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

Dive into a range of thrilling medical topics this month! Discover alarming trends in toxicology, focusing on high-potency opioids and innovative treatments for benzodiazepine overdoses. Learn about the Green ED project addressing climate change's impact on healthcare. New insights on the best ventricular fibrillation pad placements and the role of tranexamic acid in trauma care are also explored. Plus, find out how to maintain positivity in challenging times, emphasizing small victories and the joys of emergency medicine!

The podcast dives into insights from the London Trauma Conference, emphasizing advancements in trauma and cardiac arrest management. Discussions reveal evolving prognostication methods and the importance of defibrillation techniques. The speakers highlight the crucial role of wellness in emergency medicine, featuring experts on psychosocial care. They also address representation challenges in medical conferences and the significance of palliative care. Overall, it's a celebration of innovation and collaboration in the medical field.

Chris Bishop, a clinical research fellow at the Centre for Trauma Sciences, dives deep into veno-arterial ECMO and its critical role in trauma situations. He discusses current practices and challenges in the adoption of ECMO, compared to its more established pediatric use. The conversation highlights patient selection criteria and the importance of multidisciplinary decision-making. Innovative techniques like selective aortic arch perfusion and emergency preservation are explored, showcasing the future of trauma resuscitation in critical care.

Explore the hidden dangers of bad behavior within high-performing medical teams. Discover how subtle actions like eye-rolling can jeopardize patient safety just as much as overt harassment. The importance of psychological safety and self-awareness is emphasized for fostering a healthier team environment. Learn about the roles individuals play in team dynamics, and the necessity of authenticity and empathy. Practical advice highlights the significance of seeking honest feedback to enhance interpersonal relationships.

This conversation dives into patient experiences in emergency departments, tackling issues like autonomy loss and unmet expectations. Practical suggestions for enhancing comfort and communication are explored. The hosts discuss a fascinating study on dirty adrenaline drips, shedding light on remote inotrope management. They also examine the nuances of arterial blood pressure monitoring in pre-hospital scenarios. Lastly, there's a celebration of the resilience and fulfillment found within the emergency medicine community.

Dr. Claire Park dives into the vital lessons learned from civilian and military incidents, highlighting the chaos of the London Bridge and Fishmongers' Hall attacks. She discusses the importance of rapid medical interventions and the concept of survivability in hot zones. Key topics include integrated communication among emergency services and the psychological toll on first responders. Practical strategies like 10-second triage showcase how timely responses can save lives. Ultimately, the human element in trauma care is underscored, emphasizing clinician-patient interactions.

Alice Hutin, an emergency physician from Paris with a focus on refractory cardiac arrest and therapeutic hypothermia, shares her expertise. She discusses the logistics of implementing pre-hospital eCPR with SAMU in Paris, highlighting decision-making processes for patient eligibility and the importance of team communication. Alice also delves into innovative approaches like total liquid ventilation and the challenges of post-resuscitation care. This engaging conversation offers insights into how these advancements can revolutionize emergency medical services.

Hosts share insights from major medical conferences, exploring critical care's 'Goldilocks moments' for life-saving interventions. They discuss innovative training methods like shadowboxing for decision-making under pressure. The conversation highlights a pivotal smoking cessation trial in emergency departments, linking it to broader public health initiatives. Pain management strategies are examined, particularly comparing intranasal and intravenous Ketorolac. They also critique the traditional peer review process in medical research, advocating for more accessible and open practices.

Explore the innovative use of simulation in trauma care and its impact on blood delivery and resuscitation protocols. Discover the idea of 'intelligent failure' and how it helps reduce cognitive overload for medical professionals. Learn about significant improvements, including a 50% decrease in blood delivery times. The discussion highlights the integration of performance data in CPR evaluation and clinical space design, advocating for constructive views on failure and the scalable application of these practices in healthcare.