency scenarios and the potential impact of the tool on reducing distress and improving outcomes for both responders and patients. 00:00 Introduction 00:37 Background on Major Incident Triage 01:01 Challenges with Existing Triage Systems 01:15 Designing the 10 Second Triage Tool 05:16 Implementing the Triage Tool 06:50 How the 10 Second Triage Tool Works 13:48 Real-World Applications and Benefits 18:54 Conclusion and Final Thoughts…
T
The St.Emlyn’s Podcast

1 Ep 256 - Monthly Update November 2024 - Learning Culture, Chest Drains, Arterial Lines and more 31:53
31:53
나중에 재생
나중에 재생
리스트
좋아요
좋아요31:53
During Winter's Challenges, Iain Beardsell and Simon Carley reviewed the November 2024 blog posts for St Emlyn's podcast, marking the start of 2025. They discuss the busy state of emergency departments, critical incidents, and the importance of maintaining a learning culture. They highlight the upcoming Big Sick Conference in Zermatt and the IncrEMentuM in Spain, noting their potential benefits for networking and education. Simon emphasizes creating a psychologically safe environment and fostering curiosity, growth, and knowledge-sharing among emergency department staff. They also review a range of medical studies, including those on small bore vs. large bore chest tubes for haemothorax, intra-arrest arterial blood pressure monitoring, and the new GLP-1 receptor antagonists for obesity treatment. Lastly, they address the importance of handling bad behavior in the team and maintaining kindness and professionalism, even during high-stress periods. 00:00 Introduction and New Year Greetings 00:35 Current State of Emergency Departments 01:17 Upcoming Conferences: The Big Sick and IncrEMentuM 03:43 Building a Learning Culture in Emergency Medicine 12:24 Pre-Hospital ECPR and ECMO 13:58 Small Bore vs Large Bore Chest Tubes 17:37 Intra-Arrest Arterial Blood Pressure Monitoring 24:01 New Drugs and Toxicology 24:47 Care in the Hot Zone 27:12 Addressing Bad Behaviour in Emergency Departments 30:42 Conclusion and Future Plans for St Emlyn's…
T
The St.Emlyn’s Podcast

1 Ep 255 - Likelihood Ratios: Critical Appraisal Nugget 12 11:30
11:30
나중에 재생
나중에 재생
리스트
좋아요
좋아요11:30
In this episode of the St. Emlyn's podcast, Rick Body and Greg Yates delve into the concept of likelihood ratios, an advanced yet practical tool for diagnosing patients in the emergency department. Building on the previous episode about predictive values, they explain how likelihood ratios help compare the probability of test results between diseased and non-diseased patients. They provide examples, like evaluating chest pain and using the Smith Calculator for Anterior ST Elevation, to show how likelihood ratios can change clinical decision-making. Rick and Greg also discuss Bayesian reasoning and how pretest and post-test probabilities are used in practice. 00:00 Introduction to the Podcast 00:34 Understanding Likelihood Ratios 02:05 Practical Example: Chest Pain Case 03:53 Calculating Likelihood Ratios 07:17 Applying Bayesian Reasoning 09:50 Recap and Conclusion…
T
The St.Emlyn’s Podcast

1 Ep 254 - Monthly Round Up October 2024 - Toxicology, Cardiac Arrest and more 27:02
27:02
나중에 재생
나중에 재생
리스트
좋아요
좋아요27:02
In this episode of the St Emlyn's podcast, Iain Beardsell and Simon Carley provide a comprehensive update for October 2024. They discuss key blog posts covering diverse medical topics, including highlights from the Royal College of Emergency Medicine's academic science conference focusing on toxicology, high-potency opioids, novel benzodiazepines, and the use of flumazenil. They also explore the Green ED project and the impact of climate change on healthcare. Additionally, they delve into recent research on ventricular fibrillation pad positions, the use of tranexamic acid (TXA) in trauma care, and the importance of maintaining a positive outlook amidst winter challenges by seeking small wins and engaging in enjoyable aspects of emergency medicine. The episode offers valuable insights and updates for emergency medicine professionals. 00:00 Welcome and Introduction 01:27 Highlights from the Royal College of Emergency Medicine Conference 01:50 Toxicology Insights: High Potency Opioids and Benzodiazepines 05:11 Climate Change and Healthcare: The Green ED Project 08:23 Medical Conferences: A Phoenix from the Ashes 10:38 Ventricular Fibrillation and Pad Position: New Insights 17:22 Tranexamic Acid (TXA) in Trauma Care 24:01 Maintaining Positivity in Challenging Times…
T
The St.Emlyn’s Podcast

1 Ep 253 - Highlights from the London Trauma Conference 2024 19:45
19:45
나중에 재생
나중에 재생
리스트
좋아요
좋아요19:45
In this episode of the St Emlyn's podcast, Iain Beardsell and Natalie May reflect on their experiences at the London Trauma Conference, a four-day event covering various aspects of trauma and pre-hospital care. They discuss key takeaways from sessions on cardiac arrest, including talks on perioperative cardiac arrest and the prognostication of cardiac arrest patients. The episode also delves into wellness in the medical field, featuring insights from senior emergency physician Rod McKenzie and pre-hospital expert Matt Hooper on practical psychosocial care. Additionally, the podcast highlights advancements in trauma care, defibrillation strategies, and the importance of correct pad placement and basic practices. The episode underscores the holistic approach to patient care and the significance of personal well-being for medical professionals. 00:00 Welcome to the St Emlyn's Podcast 00:52 Highlights from the London Trauma Conference 01:13 Cardiac Arrest Symposium Insights 03:53 Prognostication After Cardiac Arrest 06:44 Defibrillation Strategies and Basics 08:29 Wellness and Mental Health in Emergency Medicine 11:10 Palliative Care in Pre-Hospital Settings 12:32 Trauma Conference Highlights and Innovations 16:48 Poster Presentations and Stand-Up Science 17:58 Key Takeaways and Reflections 18:43 Closing Remarks…
T
The St.Emlyn’s Podcast

