He almost didn't come in.

45 years old. At the gym. Mid-set on the bench press when it happened. Something detonated inside his head. Peak intensity in under two minutes. Worst headache of his life. Five words. Everything stops.

In this episode we walk through the full assessment of a subarachnoid haemorrhage — why thunderclap headache is a red flag you cannot minimise, why up to 50% of SAHs are missed at first presentation, the CT timing rule that changes everything, why the lumbar puncture must wait at least 12 hours and what you're actually looking for when you do it, and what happens the moment the scan confirms blood.

The patients who get missed are not the dramatic ones. They're the ones who look fine, feel embarrassed about coming in, and get sent home with analgesia.

Don't be the doctor who sends them home.

First Bleep — scenario-based clinical teaching for junior doctors. Real calls. Real learning. Ten minutes at a time.

Disclaimer : First Bleep is for educational purposes only and does not constitute clinical guidance. Always follow your trust guidelines, your senior colleagues, and your own clinical judgment. Medicine is contextual — what works for one patient may not work for another. If in doubt, ask.

This is the First Bleep SHO Series — same patient as Episode 02A, completely different job.

In this episode: how to present a fracture in trauma meeting in under thirty seconds and actually sound like you know what you're doing. Weber classification and why it matters for surgical planning. What to cover when consenting for ORIF — including the honest conversation about returning to sport. Post-operative ward round essentials, compartment syndrome red flags, and the discharge planning that stops the readmission.

SHO Series — for the doctor who owns the patient after the emergency is over.

In this episode we discuss about trimalleolar ankle fracture-dislocation and the thing most junior doctors get wrong — the fracture is not the emergency. The dislocation is.

We walk through the full ED assessment of a trimalleolar ankle fracture-dislocation. The neurovascular check you must do before and after reduction. Why the pale tented skin is a countdown clock. How closed reduction works and what your role in it is. And why a backslab — never a full cast — goes on after.

Same patient next week from the orthopaedic SHO's perspective. Trauma meeting prep, Weber classification, surgical consent, and post-op management. Two episodes. Two completely different jobs.

Disclaimer : First Bleep podcast is for educational purposes only, and does not constitute clinical guidance. Always follow your trust guidelines , your senior colleagues and your own clinical judgement.

It's 2am. The ED calls. 83-year-old. Found on the kitchen floor. On warfarin. Right hip. Shortened and externally rotated.

What do you do first?

In this episode we walk through the full ED assessment of a neck of femur fracture — analgesia, the guidelines, what to do about the warfarin, and how to hand over to the orthopaedic team in a way that actually helps.

This is First Bleep — scenario-based clinical teaching for junior doctors. Real calls. Real learning. Ten minutes at a time.

Before the bleeps, before the scenarios, before 2am — this is where it starts.

First Bleep is a podcast for junior doctors that teaches clinical medicine through storytelling. Not lectures. Not revision. Real scenarios, real decisions, ten minutes at a time.

In this intro episode: what First Bleep is, who it's for, how it works, and why it exists. If you're an F1, F2, core trainee, or final year medical student who wants to feel more prepared for the wards — this is the show.