St Emlyn's podcast and blog

2026 PE Guidelines Pulmonary embolism (PE) is one of those diagnoses that finds its way into a lot of differential diagnoses. In the era of reasonably easy-but-occasionally-argue-with-radiologist to get CTPAs, the diagnosis has increased. An old study now, but in 2011 Wiener et al showed that the use of CTPA has increased the diagnosis but with no difference in mortality. Unsurprisingly PE and, more broadly, venous thromboembolic diseases are a vast area of research and innovation.

2026 PE Guidelines

Pulmonary embolism (PE) is one of those diagnoses that finds its way into a lot of differential diagnoses. In the era of reasonably easy-but-occasionally-argue-with-radiologist to get CTPAs, the diagnosis has increased. An old study now, but in 2011 Wiener et al showed that the…

TTL tips 7: Log rolls. Top tips on log rolls for trauma patients.

TTL tips 7: Log rolls.

Top tips on log rolls for trauma patients.

Everything You Need to Know About Making Feedback More Than Just Noise Simon and I have been talking about better feedback since I first joined the St Emlyn's crew more than a decade ago (check this out if you don't believe me - this audio file appears in a link at the end of this blog post, which Simon published in July 2012!) and in the intervening years I've loved the opportunity to speak about feedback at conferences and to run feedback workshops alongside him.

How to make feedback work for those receiving and giving it. Top tips from Natalie May. #FOAMed

TTL tips 6: CT reports TTL tips 6. How to manage your CT reports in trauma. #TTLtips #FOAMed

TTL tips 6. How to manage your CT reports in trauma. #TTLtips#FOAMed

TBS 2026: Best Intensive Care Medicine Papers A focused review of the most important intensive care medicine papers from 2025–2026, discussed at The Big Sick conference. TBS @stemlyns

A focused review of the most important intensive care medicine papers from 2025–2026, discussed at The Big Sick conference. TBS @stemlyns

TBS 2026: Best Emergency Medicine Papers Emergency medicine research rarely provides certainty, but it can guide decisions. At The Big Sick (TBS) conference 2026, we presented papers challenging assumptions around trauma, airway management, resuscitation systems and rare high-stakes decisions. This post reviews the best emergency medicine papers from 2025–2026, focusing on what they mean for clinicians working at the front door.

TBS 2026: Best Emergency Medicine Papers

Emergency medicine research rarely provides certainty, but it can guide decisions. At The Big Sick (TBS) conference 2026, we presented papers challenging assumptions around trauma, airway management, resuscitation systems and rare high-stakes decisions.…

TBS 2026: Key Prehospital Emergency Medicine papers A critical review of the most important prehospital emergency medicine papers from 2026, covering RSI, oxygen therapy, ECPR, thoracotomy and trauma access. From the TBS conference in Zermatt.

TBS 2026: Key Prehospital Emergency Medicine papers

A critical review of the most important prehospital emergency medicine papers from 2026, covering RSI, oxygen therapy, ECPR, thoracotomy and trauma access. From the TBS conference in Zermatt.

TTL tips 5: Non time critical trauma handovers part 1. Top tips for TTLs managing a non time critical hand over of a trauma patient into resus.

Trauma Team Leader Tips to make your non-time critical handovers work as well as they can. #FOAMed @stemlyns

Trauma – getting the TU trauma team right Advice on planning for trauma in Trauma Units. How does it differ to MTCs? James, Rory and John take us through some tips and ideas.

Advice on planning for trauma in Trauma Units. How does it differ to MTCs? James, Rory and John take us through some tips and ideas.

Early Blood Pressure Targets in Acute Spinal Cord Injury Background It's pretty well agreed that management of blood pressure is really important in neurological injury. We usually think about this in terms of brain injury, but the general teaching is that the same applies to spinal cord injury too. It's neurological tissue and connected to the brain, so it makes sense. It's something we've talked about a lot on St Emlyn’s over the years, in the context of traumatic brain injury (TBI), stroke, and post–cardiac arrest care.

Interesting trial on BP targets in spinal cord injury. The authors conclude no difference, but how robust??? #FOAMed

Perimortem C-section from Incrementum: how to do it Video from the perimortem c-section at Incrementum in 2025. #FOAMed @stemlyns

Amazing video from the perimortem c-section session at Incrementum in 2025. #FOAMed @stemlyns

Learn how to do it here

Making Sense of the Latest Corridor Care Update: Red Lines and Resources If you have worked an ED shift over the last year, you will almost certainly have faced this dilemma: an ambulance crew arrives with an elderly, frail, confused patient who needs a Majors space. But with no room available, and increasing pressure to release the crew, a trade-off becomes inevitable. What happens next currently defines the quality and safety landscape of emergency care - and reveals the tussle between…

Expert analysis of NHS England's latest corridor care guidance: exclusions, accountability, constraints and practical implementation for EDs.

TTL tips 4: Code Red TTL tip 4 is about getting your CODE RED instructions right, by developing the right mindset about what you want to achieve and why.

TTL tips 4: Code Red

TTL tip 4 is about getting your CODE RED instructions right, by developing the right mindset about what you want to achieve and why.

Ketamine vs Etomidate for Intubating Critically Ill Adults: What Does the RSI Trial Tell Us?

Background For as long as I can remember emergency and critical care clinicians have debated the optimal induction agent for tracheal intubation in the critically ill. When I started my anaesthetic…

Cough remedies: what actually works? This is a festive break from my usual offerings on emergency toxicology, although you will note I lapsed a bit with dextromethorphan. My last post was on the SNAP regimen in teenagers, and can be found here. I am currently recovering from pneumonia. It is not pleasant. Like Tiny Tim himself, I have been struggling with a cough. And if the information I give in ED is correct, it will be weeks before I feel better.

