Acute behavioural disturbance (ABD) is a high-stakes presentation in emergency medicine, often requiring rapid pharmacological sedation. While haloperidol has long been a go-to antipsychotic, recent evidence suggests olanzapine may offer similar efficacy with fewer side effects.

JC: Are we overtreating suspected sepsis with broad-spectrum antibiotics? From St Emlyn's journal club: are we overtreating sepsis? US study finds 87% received unnecessary or overly broad antibiotics in ED.

The EVIDENCE trial tested expedited intra-arrest transport vs extended on-scene CPR for refractory OHCA. Did faster hospital transfer improve outcomes?

Can ketamine improve seizure control in children with status epilepticus? We critically review the Ket-Mid trial and discuss what. it means for UK emergency practice.

Acute behavioural disturbance (ABD) is a high-stakes presentation in emergency medicine, often requiring rapid pharmacological sedation. While haloperidol has long been a go-to antipsychotic, recent evidence suggests olanzapine may offer similar efficacy with fewer side effects.

How we transformed emergency medicine by 2038: AI, virtual EDs, and culture change. A powerful retrospective for healthcare leaders.

A JC review of intra-arrest stellate ganglion block for refractory cardiac arrest. Could this novel technique improve ROSC rates? Critical appraisal of scoping review. @stemlyns #FOAMed

JC: When helping hurts – moral injury and the erosion of trust for UK emergency responders New UK research reveals 3 types of moral injury in emergency medicine: loss of trust in others, self & authority. St Emlyn's journal club review of key findings.

Evaluating the PECARN Abdominal Trauma Rule in the grey zone…. Can children with abdominal pain, vomiting, or tenderness avoid CT? We review PECARN's latest insights into low-risk paediatric trauma.

Our review of a small Feasibility study on arterial line placement during ED cardiac arrest shows high success and improved ROSC. Is it time to rethink resuscitation monitoring?

Emergency toxicology insights on nitazenes.

JC: Illicit Drug Induced Hyperthermia: A Time-Critical Toxicological Emergency Recognise and treat drug-induced hyperthermia fast. Learn how early sedation and rapid cooling can save lives in this ED-focused clinical review.

Can salbutamol relieve pain in renal colic? We review a phase II randomised controlled trial exploring intravenous salbutamol as an adjunct analgesic in the emergency department.

Emergency toxicology insights on differentiating serotonin syndrome from NMS and stimulant toxicity. A commentary on the latest EMCRIT podcast, including diagnostic challenges and clinical examination reliability.

Review the top trauma and resuscitation trials discussed at ICEM 2025. Expert summaries and critical appraisals from St Emlyn’s cover transfusion strategies, airway management, oxygenation, fibrinogen, and more.

Emergency Centre Thoracotomy in South Africa. Can you perform a life-saving thoracotomy without ICU, theatre, or specialist staff? A new study from Cape Town shows it's possible — and often successful — even in district hospitals facing high trauma burdens. Read our latest St Emlyn’s review 👇…

Is there still room for compassion in emergency care? Emergency care is more pressured than ever—but is compassion being lost in the chaos? This post explores the reality of compassion fatigue, the systemic and cultural barriers to empathy, and practical, evidence-based strategies to reconnect…

Emergency Centre Thoracotomy in South Africa: Real-World Insights from District-Level Hospitals Emergency care is more pressured than ever—but is compassion being lost in the chaos? This post explores the reality of compassion fatigue, the systemic and cultural barriers to empathy, and practical,…

Emergency departments (EDs) often seem to shift from calm to crisis in an instant. Why? This article explores ED crowding through the lens of complexity science and self-organised criticality, explaining how minor changes—like a few extra patients—can trigger disproportionate chaos.

Derivation and Validation of the Simplified Bleeding Audit Triage Trauma (sBATT) Score The simplified BATT (sBATT) score offers a practical trauma triage tool for use in motor vehicle collisions where monitoring equipment may be unavailable. Derived from the original BATT score and validated on…

Nat May summarises the Noosa Paeds emergency meeting. Marlene Soma covered ENT emergencies, including auricular haematomas, otitis media, and nasal fractures. Marie-Clare Elder discussed legal implications of… https://www.stemlynsblog.org/paediatric-emergencies-update-2024-noosa-day-2-3/

Acute behavioural disturbance (ABD) is a high-stakes presentation in emergency medicine, often requiring rapid pharmacological sedation. While haloperidol has long been a go-to antipsychotic, recent evidence suggests olanzapine may offer similar efficacy with fewer side effects.

Podcast – Social Media and Artifical Intelligence in Medicine with Peter Brindley at LTC Recorded at the London Trauma Conference 2024, Peter Brindley discusses social media, artifical intelligence (AI) and how those working in medicine can (and must) navigate this new world.

In this episode of the St Emlyn’s Podcast, Iain and Simon reflect on IncrEMentuM 2025, skills fade in rare procedures, arterial line placement, and emerging evidence in cardiac arrest and resuscitative hysterotomy. Essential listening for emergency clinicians.

RCEM 2025 Day 3 explored mental health, autism, palliative care, high-intensity users, and modern transfusion and diabetes management in the ED.