1 Ep 252 - ECMO in Trauma with Chris Bishop at Tactical Trauma 24 13:51
13:51
나중에 재생
나중에 재생
리스트
좋아요
좋아요13:51
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe are joined by Chris Bishop, a clinical research fellow at the Centre for Trauma Sciences at Queen Mary University of London. Chris discusses his PhD research on veno-arterial ECMO support for cardiogenic shock following major trauma haemorrhage and explains the principles and applications of ECMO, particularly in trauma patients. The conversation covers the current practices, challenges, and future directions in the use of ECMO for trauma care, including multidisciplinary decision-making, patient selection criteria, and pioneering techniques like selective aortic arch perfusion and emergency preservation and resuscitation. 00:00 Introduction 01:12 Understanding ECMO and Its Applications 02:20 ECMO in Trauma Patients 04:17 Challenges and Resistance in ECMO Adoption 05:36 Current Research and Practices 11:31 Future Directions in Trauma Resuscitation 13:28 Conclusion…
T
The St.Emlyn’s Podcast

1 Ep 251 - Bad Behaviours in Teams with Liz Crowe at Tactical Trauma 24 18:14
18:14
나중에 재생
나중에 재생
리스트
좋아요
좋아요18:14
This episode, recorded live at Tactical Trauma 24 explores the concept of bad behaviour within high-performing medical teams. Liz Crowe , who will be well known to regular listeners, discusses what constitutes bad behaviour, its impacts on team dynamics and patient safety, and the importance of self-awareness among medical professionals. Key findings from recent research highlight that even subtle actions like eye-rolling can negatively affect patient safety as much as overt harassment. The speaker emphasises the importance of psychological safety, trust, competence, authenticity, consistency, and empathy in maintaining a healthy team environment. Practical advice includes assessing one's own behaviour and seeking honest feedback from colleagues and loved ones. Comprehensive show notes are available here 00:00 Introduction: Addressing Bad Behaviour 01:18 Defining Bad Behaviour 01:49 Impacts of Bad Behaviour 03:15 Psychological Safety and Team Dynamics 04:24 Personal Experiences and Observations 05:46 Types of Bad Behaviour 07:19 Research Findings on Workplace Behaviour 09:10 Self-Awareness and Behavioural Impact 14:21 The Karpman Drama Triangle 17:29 Conclusion and Final Thoughts…
T
The St.Emlyn’s Podcast

1 Ep 250 - Monthly Round Up September 2024 - Patient Experience in the ED, Dirty Adrenaline, and More! 28:55
28:55
나중에 재생
나중에 재생
리스트
좋아요
좋아요28:55
In this episode of the St Emlyn's podcast, Iain Beardsell and Simon Carley discuss various facets of emergency medicine. They highlight a study on patient experience in emergency departments , focusing on issues like loss of autonomy, unmet expectations, and vulnerability. Suggestions for improvement include better communication, effective signage, and patient comfort. The podcast also covers a ' dirty adrenaline drip ' study from Australia, emphasizing remote inotrope management. Discussions include the use of arterial blood pressure monitoring in pre-hospital settings and the merits of CT scans beyond the traditional six-hour window for diagnosing subarachnoid haemorrhage. The episode wraps up with reflections on the positives of emergency medicine and the importance of maintaining enthusiasm and mastery in the field. 00:00 Introduction 01:08 Patient Experience in the Emergency Department 02:33 Improving Patient Experience: Practical Tips 04:05 Qualitative Studies in Healthcare 06:43 Dirty Adrenaline Drip: A Practical Insight 10:44 Emergency Endoscopy for Caustic Ingestions 14:15 Subarachnoid Hemorrhage Diagnosis: The S.H.E.D. Study 18:14 Arterial Blood Pressure Monitoring in Pre-Hospital Settings 24:18 Reflections on Emergency Medicine as a Career 27:41 Conclusion…
T
The St.Emlyn’s Podcast

1 Ep 249 - Care in the Hot Zone with Claire Park at Tactical Trauma 2024 24:32
24:32
나중에 재생
나중에 재생
리스트
좋아요
좋아요24:32
In this episode, recorded live at Tactical Trauma 2024 , Dr Claire Park explores the critical lessons learned from civilian and military incidents, focusing on her extensive experience in the Army and their role as chief investigator in a UK trial examining responses to terrorist attacks. The talk covers the significance of 'hot zones,' illustrated by detailed analyses of the London Bridge and Fishmongers' Hall attacks and key topics include risk assessment, the importance of rapid medical intervention, the concept of survivability, the need for integrated communication among emergency services, and the human factors influencing decision-making in high-pressure environments. Claire also delves into practical strategies like the 10-second triage and bridging interventions, emphasizing the need for timely and effective medical responses to save lives. 00:00 Introduction to Learning from Incidents 01:52 Setting the Scene: Hot Zones 01:55 Case Study: London Bridge Attack 04:23 Understanding Hot Zones 05:51 Case Study: Fishmongers Hall 07:58 Risk Assessment in Pre-Hospital Care 09:23 Communication and Coordination Challenges 10:16 International Models and Time Management 12:13 Triage and Life-Saving Interventions 15:18 Data and Research on Causes of Death 21:43 Human Factors in Emergency Response 24:00 Conclusion Dr Claire Park is a consultant in pre-hospital emergency medicine for London's HEMS, as well as anaesthesia and critical care medicine at Kings College Hospital in London. She also is an army consultant with over 20 years of deployed military experience. Claire is the Medical Adviser to the Specialist Firearms teams of the Metropolitan Police Service and has worked closely with all of the emergency services in London on developing the joint response to high-threat incidents, particularly following the attacks of 2017. She is the Chief Investigator on a UK nationally-funded research grant looking at evidence for improving patient outcomes in the hot zone of major incidents. She is also a CTECC Committee member.…
T
The St.Emlyn’s Podcast