Cough remedies: what actually works?

This is a festive break from my usual offerings on emergency toxicology, although you will note I lapsed a bit with dextromethorphan. My last post was on the SNAP regimen in teenagers, and can be found here. I am currently recovering from pneumonia. It is not…

TTL tips 3: Giving Blood products? Think Calcium! Check these five areas in penetrating trauma. Trauma Team Leader tips from @stemlyns #FOAMed

TTL tip number 3 reminds us to manage Calcium levels in all trauma patients, and especailly those receiving blood products.

Your Patient Already Asked ChatGPT Patients are consulting AI more and more before attending ED. What does the research say, and how should clinicians respond? Some great advice on what to do when this happens.

Patients are consulting AI more and more before attending ED. What does the research say, and how should clinicians respond? Some great advice on what to do when this happens.

Is post-induction hypotension harmful in traumatic brain injury? How bad is hypotension in TBI? What's the real world impact in a high quality PHEM service. Rich Carden reviews a recent paper that helps us understand the impact. #FOAMed @stemlyns

How bad is hypotension in TBI? What's the real world impact in a high quality PHEM service. #FOAMed @stemlyns

Make it SNAPpy! Paracetamol overdoses in teenagers Paracetamol poisoning is an uncommon, but not rare, event in children. The treatment of choice is NAC. Should we be giving them the SNAP protocol?

Make it SNAPpy! Paracetamol overdoses in teenagers

Paracetamol poisoning is an uncommon, but not rare, event in children. The treatment of choice is NAC. Should we be giving them the SNAP protocol?

TTL tips 2: Get the best from your pelvic binders! Top tips on using pelvic binxders in major trauma . Trauma Team Leader tips from @stemlyns #FOAMed #TTLtips

Top tips on using pelvic binxders in major trauma . Trauma Team Leader tips from @stemlyns #FOAMed #TTLtips

TTL tips 1: Check these FIVE areas (and more) in Penetrating Trauma. Check these five areas in penetrating trauma. Trauma Team Leader tips from @stemlyns #FOAMed

TTL tips 1: Check these FIVE areas (and more) in Penetrating Trauma.

Check these five areas in penetrating trauma. Trauma Team Leader tips from @stemlyns #FOAMed

Introducing the Trauma Team Leader Tips (TTL Tips) Series Edited by Prof. Simon Carley & Dr. Greg Yates Leading a trauma team is one of the most challenging and rewarding roles in emergency medicine. It’s a blend of clinical expertise, calm leadership, communication, and the ability to make decisions when the stakes are high. The Trauma Team Leader (TTLtips) Tips on St Emlyn’s explores what it really means to lead in trauma, through clinical insight, human factors, and team dynamics.

An introduction to our TTLtips series. How to be a better trauma team leader. #FOAMed @stemlyns

Gastroenteritis in children: should we be sending them home with ondansetron? Autumn is here, and winter is on its way. In children with gastroenteritis, should we be prescribing take-home doses of ondansetron?

Gastroenteritis in children: should we be sending them home with ondansetron?

Autumn is here, and winter is on its way. In children with gastroenteritis, should we be prescribing take-home doses of ondansetron?

What does the Medical Training Review mean for Emergency Medicine training in the UK? The 2025 Medical Training Review (MTR) is the most significant rethink of UK postgraduate medical education in decades. It calls for more flexible, inclusive, team-based training that recognises learning across all grades, not just numbered trainees. For emergency medicine, this may mean redesigning pathways to include SAS and LED doctors, refreshing the RCEM curriculum, and re-establishing supportive team structures. EM must lead the way in creating sustainable, flexible, and patient-centred training for the next generation.

What does the Medical Training Review mean for Emergency Medicine training in the UK?

The 2025 Medical Training Review (MTR) is the most significant rethink of UK postgraduate medical education in decades. It calls for more flexible, inclusive, team-based training that recognises learning across…

Factors in the Initial Resuscitation of Patients With Severe Trauma – The FiiRST-2 Trial

The FiiRST-2 randomised trial compared fibrinogen and prothrombin complex concentrate with plasma in trauma patients needing massive transfusion. No significant benefit was found. Read our St Emlyn’s critical…

Design as repair: what Emergency Medicine can learn (and why it is so hard) The NHS drowns in innovation whilst repair work goes unsupported. Why Bronson's Design as Repair framework matters for emergency medicine.

The NHS drowns in innovation whilst repair work goes unsupported. Why Bronson's Design as Repair framework matters for emergency medicine.

SUPraclavicular Block for Emergency Reduction of Upper Limb Injuries Versus Bier Block (SUPERB Trial) The SUPERB trial compared ultrasound-guided supraclavicular block with Bier block for distal forearm fracture reduction in the ED. Both provided excellent pain relief, with supraclavicular block noninferior and offering longer analgesia. Safe, feasible, and well-tolerated, this trial supports expanding regional anaesthesia options for emergency physicians managing upper limb injuries.

The SUPERB trial compared ultrasound-guided supraclavicular block with Bier block for distal forearm fracture reduction in the ED. Both provided excellent pain relief, with supraclavicular block noninferior and offering longer analgesia. What do you currently do?

Cardiac arrest: three quick hits Learn more about innovations in Cardiac Arrest management: 3 quick hits to stay prepared and respond effectively in critical situations. @stemlyns #FOAMed

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.

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.

Stay or go? Should we Move Patients with Refractory Out-of-Hospital Cardiac Arrest to Hospital? The EVIDENCE Trial The EVIDENCE trial asked if rapid transport with ongoing CPR improves survival in refractory out-of-hospital cardiac arrest. Results: no clear benefit over on-scene resuscitation.

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