RCEM Learning

Maegan Ladell, a pediatric emergency medicine physician and patient safety researcher, shares her insights on fostering a culture of patient safety. She delves into the complexities of diagnostic errors, emphasizing the influence of hindsight bias in high-stakes decision-making. Ladell critiques traditional error analysis methods and advocates for a systems-thinking approach that considers the interplay of human behavior and healthcare systems. This engaging discussion highlights the necessity for a more nuanced understanding of medical errors to improve patient care in emergency settings.

Happy March! This month for the March 2025 episode of the RCEM Learning Podcast starts with an update from Rob. We have Andy and Dave talking about oxygen targets in trauma in the TRAUMOX2 RCT. Becky and Chris talk about a BOAST orthopaedic guideline for the management of lateral patella dislocation. We interview Raine Astin-Chamberlain about sex, gender and pregnancy in research and then finally, as always, New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:26) New in EM - Oxygen targets in trauma Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Randomized Clinical Trial (Arleth et al., 2025) (18:59) Guidelines for EM - BOAST guidelines for lateral patella dislocation BOAST - Assessment and Management of First Time Lateral Patellar Dislocation (FTLPD) (BOAST, 2024) (45:09) Sex, gender and pregnancy in research - Raine Astin-Chamberlain Sex and gender reporting in UK emergency medicine trials from 2010 to 2023: a systematic review (Astin-Chamberlain et al., 2025) (01:03:37) New Online – new articles on RCEMLearning for your CPD Psychological support in the ED - Charlotte Davies Beyond the Tick Box - Embracing Reflective Practice - Chris Walsh Foreign Bodies in Ears and Noses: Practi cal Tips for ED Management - Charlotte Davies and Olu Adenugba Retaining ED staff: Policy, practice and research perspectives Retaining ED staff: Policy, practice and research perspectives - book your tickets

In a festive twist for Valentine’s Day, hosts explore the PERC-35 rule for diagnosing pulmonary embolism in younger patients, highlighting key studies and their implications. They also dive into guidelines for handling glucocorticoid-induced adrenal insufficiency, emphasizing the complexities faced by healthcare professionals. Discussions include the challenges of serum glucocorticoid management in emergencies and the vital importance of careful monitoring. Lastly, they touch on pediatric care insights, particularly on dehydration assessment and evaluating pregnant patients.

Becky Maxwell, an expert in emergency medicine, and Chris Connolly, an emergency medicine physician, dive deep into the updated NICE guidelines on acute kidney injury (AKI). They emphasize the importance of timely imaging and collaboration across specialties for improved patient outcomes. The duo also navigates the challenges of diagnosing kidney issues, including creative alternatives for obtaining ultrasounds. Additionally, they tackle the complexities of assessing febrile infants and the evolving clinical decision aids that support physicians in pediatric emergency care.

In this festive discussion, the hosts explore innovative surgical techniques for treating hemorrhagic strokes, including minimally invasive methods. They tackle the pressing issues of acute pain management in emergency settings, stressing the importance of a pain-vigilant culture and effective communication among healthcare professionals. The revival of the BestBETS project aims to enhance evidence-based practices in emergency medicine. Listeners are also invited to reflect on the past year while looking forward to 2025 and upcoming conferences.

This month for the November 2023 episode of the RCEM Learning Podcast we're focusing on the RCEM ASC. Rob and Liz talk through their favourite talks from the conference and then we move on to our RCEM ASC Interview Megamix where I speak with thirteen presenters about their work from the RCEM ASC. This is going to be a mix of paediatric and adult EM, so feel free to have a look at the timestamps if you want to get to the stuff that is most relevant to you - I'd recommend you listen to it all! If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! Submit an abstract to the EMTA Conference EMTA Conference 2025 - Bristol, 26-27th February 2025 Submit an abstract here (direct link) by 27th November (07:54) RCEM ASC Interview Megamix (07:54) Cath Taylor - Using livestreaming phones in the ambulance service (17:10) Phil Cowburn - The Major Incident Ten Second Triage Tool (23:25) Mark Macmillan - Whole-body CT scanning in older injured patients (29:42) Leilah Dare - Using GIRFT data to implement change (38:10) Ben Clarke - TERN Update and the UnCORKED study (49:38) Alison Porter - Using qualitative research in emergency medicine (58:10) Christopher Humphries - Cannabinoids and tailoring your anti-emetic selection (01:05:42) Steve Goodacre - Diagnosing acute aortic syndrome and the ASES study (01:10:57) Tom Waterfield - PERUKI Update (01:20:18) Shrouk Messahel - CRESCENT Study (01:29:16) Damian Roland - Bronchstart, bronchiolitis, and vaccination (01:39:34) Dave McCreary - Introducing a culture of paediatric point of care ultrasonography (01:50:10) Emma Lim - Spotting Sepsis in the PED Further Links and Reading Cath Taylor - The SEE-IT Trial: emergency medical services Streaming Enabled Evaluation In Trauma: a feasibility randomised controlled trial Phil Cowburn - National Ambulance Resilience Tool - Ten Second Triage Leilah Dare - Getting It Right Time - SEDIT Ben Clarke - TERN Research Ben Clarke - TERN UNCORKED Expression of Interest Form Christopher Humphries - RCEM Guideline - Suspected Cannabinoid Hyperemesis Syndrome in Emergency Departments Steve Goodacre - The ASES Study Tom Waterfield - PERUKI Shrouk Messahel - The CRESCENT Trial Damian Roland - Bronchstart David McCreary - ResearchGate Emma Lim - RCPCH Paediatric Sepsis Podcasts Emma Lim - Lancet Paediatric Sepsis Series

Ryan McHenry, an Emergency Medicine registrar and clinical research fellow, and Kath Aspidon, a Consultant in Emergency Medicine, delve into the EM at the Deep End project. They explore the transformative use of peripheral hypertonic saline in emergencies, sharing insights on its safety and dosages. The discussion also critiques defibrillation strategies for refractory ventricular fibrillation, emphasizing innovative techniques like dual sequential defibrillation. Additionally, they highlight the importance of communication tools for supporting patients with learning disabilities in healthcare settings.

Becky and Chris, contributors to emergency medicine, delve into the latest NICE guidelines for meningitis, highlighting diagnostic challenges, particularly in young populations. They also discuss how non-invasive ventilation (NIV) can enhance pre-oxygenation during rapid sequence intubation. Dan Horner, a former TERN Fellow, provides insights from the Subarachnoid Hemorrhage study in emergency settings. The conversation emphasizes the importance of continuous learning and adapting new protocols to improve patient outcomes.

Becky, an expert in Emergency Medicine, and Chris, a contributor to opioid toxicity guidelines, discuss new approaches to managing opioid toxicity. They dive into the alarming rise of opioid-related deaths and the importance of naloxone in emergency settings. The conversation also covers the comparison of high flow nasal cannulas versus non-invasive ventilation in treating COPD patients. Their insights highlight the evolving strategies in emergency care, particularly related to opioids and respiratory illnesses.

This month dives into febrile infant algorithms, exploring their performance based on fever duration. It also tackles the management of sickle cell crises in emergency settings. A lively debate unfolds over the use of absorbable versus non-absorbable sutures for facial lacerations, backed by recent clinical studies. Insights into healthcare culture and professional development round out the discussion, emphasizing the importance of collaboration and ongoing education in emergency medicine.