The end of specialty training is an eagerly awaited moment for a huge number of trainees across the globe. This important step is usually marked by a frequently dreaded “exit exam” where trainees are expected to prove their skills and competencies within their chosen specialty. In 1996, a new exam emerged for Emergency Medicine (EM) […]
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Black Wednesday or the hunting season in the NHS
The first Wednesday of August in England is known by some observers of the NHS as ‘Black Wednesday’, the more cynical ones calling it the start of ‘the killing season’. Recent studies show there are 6 – 8% more patient deaths in the first week of August than in the last week of July. […]
January Primary Survey
Here are the highlights from this month’s issue… Location, location, location Five departments in the South West replied to a survey to see if they followed the CEM guidelines about having immediate availability of antidotes to a variety of poisoning agents. The questions asked if they knew were the antidotes were, […]
December Primary Survey
Here are the highlights from this month’s issue… Ophthalmoscopy in the Emergency Department Ophthalmoscopy is a difficult but essential skill in the Emergency Department environment. In this short report, the panOptic ophthalmoscope was compared to traditional direct ophthalmoscopy in conditions comparable to those found in most EDs. While the newer instrument was preferred, […]
Consultant delivered care: thoughts from one of the authors
In this short blog, Aruni Sen shares his thoughts on a retrospective study he conducted with some of his colleagues around a 24/7 senior clinician delivered emergency care and the reactions from the profession. The philosophy we strive for in the care we offer in the Emergency Department at Wrexham Hospital is that […]
ED = Exhausted Doctors?
ED attendances are increasing at a phenomenal rate worldwide. This, along with staff shortages has resulted in an ever-growing mob of exhausted and dissatisfied staff members. Exhaustion can result in worsening patient care and even lead to serious medical errors. The European Working Time Directive (EWTD) have succeeded in capping average weekly hours, but 13-hour […]
Crew Resource Management in the ED
The brave new world of major trauma centres (MTCs) is here; most Emergency Departments (EDs) are planning for them, be it reassurance (and relief?) for smaller ones as trauma patients are whisked off to the local MTC, or the increased workload for the new MTCs as ambulances head to their doors. Changes of this nature […]
On how the Internet changed medicine in the 21st century…
Do you remember that really irritating patient that came to ED at 3AM with a five-month history of neck pain, saying that the web told her that she might have a subarachnoid bleed? You probably thought – who the hell are you to self-diagnose – I am the doctor, not you! The rapid propagation of […]
Withholding and withdrawing care in acute care: a better death?
Ars Moriendi (“The Art of Dying”) is the name of two Latin texts from the Middle Age – the time of the Black Death. They give advice on a good death. They told readers what to expect, and prescribed prayers, actions, and attitudes to achieve a “good death” and salvation. The belief that death is the […]