1 Ep 248 - Prehospital eCPR with Alice Hutin at Tactical Trauma 2024 14:29
14:29
나중에 재생
나중에 재생
리스트
좋아요
좋아요14:29
Join Iain Beardsell and Liz Crowe in an engaging discussion with Alice Hutton, an emergency physician from Paris, at Tactical Trauma 24 in Sundsvall, Sweden. The episode delves into the implementation and logistics of pre-hospital eCPR (Extracorporeal Cardiopulmonary Resuscitation) by SAMU in Paris. Alice shares insights from her PhD research on refractory cardiac arrest and discusses the use of therapeutic hypothermia, including experimental approaches like total liquid ventilation. Key topics include team composition, decision-making for patient eligibility, real-time management strategies, bypassing traditional emergency rooms for specialized facilities, and the challenges of scene management, family communication, and post-event debriefing. This conversation offers a comprehensive look at the latest innovations that could transform pre-hospital emergency medical services. Read more here ... 00:00 Introduction and Guest Introduction 01:29 eCPR in Paris: Current Practices 02:35 Dispatch and Response Protocols 03:32 On-Scene Procedures and Challenges 04:23 Decision Making and Scene Management 05:53 Training and Handling Difficult Situations 06:59 Challenges of eCPR Decision-Making 08:07 Importance of Team Debriefing 08:52 Post-Resuscitation Procedures 10:12 Operational Logistics and Success Rates 11:20 Innovative Research in Therapeutic Hypothermia 13:13 Future of Pre-Hospital Cooling Techniques 13:46 Conclusion and Final Thoughts…
T
The St.Emlyn’s Podcast

1 Ep 247 - August 2024 Round-Up - Goldilocks Moments, Nasal Analgesia, and Public Health in the ED 20:59
20:59
나중에 재생
나중에 재생
리스트
좋아요
좋아요20:59
In this episode of the St. Emlyn's podcast, hosts Iain Beardsell and Simon Carley share their insights from recent conferences, including Gateshead's RCEM scientific conference, Tactical Trauma 24 in Sweden, and the Premier Conference. They explore 'Goldilocks moments' for executing life-saving procedures in critical care, emphasizing optimal timing for interventions like thoracotomies. The episode also discusses innovative training methods like shadowboxing to enhance decision-making in high-stress medical scenarios. In addition, they review a significant trial on smoking cessation in emergency departments, highlighting its potential role in broader public health initiatives, including sexual health and HIV screening. Discussions also cover various pain management strategies, such as the use of intranasal vs. intravenous Ketorolac for renal colic. The hosts critique the traditional peer review process in medical research and advocate for open peer review to support equitable and accessible scientific publishing. 00:00 Introduction and Catching Up 02:07 The Goldilocks Moment in Critical Care 05:25 Training and Decision-Making in Emergency Procedures 07:23 Smoking Cessation in Emergency Departments 10:07 Challenges in Implementing Preventive Health Strategies 10:38 Successful Public Health Projects in Emergency Medicine 11:19 Exploring Alternative Interventions in Emergency Departments 11:52 Highlights from the Premier Conference 12:54 Intranasal Ketorolac for Pain Management 15:46 The Future of Peer Review in Medical Research 20:09 Concluding Thoughts and Upcoming Content…
T
The St.Emlyn’s Podcast

1 Ep 246 - Simulation for Elite Team Performance with Andrew Petrosoniak at Tactical Trauma 2024 20:13
20:13
나중에 재생
나중에 재생
리스트
좋아요
좋아요20:13
In this episode, recorded at Tactical Trauma 2024, Andrew Petrosoniak discusses real-world experiences in trauma care, and the innovative use of simulation to resolve systematic issues in blood delivery and overall trauma resuscitation protocols. Key takeaways include the concept of intelligent failure, reducing cognitive overload for medical staff, and the creation of efficient medical environments. Moreover, the episode delves into the significant improvements achieved through simulation, such as a 50% reduction in blood delivery times, and the integration of performance data to enhance CPR and clinical space design. Emphasizing the importance of using data to drive improvements, the conversation explores the implementation of roles like a CPR coach and the scalable application of these practices across individual, team, and systemic levels. Listeners are encouraged to view failures constructively and leverage simulations and data for better patient outcomes and team performance. 00:00 Introduction to Simulation in Emergency Medicine 01:05 A Real-Life Trauma Case 02:18 Identifying Systemic Issues 02:46 Implementing and Testing Solutions 05:45 The Concept of Intelligent Failure 09:41 Scaling and Impact of Simulation 10:22 The Power of Simulation in Experimentation 10:56 Data Integration in Healthcare and Sports 11:29 Evaluating CPR Quality Through Simulation 12:14 Using Data to Improve Clinical Performance 13:47 Designing Clinical Spaces with Simulation Data 15:28 Scaling Impact with Simulation 18:02 Efficient Team Communication in Trauma Bays 19:04 Broadcasting and Recording Simulations for Education 19:39 Conclusion and Future Directions The Speaker Dr. Andrew Petrosoniak is an emergency physician and trauma team leader at St. Michael’s Hospital and an Assistant Professor in the Department of Medicine at the University of Toronto. He has completed a Master of Science in medical education where he focused on the use of in situ simulation (practice in the actual workplace) in procedural skill acquisition. Andrew’s field of research includes in situ simulation and simulation-based technical skill acquisition. His work focuses on usability testing and the identification of personnel- and systems-based safety threats within acute care medicine. He is the principal investigator of the TRUST study (Trauma Resuscitation Using in Situ simulation for Team Training) that includes a partnership with human factors experts to evaluate systems and processes during high-stakes trauma simulations.…
T
The St.Emlyn’s Podcast

