Steve Black, a data scientist with over 20 years of experience in emergency department analysis, shares fascinating insights about the history of ED performance. He discusses the evolution of the NHS A&E four-hour wait target and its implications for patient care. The conversation highlights rising waiting times and mortality rates, emphasizing systemic issues in healthcare. Steve also touches on the challenges of managing complex admissions, advocating for improved guidelines and training to enhance patient outcomes.
The STANDING algorithm enhances diagnostic accuracy for vertigo, demonstrating high sensitivity and specificity in emergency department evaluations.
Recent NICE head injury guidelines emphasize the need for CT scans in patients on anticoagulants, shifting traditional protocols to improve patient safety.
Discussions around the use of take-home topical anesthetics for corneal abrasions reveal significant specialty differences that warrant ongoing dialogue in emergency medicine practices.
Deep dives
ED Induction Resources for New Doctors
The episode highlights the significance of providing structured induction resources for new doctors entering emergency departments (EDs). An induction package on the Archem Learning website presents a wealth of educational modules covering various ED topics, from common conditions like abdominal pain to rare syndromes. This package aims to ease the transition for newcomers by familiarizing them with essential procedures and medical terminology. The hosts encourage established staff to guide new recruits to these resources for effective onboarding.
Use of the Standing Algorithm for Vertigo Assessment
A new segment explores the effectiveness of the standing algorithm for assessing vertigo, a condition that often perplexes medical professionals. The standing algorithm, validated in prior studies, boasts high sensitivity and specificity for identifying central causes of vertigo. The discussion also emphasizes the importance of proper patient examination techniques, including the use of Frenzel lenses to assess nystagmus more accurately. The need for a structured approach and continuous training for ED staff is underscored, emphasizing the potential benefits in diagnostic accuracy.
Advancements in ED Performance Data Analysis
A segment featuring Steve Black, a data scientist, delves into the historical context and future implications of performance data in emergency medicine. Black recounts his experiences analyzing emergency department data and shares insights into the importance of understanding the factors contributing to long wait times. The discussion emphasizes that most delays in patient care within the ED are often due to issues outside its walls, primarily related to patient admissions and hospital bed availability. Black advocates for a more nuanced approach to performance metrics, focusing on improving the overall efficiency of patient flow through the healthcare system.
Changes in Head Injury Guidelines
The episode reviews updates to head injury guidelines, notably around the use of CT scans for patients on anticoagulants and antiplatelets. The guideline now recommends considering scans for such patients, reflecting a significant shift in the previous protocol. The hosts discuss the practical implementation of these guidelines and the importance of shared decision-making with patients and their families in contexts where imaging may not be immediately necessary. They raise concerns about balancing patient safety with operational efficiency in emergency care settings.
Ophthalmological Perspectives on Topical Anesthetics
In another segment, the hosts analyze a study surveying ophthalmologists regarding the use of take-home topical anesthetics for corneal abrasions. The results indicate a strong reluctance among ophthalmologists to support their use, particularly when assessed by ED providers, despite acknowledging a more lenient stance when considering personal use. The discussion reflects on the potential for differing opinions between specialities and highlights the importance of understanding those perspectives when it comes to managing common conditions like corneal abrasions in the ED. The segment also emphasizes the need for ongoing dialogue about best practices in emergency medicine.
New Online Educational Resources
The podcast concludes by introducing three new online educational resources from the Arkem Learning website. One resource discusses strategies for making emergency departments more sustainable, addressing the pressing need for environmentally conscious healthcare practices. Another offers a comprehensive guide to syncope, detailing the complexities and management of this common presentation. Lastly, a dermatological examination guide is presented to aid emergency staff in accurately diagnosing skin conditions, bridging the educational gap often seen in dermatology training among ED professionals. These resources are seen as valuable tools for ongoing medical education.
This month for the August 2023 episode of the RCEM Learning Podcast we’ve got a New in EM segment looking at the STANDING Algorithm in Vertigo. We then continue hearing from Becky & Chris about the new NICE head injury guidelines which is the exciting conclusion to our two parter. We then have a discussion with Steve Black discussing the history of ED performance. We rejoin Andy & Dave for a New in EM looking at the use of take-away topical anaesthetics in corneal abrasion and then end with New Online. If you'd like to email us, please feel free to do so here.
(02:24) New in EM - The STANDING Protocol for Vertigo
