A summary of some of the best papers we published in the March 2023 issue of the Emergency Medicine Journal. EMJ's deputy editor Rick Body and social media editor Sarah Edwards talk through topics including biomarkers of traumatic brain injury, the limping child, hypothermia and sepsis in infants and the importance of avoiding secondary insults in patients intubated for traumatic brain injury in the prehospital environment.
Read the highlights: https://emj.bmj.com/content/40/3/157
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Primary Survey - the highlights of March 2023

Emergency Medicine Journal (EMJ) is an international peer review journal covering pre-hospital and hospital emergency medicine, and critical care. The journal publishes original research, reviews and evidence based articles on resuscitation, major trauma, minor injuries, acute cardiology, acute paediatrics, toxicology, toxinology, disasters, medical imaging, audit, teaching and reflections on clinical practice. The journal is aimed at doctors, nurses, paramedics and ambulance staff.

Medicine

Science & Medicine

Health & Fitness

“Social distancing is a privilege,” is the core message underlying the first paper brought by Sarah to this month’s roundup, as it unpacks the stark differences in COVID-19 outcomes across the spectrum of racial and ethnic groups in the United States. A second paper examines the returning rates of COVID patients across a large group of emergency departments in Canada, and the factors at play there. The final topic is one of Rick’s favourites, focusing on troponin testing in ambulances.
Articles discussed in this episode:
Pandemic phase-related racial and ethnic disparities in COVID-19 positivity and outcomes among patients presenting to emergency departments during the first two pandemic waves in the USA. Khosla S, Del Rios M, Chisolm-Straker M, et al. 
Characteristics and outcomes of patients with COVID-19 who return to the emergency department: a multicentre observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). Rosychuk RJ, Khangura JK, Ortiz SS, et al. 
Perceived barriers and opportunities to improve working conditions and staff retention in emergency departments: a qualitative study. Daniels J, Robinson E, Jenkinson E, et al.
Prehospital T-MACS and HEART scores in the prediction of myocardial infarction: a prospective evaluation. Cooper JG, Donaldson LA, Coutts AJ, et al.
 
The EMJ podcast is hosted by:
Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)
Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards)
You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Suspicious chest pain, inequality in COVID outcomes, and staff retention problems: April 2024 Primary Survey

A feast of aortic papers this month, including a study on missed aortic dissection diagnoses and an analysis of coroners' reports. Rick runs through the findings of an interesting study from the Trainee Emergency Research Network (TERN), and Sarah finishes off with a paper on predicting adverse outcomes in elderly patients with orthopaedic trauma.
Articles discussed in this episode:
Ohle R, Savage DW, Caswell J, et al. Mortality and risk factors associated with misdiagnosis of acute aortic syndrome in Ontario, Canada: a population-based study.
Hodgson S, O'Mahony K, Nicholson J, et al. Thematic analysis of ‘Prevention of Future Deaths’ reports related to emergency departments in England and Wales 2013–2022. 
McLatchie R, Reed MJ, Freeman N on behalf of the DAShED investigators, et al. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome.
Isaac CJ, Moore L, Bérubé M, et al. Predictors of adverse outcomes in elders hospitalised for isolated orthopaedic trauma: a multicentre cohort study.
 
Related links:
RCEM Learning: Aortic Dissection podcast.
Trainee Emergency Research Network.
 
The EMJ podcast is hosted by:
Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)
Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards)
You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Aortic dissection, coroners' court, and age-related outcomes: March 2024 Primary Survey

There's a lot of drugs to be talked about this month, and a heap of randomised control trials to be covered too. Rick and Sarah talk though the combining of nitrous oxide and fentanyl for sedation, the environmental impact of analgesics, the efficacy of acute heart failure treatment with high-dose and low-dose nitrates, and more newly published work from the latest issue of the journal.
 
Articles discussed in this episode:
Safety and efficacy of a nitrous oxide procedural sedation programme in a paediatric emergency department: a decade of outcomeshttps://emj.bmj.com/content/41/2/76
Environmental impact of low-dose methoxyflurane versus nitrous oxide for analgesia: how green is the ‘green whistle’?https://emj.bmj.com/content/41/2/69
High-dose versus low-dose intravenous nitroglycerine for sympathetic crashing acute pulmonary edema: a randomised controlled trialhttps://emj.bmj.com/content/41/2/96Trip-killers: a concerning practice associated with psychedelic drug usehttps://emj.bmj.com/content/41/2/112
Effect of intranasal sufentanil on acute post-traumatic pain in the emergency department: a randomised controlled trialhttps://emj.bmj.com/content/41/2/83
 
The EMJ podcast is hosted by:
Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)
Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards)
You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Trip killers, sympathetic crashing, and all sorts of sedatives: February 2024 Primary Survey

What are the questions to ask when dealing with acute behavioural disturbance? Join Sarah and Rick this month for a discussion of this difficult presentation. They also explore the topics of reducing low-acuity attendance, taking NHS 111 online, and the impact of a health coaching intervention for potentially recurrent attendees.Articles discussed in this episode:
Highlights of the January 2024 issuehttps://emj.bmj.com/content/41/1/1
Consensus on acute behavioural disturbance in the UK: a multidisciplinary modified Delphi study to determine what it is and how it should be managedhttps://emj.bmj.com/content/41/1/4
What impact would reducing low-acuity attendance have on emergency department length of stay? A discrete event simulation modelling studyhttps://emj.bmj.com/content/41/1/27
How could online NHS 111 reduce demand for the telephone NHS 111 service? Qualitative study of user and staff viewshttps://emj.bmj.com/content/41/1/34
Impact on all-cause mortality of a case prediction and prevention intervention designed to reduce secondary care utilisation: findings from a randomised controlled trial
https://emj.bmj.com/content/41/1/51
The EMJ podcast is hosted by:
Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)
Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards)
You can subscribe to the EMJ podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes page (https://podcasts.apple.com/us/podcast/emj-podcast/id445358244).

Managing acute behavioural disturbance, and some innovations in emergency care: January 2024 Primary Survey

Hear a summary of some of the best papers published in the December 2023 issue of the Emergency Medicine Journal. The podcast this month covers a trio of ultrasound papers addressing its use in the treatment of distal radial fractures, and thoracic and abdominal stab wound injuries. Featured also is a paper investigating the effectiveness of a predictive system for COVID-19 triage by telephone.
Read the highlights: https://emj.bmj.com/content/40/12/803 
 
The EMJ podcast is hosted by:
Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)
Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, UK (@drsarahedwards)
You can subscribe to the EMJ podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes page (https://podcasts.apple.com/us/podcast/emj-podcast/id445358244).

Primary Survey - the highlights of March 2023

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