1 Ep 245 - Leading through failure with Kevin Cyr at Tactical Trauma 2024 34:00
34:00
나중에 재생
나중에 재생
리스트
좋아요
좋아요34:00
Recorded at Tactical Trauma 2024, in this episode of the St. Emlyn’s podcast, Iain Beardsell and Liz Crowe sit down with Kevin Cyr , commander of a SWAT-like unit in the Royal Canadian Mounted Police, to discuss leadership, failure, and resilience in high-stakes environments. Kevin shares the powerful story of a tragic hostage situation that resulted in the unintended death of the hostage by the police, a failure of the highest order. Through this tragedy, Kevin highlights the importance of visible leadership, team resilience, and learning from failure in both law enforcement and healthcare settings. Key Themes: 1. Handling Failure in High-Pressure Situations: Kevin discusses a significant incident where a hostage was killed by his SWAT team during a rescue attempt, describing it as the “epitome of failure.” This tragic event not only made national news but left an indelible mark on the team. The podcast dives into the lessons learned from this event and how the team used it to drive growth and improvement. In healthcare, much like in policing, failure can feel devastating and highly public, but it’s also a critical aspect of development for teams and leaders. 2. Visible Leadership and Unwavering Support: In the aftermath of a traumatic event, Kevin emphasizes the importance of leadership being present and supportive. He recounts how he and his commanding officer went to visit the officers involved in the shooting immediately after the event, providing what he calls “unwavering support.” In healthcare, leaders should adopt similar strategies, offering visible and sustained support to their teams in the immediate aftermath of difficult cases. 3. Sustained Support Over Time: While initial support following a traumatic event is crucial, Kevin points out that it’s often after 48 hours, or even weeks later, that people start feeling isolated. Leaders must continue to check in with their teams weeks after the event, when the immediate crisis may have passed, but the emotional toll is still present. This ongoing visibility and emotional support are key to retaining staff and ensuring their well-being in both law enforcement and healthcare. 4. Debriefing to Learn, Not to Blame: Kevin advocates for a debriefing process that focuses on learning from failure rather than assigning blame. After their tragic event, his team didn’t just move on; they dissected the event to understand what went wrong and how to prevent similar failures in the future. In healthcare, this process is equally valuable—debriefs should aim to identify learning opportunities and reinforce positive actions, not to point fingers. 5. The Role of Organizational Culture: Kevin touches on how organizational apathy, or a lack of emotional and psychological support, can cause more damage than the actual traumatic event itself. He highlights the importance of developing a high-trust environment where team members feel safe to express vulnerability. In healthcare, fostering a culture of open communication and mutual support is essential to prevent burnout and moral injury. 6. The Value of Failure in Team Growth: One of the most profound insights Kevin shares is the idea that failure is a necessary part of growth. Three years after their tragic hostage situation, his team was called to a similar event, but this time they were successful in rescuing both hostages. Kevin attributes this success directly to the lessons learned from their earlier failure, emphasizing that failure, when handled correctly, can lead to transformational change. 7. Selection and Resilience in High-Performance Teams: Kevin discusses the importance of selecting team members with high emotional intelligence and the humility to ask for help when needed. He explains how his team differentiates between rank and role, giving autonomy to those with the most subject matter expertise, regardless of their rank. In healthcare, this is a critical point—leaders must recognize that true leadership isn’t just about authority, but about empowering others to take charge when appropriate. 8. Managing Expectations and Mental Health: The episode also delves into how individuals in high-stakes roles, whether in policing or healthcare, cope with the psychological aftermath of traumatic events. Kevin explains how his team has shifted from the belief that emotional support is unnecessary to recognizing the value of helping team members process their experiences in a healthy way. This parallels the increasing focus in healthcare on preventing burnout and ensuring emotional well-being through proactive support. Key Takeaways: - Failure is Inevitable: In high-stakes environments like policing and healthcare, failure will happen. What matters is how teams respond to failure—learning from it, growing stronger, and preventing future mistakes. Leadership Requires Visibility: Leaders must be present, especially in the aftermath of failure. Showing unwavering support and maintaining visibility over time is crucial for maintaining team morale and trust. - Debriefing to Learn: After a failure, it’s essential to have structured debriefs that focus on learning and improving, rather than blaming. This helps teams identify areas of improvement and ensures they grow stronger from difficult experiences. - Long-Term Support is Critical: Immediate support after a traumatic event is important, but equally important is sustaining that support over time, checking in with team members weeks or even months later to ensure their well-being. - Resilience through Humility: Teams should be built on trust and humility, where members can ask for help when needed and offer help to others. Selecting individuals with high emotional intelligence is key to creating a resilient team. - Failure Leads to Growth: When handled correctly, failure can drive transformational change within teams. It allows for the development of new skills and ensures that teams are better prepared for future challenges. Quotes: - “Failure is a necessary part of growth. It’s not just something to get over, it’s something you get better from.” - “Visible leadership and unwavering support are critical in the immediate aftermath of failure. Your team needs to know you’re there with them.” - “Debriefing to learn, not to blame, is essential. We must focus on what went well, what went wrong, and how to improve next time.” - “In high-pressure environments, we can’t control every variable, but we can control how we respond to them and how we prepare for the future.”…
T
The St.Emlyn’s Podcast

