The St.Emlyn’s Podcast

Patients often come to us with the fundamental question: "Doctor, what's wrong with me?" Our goal is to provide an answer through history, examination, and tests. Let's explore what it means to make a diagnosis in emergency medicine. The Role of Diagnosis in Emergency Medicine In day-to-day practice, making a diagnosis often means applying a label to a patient. This label helps us decide on the next steps, whether to treat or reassure and send them home. In emergency medicine, we frequently focus on ruling out serious conditions rather than confirming them. This approach allows us to prioritize immediate life-threatening issues and manage resources effectively. Working Backwards: Ruling Out Serious Conditions Our primary concern in emergency medicine is to identify conditions that can kill quickly, often within hours. Therefore, we start by ruling out the most serious conditions first. Diagnostic tests, including history and physical examination, play a crucial role in this process. Every question we ask and every examination we perform are part of our diagnostic strategy, aiming to rule out or confirm serious illnesses. Sensitivity and Specificity in Diagnostic Testing Understanding diagnostic tests involves two key concepts: sensitivity and specificity. Sensitivity refers to a test's ability to correctly identify those with the disease (true positives). High sensitivity means that a negative test result is reliable for ruling out the disease. Specificity measures a test's ability to correctly identify those without the disease (true negatives). High specificity means that a positive test result is reliable for confirming the disease. For example, a D-Dimer test for thrombotic disease is highly sensitive. It picks up most cases of the disease but also includes some false positives. Conversely, a highly specific test like jaw claudication for temporal arteritis has very few false positives but isn't useful as a broad screening tool because only a small percentage of patients with the disease exhibit this symptom. The Importance of Probability and Risk In emergency medicine, we rarely achieve 100% certainty in diagnosis. Tests with 98% sensitivity, for instance, still miss 2% of cases. This level of uncertainty is part of our practice, and we must communicate it effectively to patients. Explaining the probabilistic nature of diagnosis helps patients understand the limitations of medical testing and the importance of follow-up if symptoms persist or worsen. Balancing Diagnosis and Treatment The consequences of diagnosing and treating a condition vary. For life-threatening conditions like myocardial infarction (MI), the treatment involves significant interventions such as thrombolysis or PCI, which carry their own risks. Therefore, we need a high degree of certainty before initiating such treatments. In contrast, diagnosing a viral sore throat, which requires minimal intervention, demands less certainty. Continuous Learning and Improvement Reflecting on our diagnostic processes is crucial for improvement. Recognizing that we work in a probabilistic environment helps us balance the need for thorough investigation with the risk of over-testing. By continuously learning and refining our approach, we can enhance patient care and outcomes. Favourite Diagnostic Tools To conclude, let's talk about our favorite diagnostic tools. Personally, I appreciate the value of ultrasound in the resuscitation room, especially for diagnosing pneumothorax in trauma patients. It's a quick, effective tool that guides immediate intervention. Simon, on the other hand, highlights the D-Dimer test. Despite its controversial reputation, it serves as a prime example of a test that, when understood and used correctly, can be incredibly valuable. We hope this podcast has provided some insight into the complexities and nuances of diagnosis in emergency medicine. Stay tuned for our next episode, where we'll delve deeper into the probabilistic nature of diagnosis and how we make informed decisions in the emergency department. Until then, take care and continue to enjoy your practice in emergency medicine. More listening about diagnosis Podcast – Diagnosis in Emergency Medicine Part 1 – SpIN and SnOUT Podcast – Diagnosis in Emergency Medicine Part 2 – Beyond a simple yes or no Podcast – Diagnosis in Emergency Medicine Part 3 – The importance of prevalence

