Nuances of Neurogenic Shock

Even when the mechanism is highly suggestive for significant spinal injury, the shocked major trauma patient is haemorrhaging until proven otherwise; cue blood products and damage control resuscitation. When there is no evidence of external haemorrhage in the primary survey, the EFAST is negative, and the trauma series CT shows no evidence of bleeding, a […]

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The weekend effect: Part 2 – a traumatic time!

If you haven’t already, listen to Ellen Weber and Chris Moulton talk about the background to the weekend effect. Click HERE. The UK Junior Doctors’ contract changes imposed by the government in order to shape their poorly defined ‘Seven Day NHS’ caused much debate and consternation surrounding the ‘weekend effect’, which seemed to be the […]

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How Junior Doctors Think: A Guide for Reflective Practice

In the UK, junior doctors will rotate through emergency medicine in their second year post-graduation (Foundation Year 2). They’re granted autonomy to make independent decisions and ‘own’ patients for the first time. Elsewhere in the hospital, a junior’s role is largely secretarial, and generally within the confines of ‘normal working hours’. In the ED, the hours are brutal, the […]

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ECG Marksmanship: Posterior Wellen’s Syndrome

One of the most rewarding elements of emergency medicine is spotting a potentially catastrophic situation at an early stage, and proceeding to ‘nip it in the bud’ before things start getting hairy. To coin a military analogy: a battalion might be perfectly capable of neutralising the enemy in close-quarters combat, but in an ideal world, […]

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Should More Emergency Physicians be ‘Piloting British Airways’? The Musings of a Trainee: EMJ

Emergency physicians (EPs) routinely manage the sick, undifferentiated patients in whom life-saving interventions need to be executed rapidly. Our Royal College defines emergency medicine as ‘the specialty in which time is critical.’ In severe illness or injury, ‘A’ comes first. Securing a definitive airway is the gateway to the rest of critical care; without one, our […]

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