1 Ep 244 - July 2024 Monthly Update - Chest Pain, REBOA, Lidocaine patches and lots of paediatric emergency medicine 27:03
27:03
나중에 재생
나중에 재생
리스트
좋아요
좋아요27:03
In this episode, hosts Iain Beardsell and Simon Carley provide the St Emlyn's podcast blog update for July 2024. They discuss their recent experiences, including Simon's trip to Malaysia for the MRCEM exams and Iain's upcoming attendance at the Tactical Trauma conference in Sweden. The main topics include a systematic review on the Manchester Acute Coronary Score (MACS) and its application in emergency departments, the potential influence of AI in diagnosing occlusive myocardial infarctions through ECGs, and guidelines for managing non-fatal strangulation cases. Additionally, they touch on the feasibility of using lidocaine patches for elderly patients with rib fractures and the role of partial REBOA in pre-hospital care for exsanguinating subdiaphragmatic haemorrhage. They also highlight informative segments from the premier conference on pediatric emergency medicine, covering topics such as eating disorders, hybrid closed-loop insulin pumps, and button battery ingestion. Finally, they emphasize the importance of understanding medical statistics and using diagnostic tests effectively in emergency medicine practice. 00:00 Introduction and Summer Updates 00:55 Upcoming Conferences and Events 01:44 Manchester Acute Coronary Score (MACS) Review 05:30 AI in ECG Analysis with Steve Smith 08:18 Non-Fatal Strangulation Awareness 10:45 Reboa: Pre-Hospital Use and Insights 14:11 Pediatric Emergency Medicine Highlights 14:36 Eating Disorders and Diabetes Management 19:00 Lidocaine Patches for Rib Fractures 21:46 Critical Appraisal and Medical Statistics 24:28 Button Battery Ingestion Dangers 26:12 Conclusion and Farewell…
T
The St.Emlyn’s Podcast

1 Ep 243 - The Subarachnoid Haemorrhage in Emergency Department (SHED) Study 41:22
41:22
나중에 재생
나중에 재생
리스트
좋아요
좋아요41:22
In this episode of the St Emlyn's podcast, Iain Beardsell is joined by Dan Horner , a consultant in Emergency Medicine and Neurocritical Care, and Tom Roberts , an Emergency Medicine Registrar and clinical lecturer, to discuss their recently published SHED study on subarachnoid haemorrhage in the Emergency Department (ED). This landmark study, published in the Emergency Medicine Journal, explores the safety of CT scans in diagnosing subarachnoid haemorrhage up to 24 hours after headache onset and evaluates the role of further investigations like a lumbar puncture. The study examines acute severe headache presentations in the ED and the diagnostic approach to ruling out subarachnoid haemorrhage, a critical and often feared diagnosis among emergency physicians. Conducted through the Trainee Emergency Research Network (TURN), the study included over 3,600 patients from 88 UK EDs with acute severe headaches reaching maximum intensity within one hour and no focal neurology. Data collection included CT scans, lumbar puncture results, and 28-day follow-up to identify missed cases of subarachnoid hemorrhage. Key findings from the study revealed a 6.5% prevalence of subarachnoid haemorrhage, with a significant number presenting within six hours of headache onset. The sensitivity of CT scans remained high beyond the traditional six-hour window, suggesting that CT alone could safely rule out subarachnoid haemorrhage up to 18 hours in many cases, potentially reducing the need for lumbar puncture. The risk of missing an aneurysmal subarachnoid haemorrhage after a negative CT was found to be extremely low, around 1 in 1,000. These findings challenge the routine use of lumbar puncture in patients presenting beyond six hours if the CT scan is negative, potentially changing ED practice and reducing unnecessary invasive procedures. The discussion also emphasized the importance of shared decision-making and recognizing that diagnostic testing is about managing probabilities, not certainties. For clinicians, the episode highlights the need to expedite CT scans for patients with acute severe headaches, especially those presenting within 10 minutes of onset, as they are more likely to have significant pathology. Emergency physicians are encouraged to own the decision-making process for ruling out serious causes of headaches and not defer solely to 'specialists'. The SHED study supports extending the diagnostic window for CT scans in ruling out subarachnoid hemorrhage up to 18 hours, reducing the need for lumbar puncture in many cases. This data empowers emergency clinicians to make informed decisions, manage patient expectations, and streamline ED processes. For more information, listeners are encouraged to read the SHED Study in the Emergency Medicine Journal and explore the related blog post on the St Emlyn’s website. Emergency clinicians are also invited to connect with TERN to get involved in future research opportunities. This episode provides valuable insights for clinicians in managing acute severe headaches, emphasizing a more nuanced approach to subarachnoid hemorrhage diagnosis and the importance of clinical decision-making in the ED.…
T
The St.Emlyn’s Podcast

1 Ep 242 - Prehospital Neuroprotection with Ed Langford at PREMIER 2024 11:09
11:09
나중에 재생
나중에 재생
리스트
좋아요
좋아요11:09
In this episode, we delve into the critical role of neuroprotection in pre-hospital care, particularly in pediatric head injuries. Through a real-life case study of a 13-year-old boy who suffered a traumatic brain injury after being hit by a car, we explore the steps taken by paramedics and critical care teams to stabilize him and prevent further neurological damage. From airway management to advanced interventions, this episode highlights the challenges of pre-hospital neuroprotection and the incredible teamwork that led to the patient’s remarkable recovery. There is more detail on the full blogpost here. This podcast was recorded live at the Hope Church in Winchester as part of the PREMIER conference . We are grateful to the organizing team for hosting us and allowing us to use the audio. The PIER and PREMIER websites are full of amazing resources for anyone working in Paediatric Emergency Medicine, and we highly recommend them. The Speaker Ed is a Speciality Trainee in Emergency Medicine in Wessex and a trainee Critical Care Practitioner with Dorset and Somerset Air Ambulance . Ed is also the co-founder and Managing Director of Enhanced Care Service s, a Southampton-based company delivering enhanced and critical care to the event medical sector, providing frontline ambulance services across Hampshire and clinical education at all levels, employing over 200 clinicians. Ed holds the Diploma in Immediate Medical Care (RCSEd) and, having promised to not take on any more work, is currently undertaking a Masters in Resuscitation, Pre-hospital and Emergency Medicine at QMUL. Enhanced Care Services Enhanced Care Services ' mission is to provide and influence excellent patient care, irrespective of injury, illness or location, through the delivery of high-quality clinical operations and education. Founded in 2015, ECS now provide frontline ambulance operations across the South, delivers extensive medical cover to some of the most prestigious events across the UK and provides education from its bespoke education centre in Southampton and beyond.…
T
The St.Emlyn’s Podcast