Life 2.0 – What the dead can teach us about living – Matt Morgan at TBS 2025 For as long as I can remember, I’ve been scared of dying. Not in that vague, philosophical “we all go someday” way—but properly terrified. Heart racing. Stomach flipping. The sort of fear that sneaks up on you in traffic…

From pragmatic frailty care to neurodiversity in medicine and creating safer cultures, Day 2 of RCEM 2025 blended sharp clinical insights with systems thinking. Syncope, cardiology, culture, paeds, neurodiversity and more

Day 1 at RCEM Conference 2025 tackled identity, innovation, wellbeing, and risk in Emergency Medicine. Key insights from Joey Godfrey on St Emlyn’s.

Podcast – Excellence in Debriefing with Richard Lyon at LTC Recorded at the London Trauma Conference 2024, Richard Lyon shares insights from his powerful presentation on the importance of detailed case learning and debriefing both in hospital and pre-hospital settings.

Should we be giving ketamine to opioid users in acute pain? Should ketamine be used for opioid-dependent patients in acute pain? A recent randomized controlled trial explores the effectiveness of low-dose ketamine (LDK) as an adjunct to morphine in emergency settings. Results show significant…

Podcast – High Performing Teams with Dan Dworkis at Tactical Trauma 24 This epiode of the St Emlyn’s Podcast features Dr. Dan Dworkis discussing high-performance teams, excellence in crisis, and how emergency clinicians can continuously improve under pressure.

Halden reviews the publication from London's Air Ambulance of their fascinating data on the survivability from resuscitative thoracotomy. Learn when and who benefits. @stemlyns #FOAMed

The St Emlyn’s Podcast explores hyperbaric medicine with Dr. Jeff Kerrie. Learn how hyperbaric oxygen therapy (HBOT) treats decompression illness, carbon monoxide poisoning, radiation injuries, and necrotizing infections.

Cannabis edibles are raising concerns in emergency medicine due to potential delayed effects, high THC potency, and inconsistent labeling. A recent study highlights increased ED admissions and resource use among edible users.

The latest St Emlyn's podcast - an interview with Matt Hooper recorded at the London Trauma Conference about compassionate resuscitation and some of the lessons we can learn in Emergency Medicine from the world of palliative care.

Death in 2025 – What’s Changing? The AOMRC has updated how we define Death by Neurological Criteria (DNC). What do these changes mean for emergency and critical care medicine? Our latest post breaks it down. Thanks for being part of the St Emlyn's community.

Podcast – Moral Injury with Caroline Leech at Tactical Trauma 24 The St Emlyn’s podcast delves into moral injury in healthcare with Dr. Caroline Leech. Learn how repeated exposure to ethical dilemmas leads to distress and explore strategies to mitigate its impact on clinicians.

A new review maternal and neonatal survival following resuscitative hysterotomy for out-of-hospital cardiac arrest. This systematic review highlights survival rates, intervention timing, and implications for emergency and prehospital care. Better survival for neonates > mother, and much greater time

There is increasingly evidence that diastolic blood pressure (DBP) is a crucial resuscitation target in trauma and cardiac care. Based on a great article by Dan and Rich we look at how optimizing DBP may improve survival rates in emergency medicine.

Podcast – Monthly Round Up December 2024 – Chest trauma, IO access, AI and more This month’s St Emlyn’s podcast wraps up Season 11 with a review of key emergency medicine topics. We cover new evidence on chest trauma management, intraosseous access safety, pediatric imaging updates, AI in…

This blog post provides concise summaries of recent critical care trials, including HEMOTION, PREOXI, BLING III, CLASSIC, EVIDENCE, VICTOR, and PARAMEDIC-3. Each trial is examined for its key findings, strengths, limitations, and practical implications for clinical practice. The post aims to inform

The latest St Emlyn's podcast - Emergency medicine demands constant practice, yet many clinicians experience skills fade due to lack of exposure. Nathalie Pattyn explores how this decline occurs, why it’s a systemic issue rather than an individual failure, and what changes are needed to maintain com

The latest St Emlyn's podcast - an interview with Matt Hooper recorded at the London Trauma Conference about compassionate resuscitation and some of the lessons we can learn in Emergency Medicine from the world of palliative care.

This article explores the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. The article suggests a benefit, but how robust is that finding?

The latest St Emlyn's podcast - an episode about the Ten Second Triage tool recorded ay Tactical Trauma 24.

Our latest monthly update podcast from St Emlyn's blog, with lots on developing a learning culture, chest drain size in haemothorax, arterial lines in cardiac arrest, and much more. Listen whevere you get your podcasts and please like and subscribe.

Explore the variability in maintaining PHEA for trauma patients. With insights into drug protocols, administration methods, and governance. #FOAMed @stemlyns

London Trauma Conference 2024: Key Insights Day 2 of the London Trauma Conference delivered impactful discussions on trauma care innovations, including advanced resuscitation strategies, rib fracture management, and prehospital interventions. Highlights

Podcast – Likelihood Ratios: Critical Appraisal Nugget 12 Mastering likelihood ratios can transform your diagnostic skills. In this podcast with Rick and Greg, discover how likelihood ratios can enhance decision-making and improve patient care.

How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impact trauma care timelines compared to emergency department RSI (EDRSI). This retrospective study explores time efficiency, injury severity, and