Very sad to hear of the death of Douglas Chamberlain. A visionary, founder of paramedic training, tireless advocate for better prehospital care, founder of the Resuscitation Council and a great (if a bit scary!) teacher.

Extraordinary book. Written 1947. Describes precisely both the government and public reactions to the #COVID_19 pandemic. Should have been read by those in charge in 2019/20!

Just reminded of this great paper. 59.8% of non-trauma patients have midline cervical spine tenderness - such a non-specific sign. Seems more likely to mislead than help in trauma secondary survey. So why do I still feel the neck? emj.bmj.com/content/39/4...

Do we place too much reliance on NEWS2 score in our risk stratification in emergency care? Pretty poor ability to predict individual need for time critical treatment (or death). Maybe it’s a "one score cannot be right for all patients" problem? emj.bmj.com/content/earl...

Interesting suggestion of changing ‘significance level’ from 5% to 2.3% or 0.5%! Needed to counteract p-hacking?

So nice to see Ffion Davies receive a RCEM medal today. Setting the intercollegiate framework for PEM in the UK. Writing paeds EM standards. Designing PEM training. Mentoring and supporting EM development in many countries around the world as IFEM president. Always awesome @rcem.bsky.social

A great article for anyone who thinks that the EM situation in Australia is all sunshine. www.abc.net.au/news/2024-06...

We are not documenting crowding in individual patient notes. Makes it difficult to give context around delayed care for coroner, solicitor etc Do you document crowding in clinical notes? If so what phrases do you use?

Is it better for ED staff to provide inadequate care in the ambulance car park than no care? Problem is coroner and solicitor hold staff accountable for inadequate care - but if you haven’t seen the patient you cannot be personally held liable.

Should we put limits on car park care? Send blood tests? IV antibiotics in sepsis? IV morphine in hip fracture? Into X-ray, then back to amb? Into CT, then back to amb? Horrible discussion, but is a reality.

Agree emergency systems should be optimised by matching whole hospital resources to predicted patient arrival times. BUT matching to average numbers means you are under-resourced 50% of the time! Also matching to predicted variation (as well as predicted numbers) is absolutely key.

Interesting - but. 7 day follow up. More falls with a higher step count. So if you try and get around early you are more likely to fall (of course). But maybe early mobilisers have better long term outcomes. Interesting use of tech - conclusions: doi.org/10.1111/jgs....

Diagnosis based on the data: The NHS is run too lean to be efficient. Every word of this rings true from the frontline. www.thetimes.com/comment/colu...

Anyone solved the problem of major incident call out at night? In the olden days land lines and pagers worked 24/7. Now most people have only mobiles - and have them silenced at night? How does your HMIP approach this? (And has anyone done a 2am rest?)

OK. The TraumaCare webinar was fun! So many questions and I am sorry that there was not time to answer them all. If I couldn’t get round to you - post here (or the other) and I will continue the conversation.