1 Ep 241 - Paediatric Palliative Care with Tim Warlow at PREMIER 2024 10:51
10:51
나중에 재생
나중에 재생
리스트
좋아요
좋아요10:51
In this episode, Dr Tim Warlow, a consultant in Paediatric Palliative Care, explores the complexities of caring for children with life-limiting conditions in the emergency department (ED). The discussion highlights the increasing prevalence of paediatric life-limiting conditions and the growing medical complexity of these cases, which pose significant challenges for ED staff. The episode begins by clarifying what paediatric palliative care truly involves. Contrary to common misconceptions, palliative care is not about withdrawing care but rather enhancing the quality of life for children from the point of diagnosis, whether the condition is present from birth or develops as the child deteriorates. This proactive approach often involves increasing the level of care and support as the child’s needs evolve. As the number of children with life-limiting conditions continues to rise, EDs are encountering more medically complex cases, including children who are technology-dependent and require high levels of care at home. These challenges are compounded by the evolving expectations of parents, who are often better informed and more involved in their child's care decisions. Post-COVID, community services have struggled to recover, particularly in nursing support, making the role of the ED even more critical. The episode provides practical tips for ED professionals to better manage these cases. Key strategies include: Recognising Life-Limiting Conditions: With over 400 recognized life-limiting conditions and many more undiagnosed, it’s crucial to assess whether a child might have palliative care needs. Listening to Families: Families often have an intimate understanding of their child’s unique medical baseline. Listening deeply to their insights, even when they seem unusual, is essential for providing appropriate care. Building Rapid Rapport: Quickly establishing a connection with the family is vital, as these children can deteriorate rapidly. Acknowledging the child’s presence, summarizing the situation, and validating the family’s experience can help build trust. Understanding the Child Beyond Their Illness: Families worry that healthcare professionals only see their child when they are unwell. Taking the time to learn about the child’s life outside of the hospital can lead to better care decisions. Reading the Advanced Care Plan: If available, review the child’s advanced care plan before discussing the case with the family. This ensures that the family doesn’t have to recount their entire journey and that care decisions are based on the most current information. The episode also addresses the importance of being aware of unconscious prejudice. Healthcare professionals must ensure that decisions are based on the child’s specific needs rather than assumptions about their quality of life due to their disability. In conclusion, the episode emphasizes that while caring for children with life-limiting conditions in the ED is challenging, it is also deeply rewarding. The key to providing excellent care lies not just in medical interventions but in being present, listening, and supporting the family through difficult times. Whether things go as planned or not, your presence and compassion are what families remember most. This episode is a must-listen for anyone involved in pediatric care, offering valuable insights into the critical role of the ED in supporting children with life-limiting conditions and their families. There is more detail on the blogpost here.…
T
The St.Emlyn’s Podcast

1 Ep 240 - June 2024 Monthly Round Up - Nebulised Ketamine, Risky Intubations, Better Presentations, DSED, Preoxygenation and more 33:52
33:52
나중에 재생
나중에 재생
리스트
좋아요
좋아요33:52
As the UK enjoys its unpredictable summer, with everything from sunshine to hailstorms, we bring you a mix of updates and discussions on emergency medicine, blog content, upcoming conferences, and insightful research reviews. So, whether you're basking in the sun or sheltering from the rain, sit back and enjoy our latest insights into the world of emergency medicine. In this round-up of Month Year, we talk about a wide range of issues relating to emergency medicine, including nebulised ketamine for analgesia in the ED, risky intubations, presentation skills, more about the DOSE VF trial and analysis of the much-hyped PREOXI trial about preoxygenation before tracheal intubation. We're excited to announce our participation in two upcoming conferences. The Tactical Trauma Conference in Sweden this October promises to delve into pre-hospital emergency medicine, offering sessions from renowned speakers. It's a fantastic opportunity to learn and network, with flights to Sweden being relatively affordable. The event takes place just north of Stockholm, providing a chance to explore the beautiful city. In March next year, we look forward to the Incrementum Conference in Murcia, Spain. This is a significant event as emergency medicine has recently been recognized as a specialty in Spain. The conference will feature an impressive lineup of speakers from the FOMED world, including Scott Weingart, Ken Milne, Hany Malamatt, and Slim Resie , among others. Our very own Simon Carly will also be presenting. We'll be there to conduct interviews and gather exclusive content for our listeners. Thank you for joining us, please do like and subscribe wherever you get our podcasts.…
T
The St.Emlyn’s Podcast

1 Ep 239 - Button Battery Ingestion with Francesca Steadman at PREMIER 2024 15:54
15:54
나중에 재생
나중에 재생
리스트
좋아요
좋아요15:54
In this podcast from the PREMIER conference 2024 , Francesca Stedman, a consultant paediatric surgeon from Southampton Children's Hospital discusses the care of the child who has ingested a button battery. Button batteries are ubiquitous and come in various types and sizes. There are about 85 different kinds available or in use in the UK alone, found in everything from toys to hearing aids. The most notorious is the CR2032, which is about 20 millimeters in diameter and 3.2 millimeters thick. It contains lithium manganese oxide, and while its small size makes it convenient for electronics, it poses a significant risk if ingested. The danger with button batteries lies in their potential to cause severe injuries when lodged in the esophagus. They can cause necrosis, which is essentially tissue death, due to a strong alkaline substance produced by the battery. This substance acts like a potent oven cleaner, rapidly causing damage. The esophagus has three natural narrowing points where these batteries often get stuck, increasing the likelihood of injury. The situation becomes critical very quickly, often within two hours of ingestion. One of the most concerning aspects of these incidents is that button battery ingestions are rarely witnessed. Children might present with vague symptoms like drooling, difficulty swallowing, or even just being generally unwell. These can easily be mistaken for other common illnesses, leading to delays in diagnosis. In one particularly harrowing case, a child presented multiple times with symptoms of a respiratory infection, only for an x-ray to reveal a button battery lodged in the esophagus. By then, the damage was extensive. When ingestion is suspected, immediate action is crucial. Getting a chest x-ray is the first step, and if necessary, a lateral x-ray can confirm the presence of a button battery by revealing a characteristic double rim or halo sign. Pre-hospital measures can include giving honey or jam, depending on the child’s age, to help mitigate the damage. However, these should never delay getting the child to the hospital. Once at the hospital, the primary goal is to remove the battery as quickly as possible to prevent further injury. Depending on the location of the battery and available specialists, either ENT surgeons or paediatric surgeons may perform the removal. Post-removal care involves monitoring for complications like perforations or fistulas, which can develop days or even weeks later. In severe cases, these injuries can lead to life-threatening conditions, such as aorto-esophageal fistulas, which require immediate surgical intervention. In summary, button battery ingestion is a serious and often underappreciated risk. Even in homes where precautions are taken, accidents can happen. The key is quick recognition and action. As parents and caregivers, we need to be vigilant about keeping these small, dangerous objects out of children's reach. And if an accident does occur, immediate medical attention is essential to minimize the risk of serious injury. More details are available on the blogpost here .…
T
The St.Emlyn’s Podcast

