St Emlyn's podcast and blog

Manual pressure augmentation reduces transthoracic impedance during defibrillation, but does that translate into better outcomes? We review the AUGMENT-VA randomised trial and revisit our previous BestBET on this intervention.

RCEM Manchester 2027: Come and join us Next April, the RCEM Annual Conference comes to Manchester, and I’d really like to encourage colleagues from across the UK, and especially our friends and colleagues from around the world, to come and join us....

Ep 283 – Best Bits of 2025 — Bonus: Clinical Pearls This bonus episode is a quick-fire collection of clinical pearls drawn from across the St Emlyn’s podcast in 2025....

More from our communication series with Liz Crowe: Listening. Good listening strengthens patient safety, trust and teamwork, but distraction makes it increasingly difficult. Explore the five levels of listening and practical ways healthcare professionals can become more attentive, empathic…

Ep 285 – Resuscitative Hysterotomy with Caroline Leech at BASICs 2025 In this episode of the St Emlyn’s Podcast, Iain Beardsell and Simon Carley talk with Caroline Leech at the BASICs Conference about resuscitative hysterotomy following maternal cardiac arrest....

The ghost jam Have you ever noticed how a traffic jam can form on a motorway despite no breakdowns, accidents or road closures?... Ghost jams and the seams between the Model UEC papers

Ep 293 – Making Feedback Sticky, TTL Tips and more (February 2026 round up) In this episode of the St Emlyn’s Podcast, Iain Beardsell and Simon Carley catch up on the February blog posts, recorded in the rather unseasonal context of a UK heatwave. They begin with congratulations to Simon on his…

Peri-intubation cardiovascular collapse occurred in over 40% of critically ill patients in the INTUBE cohort. Propofol was the only potentially modifiable factor consistently associated with collapse, but this remains observational evidence. What should this mean for emergency and prehospital RSI?

In this episode, we talk to Sheldon Cheskes about the evolving science of cardiac arrest, with a focus on refractory and recurrent ventricular fibrillation. We explore the evidence behind double sequential external defibrillation (DSED), how it compares to standard defibrillation, and what the DOSE…

Routine sodium bicarbonate has largely disappeared from modern ALS algorithms, but it continues to be used in many cardiac arrests. We review the BIHCA trial and discuss what it means for emergency physicians and prehospital clinicians.

TTL tips 18: Lead Yourself Before You Lead the Team Learn practical stress management techniques for Trauma Team Leaders, including I'M SAFE and BTFS, to improve performance under pressure and lead complex resuscitations safely....

JC: Magnesium for Acute Headache: Maybe, but perhaps not for all.. Does intravenous magnesium improve outcomes for patients with acute non-traumatic headache in the emergency department? We review the latest Annals RCT and discuss whether it should change practice.

{TTL tip 17: No chat below 10,000} Learn how trauma team leaders can use the aviation "sterile cockpit" principle to reduce interruptions, improve communication and increase patient safety during high-risk procedures....

Artifical Intelligence, Assessment and the Future of Training ChatGPT can now pass many medical examinations with scores that exceed those of average candidates. Does that mean traditional assessments are no longer fit for purpose? We review the evidence and explore what AI means for emergency…

The association between prolonged emergency department stays, boarding and mortality is now supported by several large studies. Similar concerns have been raised by coroners, professional colleges, statutory investigators and NHS trust boards. How much evidence is required before corridor care…

In this episode, Iain and Simon catch up on the papers, posts, and conversations that have been sitting with us since the start of the year. RSI, Trauma Units. Code red and tough decisions in the resus room.

Ep 292 – Leadership, Culture and Psychological Safety in Pre-Hospital Care with Anna Dobbie at Trauma 2030 Recorded at Trauma 2030 at the Royal College of Surgeons in London, the conversation explores what it means to lead exceptional teams in one of the most high-pressure areas of emergency…

Ep 287 – Damage Control Pre-hospital Care with Harriet Tucker at Trauma 2030 Recorded at Trauma 2030 at the Royal College of Surgeons, this episode explores a shift in mindset in pre-hospital trauma care, away from maximal intervention on scene and towards rapid recognition of the patient who…

In this episode, recorded at Trauma 2030 at the Royal College of Surgeons, I sit down with one of St Emlyn's own, Rich Carden, former emergency physician, now intensive care trainee and PhD graduate in trauma sciences — to explore what shock actually means beyond the blood pressure reading.

It is tempting to think that expertise comes from accumulating enough facts, passing enough exams or simply spending 10,000 hours at work. In this episode, Iain Beardsell is joined by emergency physician, intensivist and medical educator Sara Crager to explore why expertise is less about how much…

St Emlyn's practical guide to ketamine use as a Trauma Team Leader, including analgesia, procedural sedation, delayed sequence induction, dosing and monitoring. #FOAMed

Great review from Stevan. Emergency medicine clinicians are increasingly asked to balance brutal realities with hope for a better future. Drawing on the Stockdale paradox, NHS Staff Survey data, moral injury research and personal experience, this reflective article explores burnout, leadership,…

Struggling with vascular access in trauma? Practical tips on IO access, central lines, external jugular access and rapid alternatives for trauma resuscitation.

Medical boarding extracts a crowding tax in deaths, delays and bed-days. New research quantifies it, and suggests it is fixable from within.