St. Emlyns Podcast: Get Ready for SMACC Chicago Welcome to the St. Emlyns podcast! I'm Simon Carly, and with me is Ian Beetzel. We are emergency physicians from the UK, deeply involved with the St. Emlyns team. After years of bringing you insightful content through our blog, we’ve now ventured into podcasting. Today, we’re excited to talk about the upcoming SMACC Chicago conference. What Makes SMACC Chicago Special? SMACC (Social Media and Critical Care) conferences are renowned for their exceptional blend of academic excellence and engaging presentation styles. These events are meticulously organized by Roger Harris, Oli Flower, and Chris Nixon, who have a track record of creating unforgettable experiences. Key Highlights: Innovative Format: Unlike typical conferences, SMACC sessions are designed to be performances that make learning enjoyable. It’s like attending a theatre production that educates you at the same time. Top-Notch Speakers: The conference attracts world-class speakers who are leaders in their fields, ensuring you gain the latest insights and practical knowledge. Engaging Content: From rigorous scientific discussions to thought-provoking talks on how we think and feel, SMACC covers a broad spectrum of topics in an engaging manner. Building Anticipation for SMACC Chicago The excitement for SMACC Chicago is building rapidly. On social media platforms like Twitter, the buzz is palpable. Professionals are planning their study leave a year in advance, highlighting the significance and allure of this event. Such anticipation underscores the conference's reputation and the high expectations attendees have. Importance of UK Representation We believe it's crucial for UK emergency medicine professionals to be well-represented at SMACC Chicago. Despite some recent negative press, UK emergency medicine is pioneering, and showcasing this on an international stage is vital. We urge UK doctors, nurses, paramedics, and other emergency medicine professionals to join us in Chicago to demonstrate our strengths and innovations. Why You Should Attend SMACC Attending SMACC is not just about professional obligation; it’s a transformative experience. Here’s why you should consider joining us: Professional Growth: The conference offers a unique mix of academic rigor and practical knowledge. You'll return as a better clinician with the latest insights and techniques. Networking Opportunities: Connect with peers and experts from around the globe. The diverse group of attendees provides a rich environment for sharing experiences and building professional relationships. Inspiration and Motivation: The energy at SMACC is infectious. You'll leave inspired and motivated to implement new ideas and improve patient care. Reflecting on Past SMACC Conferences The previous SMACC conferences in Sydney and the Gold Coast set high standards: Sydney and Gold Coast Highlights: These conferences successfully blended social media engagement with academic learning. They featured both right-brain talks that explored cognitive and emotional aspects, and left-brain talks focused on scientific data and clinical practices. Interaction with Leading Researchers: Participants had opportunities to engage with top researchers like Steve Bernard, who discussed groundbreaking work and its implications for clinical practice. Looking Forward to SMACC Chicago The lineup for SMACC Chicago promises to be incredible, featuring: Cutting-Edge Resuscitation Techniques: Sessions will cover the latest advancements in resuscitation, looking ahead 10-15 years. Right-Brain Thinking Sessions: These will challenge attendees to think differently and become more holistic clinicians, regardless of their background—nursing, intensive care, paramedicine, or emergency medicine. Academic Rigor: High-quality academic content will be abundant, providing a wealth of knowledge to apply in your practice. Practical Information: Plan Your Trip Now is the time to start planning your trip to SMACC Chicago. Here are some tips: Book Study Leave Early: Given the excitement and demand, securing your study leave well in advance is crucial. Arrange Travel and Accommodation: Chicago is an amazing city with much to offer. Book your flights and accommodation early to get the best deals. Engage on Social Media: Stay updated with the latest news and announcements related to SMACC Chicago by following the conversation on Twitter and other platforms. Conclusion: Join Us at SMACC Chicago In summary, SMACC Chicago promises to be an unparalleled event in the world of emergency medicine. With its unique blend of academic excellence, engaging presentations, and networking opportunities, it’s an experience you won’t want to miss. We urge UK emergency medicine professionals to join us in Chicago. Your presence will not only enhance your professional development but also showcase the strength and innovation of UK emergency medicine on an international stage. Book your study leave, arrange your travel, and prepare for an unforgettable experience at SMACC Chicago. We look forward to seeing you there! Keywords: SMACC Chicago, St. Emlyns, emergency medicine conference, UK emergency medicine, professional development, medical conference 2024, resuscitation techniques, medical networking, medical education, emergency physicians, nursing, paramedics, intensive care. Tags: SMACC, St. Emlyns, emergency medicine, medical conference, professional growth, networking, medical education, Chicago 2024. Authors: Simon Carly and Ian Beetzel Stay tuned for more updates on the St. Emlyns podcast and blog. Follow us on Twitter for the latest news and insights in emergency medicine.

Welcome to the St Emlyn's Podcast: A New Chapter in FOAMed We're thrilled to announce the launch of the St Emlyn's podcast, bringing fresh perspectives and insights from the world of emergency medicine. I'm Iain Beardsell, and alongside Simon Carley, we're excited to extend our reach from the St Emlyn's blog to your favourite podcast platforms. Why a Podcast? The landscape of medical education is evolving, and while there's a plethora of excellent podcasts out there, there's a notable gap in UK-centric content. Our aim is to fill that void, offering a unique blend of clinical discussions, evidence-based medicine, and practical management tips tailored for emergency physicians in the UK and beyond. What is FOAMed? For those new to the term, FOAMed stands for Free Open Access Medical Education. It's a philosophy we deeply believe in: sharing knowledge, experiences, and lessons to improve patient care globally. FOAMed isn't just about free resources; it's about fostering a community where we can all learn from each other. What Makes St Emlyn's Podcast Unique? While we draw inspiration from giants like EMCrit and Scott Weingart, our podcast will provide a distinct UK perspective. Here's what you can expect: Evidence-Based Medicine: We'll dive deep into journal appraisals and discuss the latest research, making it relevant to our everyday clinical practice. Practical Clinical Tips: As practising clinicians, we bring real-world experience from our busy emergency departments, tackling the challenges we all face. Management Insights: Working in high-intensity, high-risk environments, we’ll share strategies on managing departmental flow, dealing with access block, and improving patient outcomes. Upcoming Episodes Our first few episodes will focus on diagnosis—a cornerstone of emergency medicine. We'll explore what makes diagnostic tests effective, how to interpret them, and why sometimes we just get lucky. Understanding these elements is crucial for any emergency physician aiming to excel in their field. Join Our Journey We’re not just podcasters; we're part of a broader community of emergency medicine professionals. We'll be featuring guests who are experts in their fields, sharing their insights and experiences. These aren't just any guests; they're some of the smartest and most renowned clinicians, who, unbeknownst to them, will soon be part of our podcasting journey. A Regular Dose of Education We plan to release episodes regularly, ensuring you have a steady stream of content to enhance your practice. Whether you're commuting, walking the dog, or just relaxing, our podcast will be a valuable addition to your routine. Stay Tuned Subscribe to our podcast on iTunes or your preferred platform, and keep an eye on the St Emlyn's blog for more updates. We look forward to embarking on this new journey with you, bringing the best of emergency medicine education to your ears. Thank you for joining us, and let's make this an engaging and enlightening experience for all.   You can listen to our podcast in numerous ways, ensuring you never miss an episode no matter where you are or what device you’re using. For the traditionalists, Apple Podcasts and Google Podcasts offer easy access with seamless integration across all your Apple or Android devices. Spotify and Amazon Music are perfect for those who like to mix their tunes with their talks, providing a rich listening experience. If you prefer a more curated approach, platforms like Podchaser and TuneIn specialize in personalising content to your tastes. For those on the go, Overcast and Pocket Casts offer mobile-friendly features that enhance audio quality and manage playlists effortlessly. Choose any of these platforms and enjoy our podcast in a way that suits you best!