1 Ep 238 - Positive and Negative Predictive Values: Critical Appraisal Nugget 11:15
11:15
나중에 재생
나중에 재생
리스트
좋아요
좋아요11:15
In this St. Emlyn's podcast, Rick Body and Greg Yates, continue our exploration of diagnostic test accuracy, shifting our focus to positive predictive value (PPV) and negative predictive value (NPV). These concepts are vital for anyone preparing for exams or looking to enhance their application of diagnostic tests in clinical practice. While our last podcast discussion centred on sensitivity and specificity, PPV and NPV offer a different, arguably more clinically practical perspective on interpreting test results. Positive predictive value (PPV) and negative predictive value (NPV) are essential tools for understanding the effectiveness of diagnostic tests. PPV helps us determine the likelihood that a patient with a positive test result actually has the condition, whereas NPV helps us gauge the probability that a patient with a negative test result does not have the disease. These values are crucial for making informed clinical decisions, particularly when considering the prevalence of a condition in the population. Today, we’ll delve into these concepts, their practical applications, and why it's important to consider both PPV and NPV alongside sensitivity and specificity. You can find more about this on the St Emlyn's Blog and please don't forget to like and subscribe.…
T
The St.Emlyn’s Podcast

1 Ep 237 - Hybrid Closed Loop Insulin Pumps with Nicola Trevelyan at PREMIER 2024 14:52
14:52
나중에 재생
나중에 재생
리스트
좋아요
좋아요14:52
In today's episode, taken from live recordings at PREMIER 2024 , we dive into an increasingly common treatment for type 1 diabetes: hybrid closed loop insulin pumps. We'll begin with a brief overview of traditional insulin pumps and explain how hybrid closed loops are different. The core of our discussion will be centered around three case studies, illustrating potential scenarios you might encounter in a pediatric emergency department and how to manage them effectively. With NICE's recent technology appraisal advocating for universal access to hybrid closed loop systems for all type 1 diabetes patients, it's crucial to understand these devices. Over the next few years, you'll likely encounter these systems frequently. We'll cover the essentials of how these pumps work, their benefits, and potential issues that might arise, such as connectivity problems, cannula issues, and handling intercurrent illnesses. Join us as we explore the revolutionary impact of hybrid closed-loop systems, which offer better glucose control and significantly improve the quality of life for those with type 1 diabetes. Dr Nicola Trevelyan has been the Clinical Lead for the Paediatric Diabetes Service in Southampton for the last 20 years. During this time, she has seen huge changes in the management of CYP with diabetes. She has been involved in several large multicentre trials for paediatric diabetes, helping to better our understanding of how best to use new technologies in diabetes management in children and move forward access to new treatment technologies. She was one of the founding committee members for the Assoc of Children's Diabetes Clinicians (ACDC) in 2006 and has been on working parties for BSPED helping evidence base and re-write the national DKA guidelines in 2020 and for the National Paediatric Diabetes Audit. For the last 4 years, she has been on the Clinical Advisory Group for the RCPCH Quality Improvement Programme for Paediatric Diabetes.…
T
The St.Emlyn’s Podcast

1 Ep 236 - Occlusive Myocardial Infarction, ECGs and AI with Steve Smith 27:39
27:39
나중에 재생
나중에 재생
리스트
좋아요
좋아요27:39
It was a huge pleasure to sit down with Steve Smith, a name synonymous with ECG expertise. Steve, renowned worldwide for his influential ECG blog, has been a pivotal figure in advancing our understanding of ECGs. Many of us have honed our ECG skills thanks to Steve’s insights. I had the opportunity to meet Steve about a decade ago at one of the SMACC conferences . Today, we delve into the fascinating world of occlusive myocardial infarction (OMI) and its comparison to STEMI (ST-elevation myocardial infarction), and explore the promising future of artificial intelligence in ECG interpretation. In this special episode of the St Emlyn's podcast, we explore the concept of occlusive myocardial infarction (OMI) and its distinctions from ST elevation myocardial infarction (STEMI). Dr. Smith discusses his extensive work and experience in emergency medicine, spanning over three decades, and his development of Dr. Smith's ECG blog. The conversation dives into the limitations of traditional STEMI criteria and the benefits of adopting the OMI paradigm. Additionally, they discuss the revolutionary potential of artificial intelligence in ECG interpretation, particularly through the Queen of Hearts program developed in collaboration with Powerful Medical. Dr. Smith shares compelling studies and real-world applications demonstrating the efficacy of AI in diagnosing ECGs, ultimately offering a promising future for enhanced patient outcomes. 00:00 Introduction 01:43 Steve Smith's Journey in Emergency Medicine and ECGs 02:45 The Evolution of ECG Diagnosis: From STEMI to OMI 03:55 Challenges and Resistance to the OMI Paradigm 07:10 Key Indicators of Occlusive Myocardial Infarction 09:25 The Role of Artificial Intelligence in ECG Diagnosis 11:03 Development and Implementation of the Queen of Hearts AI 14:28 Clinical Studies and Real-World Applications 21:10 Future Prospects and Final Thoughts A comprehensive blog post with references is available here…
T
The St.Emlyn’s Podcast

