Provision of prompt, effective analgesia is rightly considered as a standard of care in the emergency department (ED). However, much suffering is not ‘painful’ and may be under-recognised.

A recent paper in EMJ looked to describe the burden of suffering in the ED and explore how this may be best addressed from a patient centred perspective. Ellen Weber talks to lead author Richard Body, Emergency Department Research Office, Manchester Royal Infirmary, to hear what they found.

Read the full paper:

http://goo.gl/kjs0x9

Dr Mundenga Mutendi Muller is a young doctor from Kindu province in the Democratic Republic of Congo (DRC), currently training in the Emergency Medcine Residency at Muhimbili National Hospital in Dar es Salaam, Tanzania. He was interviewed in Dar es Salaam by Ellen Weber, EMJ Editor. This is an excerpt of their conversation.

An edit of the conversation is also available as a EMJ article: http://emj.bmj.com/content/31/8/611.full

Clinicians use nonverbal cues from patients, including their facial expression content and variability, to make inferences about how ill a patient is. However the diagnostic accuracy of facial expressions as a method of physical diagnosis hasn't previously been scientifically examined.

Research just published in EMJ is the first to examine this question, and provides proof of concept that patients with serious cardiopulmonary disease processes manifest facial expressions with decreased variability and emotional content than patients with no serious cardiopulmonary diagnosis.

EMJ editor Ellen Weber discusses the findings with lead author Jeffrey Kline, professor in the Department of Emergency Medicine, Indiana University School of Medicine.

Read the full paper: http://goo.gl/MFvaxC

Cliff Mann, president of the College of Emergency Medicine, discusses how the college and the HEE are going to tackle the five major challenges in emergency medicine.

Our colleague Daniel Horner meets P Wells, a legendary figure in derivation of clinical prediction rules and author of the famous Wells scores for VTE. They discuss the difficulties in diagnosing VTE in pregnancy, the potential end of AVKs, and the future for VTE research.

Dan Horner, a research fellow from Manchester, talks to the person behind the Ottawa ankle, knee and Canadian c-spine rules. Ian Stiell is a professor of Emergency Medicine, clinical epidemiologist and chair of Emergency Research at the University of Ottawa.

They discuss implementation of decision rules in emergency medicine, current projects in Ottawa, the benefits of aggressive emergency department management of atrial fibrillation, and the unpublished findings from the recent Resuscitation Outcomes Consortium investigators about compression depth in cardiopulmonary resuscitation.

Janos P Baombe (EMJ associate editor) meets with Sir Keith Porter (professor in Clinical Traumatology at the University of Birmingham). They discuss the place of evidence based medicine in military care, lessons for civilian emergency medicine, the concepts of right turn resuscitation, damage control surgery, and consultant-delivered care in military emergency medicine.

Janos P Baombe (EMJ associate editor) talks to Nick Crombie (consultant trauma, plastic and burns anaesthetist, Queen Elizabeth Hospital, Birmingham) about errors in medicine and the emerging field of crew resource management.

See also:

Human factors and error prevention in emergency medicine http://bit.ly/17g7fXd

In this fifth episode of our podcast series Janos P Baombe (EMJ associate editor) meets with John Heyworth, immediate past president of the College of Emergency Medicine (CEM).

They discuss the issues around consultant-delivered clinical care, the acquisition of a new HQ, the bid for royal appellation and the issues faced by the specialty.

In this fourth episode of our podcast series Janos P Baombe, EMJ associate editor, meets with Meng Aw-Yong, chair of FASSGEM (the Forum for Associate Specialist and Staff Grade Doctors in Emergency Medicine).

They discuss the future of career grade doctors within emergency medicine, their worryingly declining numbers, opportunities for development and the difficulties faced by the “lost tribe”.