We’ve built a simple RCEM syllabus self-assessment tool based on the RCEM clinical syllabus to help emergency clinicians reflect on their strengths, identify development needs, and map their current learning profile. Designed for trainees, consultants and educators in emergency medicine, this…

We’ve built a simple SLO self-assessment tool based on the 12 RCEM Specialty Learning Outcomes in the RCEM curriculum. Designed for trainees, consultants and educators in emergency medicine, this reflective tool helps clinicians visualise strengths, development needs and their overall training…

What does excellence in emergency medicine really look like? Less heroics, more reliability, self-awareness, teamwork and doing the basics well. From @dftb26 in Glasgow

How should we resuscitate patients with septic shock in the emergency department? It remains one of the most controversial questions in emergency medicine and critical care. For years, clinicians have debated whether early aggressive fluid resuscitation should remain the cornerstone of sepsis…

TTL tips 14: Should I CTA this limb injury? Arterial injuries can be easy to miss. Learn how trauma team leaders recognise hard and soft signs of vascular injury, identify high-risk injury patterns and expedite limb-saving… https://www.stemlynsblog.org/ttl-tips-14-should-i-cta-this-limb-injury/

ICEM 2026 Hamburg: A Festival of Emergency Medicine ICEM 2026 in Hamburg brought together more than 3,300 emergency clinicians from around the world. Beyond an excellent scientific programme, the conference fostered… https://www.stemlynsblog.org/icem-2026-hamburg-a-festival-of-emergency-medicine/

TTL Tips 13: Set your team specific time goals TTL Tips 13 Managing time. Effective trauma team leaders don't just manage tasks, they manage time. Learn how clear time targets improve teamwork, tempo and patient flow… https://www.stemlynsblog.org/ttl-tips-13-set-your-team-specific-time-goals/

What does a good emergency physician look like? What makes an excellent emergency physician? Is it knowledge, technical skill or diagnostic brilliance? Drawing on research, personal experience and lessons from a career in emergency medicine, we explore the qualities that truly define clinical…

Pre-hospital acute behavioural disturbance, a guest post by Jack Lyon. What does the evidence say about Ketamine and other drugs. #FOAMed

Learn about the Swift trial of whole blood vs components with Halden and Zaf. Really interesting appraisal and lessons for real world practice. @stemlyns

Do AI scribes work in the ED? St Emlyn's reviews the best ED evidence to date on AI scribe adoption, quality and where to pilot safely.

Situational awareness is a core trauma team leadership skill. Learn how high-performing TTLs use perception, comprehension, and projection to stay proactive in trauma resuscitation.

Survival effect of prehospital emergency anaesthesia in major trauma A St.Emlyn’s review of a major new trauma study examining whether prehospital emergency anaesthesia and intubation improve survival using machine learning and causal inference methods.

Practical trauma handover advice for trauma team leaders in emergency medicine. Learn how to structure ATMIST handovers, prepare resus before arrival, improve teamwork with prehospital/HEMS crews, and optimise patient safety in major trauma.

The three-body problem and ED clinical staffing Most clinical staff working on Emergency Department (ED) rotas operate within a contracted maximum of one weekend in three. Resident doctors, Specialty and Specialist (SAS)… https://www.stemlynsblog.org/the-three-body-problem-ed-clinical-staffing/

Can peer recovery workers improve outcomes after opioid overdose in the emergency department? A critical review of new Annals of Emergency Medicine research

IncrEMentuM 2026 – Inspirational Emergency Medicine in Murcia IncrEMentuM 2026 in Murcia was not a conventional Emergency Medicine conference. This reflection explores how its independent design, live simulation, hosted conversations, smaller faculty, translation, production values and global…

Our review of day 3 of the RCEM annual scientific conference 2026 in Birmingham. Trauma, paeds, analgesia, AI, and more HALO. FOAmed RCEM @stemlyns

Our summary of Day 2 at RCEM Conference 2026, covering prize papers, AI in emergency medicine, major trials, health inequalities, and clinical insights.

RCEM Annual Conference 2026 – Day 1 Frontline insights from RCEM Annual Conference 2026 in Birmingham—keynotes, AI in emergency medicine, diagnostics, and career lessons.

High Five for High PEITHO? Intermediate-high risk PE @ St Emlyns Prof Dan Horner takes us through pulmonary embolism, accompanying his talk at the Royal College of Emergency Medicine Annual Conference 2026

TTL tip 10: Put the trauma patient straight onto the PORTABLE monitor. Delays in trauma transfer often come from switching monitors. Learn how early use of portable monitoring speeds transfer to CT and improves efficiency in emergency care. #TTL tips #trauma @stemlyns

Smoking cessation interventions in the ED appear effective only when nicotine replacement therapy is included. But the real-world value, cost-effectiveness, and role of EDs remain uncertain.

How many patients should we see per hour? Clinician productivity depends largely on conditions provided. This blog explains why patients per hour is the last question you should ask and not the first. St Emlyn's

Marching Backwards into the Future: Why Healthcare Needs Fewer Modules and More Systems Thinking By Jesse Spurr from the amazing Five Things Nursing Podcast, which and which is co-hosted with our very own Dr Liz Crowe. You should defo subscribe as relevant to all in healthcare. You can find it…

Join the global emergency medicine community at ICEM 2026 in Hamburg. Explore the programme, St Emlyn’s speakers, and why IFEM still matters. (and Noah Wyle too!)