1 Ep 235 - Eating Disorders in the Emergency Department with Anna Kyle at PREMIER 2024 16:25
16:25
나중에 재생
나중에 재생
리스트
좋아요
좋아요16:25
In this episode of the St Emlyn's podcast, Iain Beardsell introduces a talk by Anna Kyle, a consultant paediatrician from Somerset, delivered at the Premier conference in June 2024. Anna explores the complexities of assessing and managing eating disorders in young patients, including young adults. Highlighting the critical nature of eating disorders, she notes a 90% increase in admissions over five years and emphasizes the deadly risks, particularly anorexia nervosa with its 10% lifetime mortality rate. Kyle provides detailed guidance on recognizing symptoms, conducting risk assessments, and the importance of a thorough medical evaluation. She also touches on the MEAD guidance for managing eating disorders, stressing effective communication with patients and their families, and the critical role of empathy and support throughout the treatment process. 00:00 Introduction to the Podcast 01:03 The Deadly Nature of Eating Disorders 02:23 Medical Complications of Eating Disorders 05:08 Cardiovascular and Other Systemic Effects 07:22 Risk Assessment and MEAD Guidance 10:23 Communication and Management Tips 15:24 Conclusion and Final Thoughts Comprehensive notes can be found here…
T
The St.Emlyn’s Podcast

1 Ep 234 - May 2024 Monthly Round Up - RCEM conference highlights, being EPIC and more 35:09
35:09
나중에 재생
나중에 재생
리스트
좋아요
좋아요35:09
Welcome to the St Emlyn's Monthly Podcast, your go-to source for the latest insights, developments, and discussions in emergency medicine and critical care. Each month, Simon and Iain will bring you in-depth analysis, evidence-based practices, and practical advice to enhance your clinical practice and professional development. In this round-up of May 2024, we talk about a wide range of issues relating to emergency medicine, including highlights from the RCEM conference , including the future management of head injury, crowding, RATing and what it takes to be an awesome ED for training. There's also advice on how to be a epic Emergency Physician In Charge , as well as discussion about the use of ChatGPT for medical exams , serratus anterior blocks for rib fractures , whether first pass success matters and the return of measles . Thank you for joining us, please do like and subscribe wherever you get our podcasts.…
T
The St.Emlyn’s Podcast

1 Ep 233 - Sudden Cardiac Death with Harshil Duptia at PREMIER 2024 19:18
19:18
나중에 재생
나중에 재생
리스트
좋아요
좋아요19:18
The sudden death of anyone is a tragic event, but even more so a child, particularly when it comes completely unexpectedly. We've all seen stories in the papers or even been involved in caring for these young people. In this podcast Harshil Dhutia talks about the common causes fo sudden cardiac death, and gives a roadmap for the investigation of young people with worrying symptoms and ongoing care for their families. There are more details in the comprehensive post on the St Emlyn's blog site This podcast was recorded live at the Hope Church in Winchester as part of the PREMIER conference. We are grateful to the organising team for hosting us and allowing us to use the audio. The PIER and PREMIER websites are full of amazing resources for anyone working in Paediatric Emergency Medicine and we recommend them highly. The Speaker Harshil Dhutia is a consultant cardiologist at Glenfield Hospital, University Hospitals of Leicester the lead for inerited cardiac conditions service in the region, providing specialist care for patients with genetic heart diseases and their family members. He is a International Board of Heart Rhythm Examiners certified heart rhythm specialist for all aspects of cardiac device implantation and management including pacemakers, defibrillators and cardiac resynchronisation therapy. He is an expert in sports cardiology and has extensive clinical and research interests in the management of competitive and recreational athletes with cardiovascular disease. He is the medical lead for the Joe Humphries Memorial Trust , a Leicestershire based charity that raises awareness of sudden cardiac death in young people and provides cardiovascular resuscitation and AED training in schools, sports clubs and to members of the community.…
T
The St.Emlyn’s Podcast

1 Ep 232 - April 2024 Monthly Round Up - Bougies, cardiac arrest, trauma, sepsis, race and medicine and choosing with intention 30:11
30:11
나중에 재생
나중에 재생
리스트
좋아요
좋아요30:11
Welcome to St Emlyn's Monthly Round Up Podcast, your go-to source for the latest insights, developments, and discussions in emergency medicine and critical care. Each month, Iain and Simon bring you in-depth analysis, evidence-based practices, and practical advice to enhance your clinical practice and professional development. You can find an in-depth set of shownotes on St Emlyn's. Please do also like and subscribe, wherever you get your podcasts. This month's content includes... Introduction 00:00 - 00:34 Do Bougies increase first pass success? 00:34 - 04:28 Cardiac arrest management - dual sequence defibrillation, personalised care and drones for AEDS. 04:28 -10:50 Trauma - Cardiac tamponade vs exsanguination 10:50 - 13:35 Sepsis - effect of the microcirculation 13:35 - 15:23 A history of race and medicine 16:54 - 18:36 Differential attainment 18:37 - 19:27 What can we do about addressing EDI issues? 19:28 - 22:20 Choosing with intention 20:21 - 26:55 The ARC-H Principle 26:56 - 28:32 Closing thoughts 28:33 - 30:10 Recommended Conferences Premier Conference - 11th-12th June 2024, Winchester Tactical Trauma 24 - 7th-9th October, Sundsvall, Sweden RCEM Annual Scientific Conference…
플레이어 FM에 오신것을 환영합니다!
플레이어 FM은 웹에서 고품질 팟캐스트를 검색하여 지금 바로 즐길 수 있도록 합니다. 최고의 팟캐스트 앱이며 Android, iPhone 및 웹에서도 작동합니다. 장치 간 구독 동기화를 위해 가입하세요.