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EMJ podcast

Emergency Medicine Journal (EMJ) is an international peer review journal covering pre-hospital and hospital emergency medicine, and critical care. The journal publishes original research, reviews and evidence based articles on resuscitation, major trauma, minor injuries, acute cardiology, acute paediatrics, toxicology, toxinology, disasters, medical imaging, audit, teaching and reflections on clinical practice. The journal is aimed at doctors, nurses, paramedics and ambulance staff.* The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

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Primary Survey: the highlights of May 2020

A bit later than usual, but here we are again! Simon Carley, Associate Editor of EMJ, talks with Professor Richard Body about the highlights of the May 2020 edition of the Emergency Medicine Journal.Read the primary survey here - emj.bmj.com/content/37/5/249Details of the papers mentioned in this podcast can be found below:SARS: experience from the emergency department, Tan Tock Seng Hospital, Singapore - emj.bmj.com/content/20/6/501Views and experiences of nurses in providing end-of-life care to patients in an ED context: a qualitative systematic review - emj.bmj.com/content/37/5/265End of life care in the emergency department - emj.bmj.com/content/37/5/273That was a game changer: clinical impact of an emergency department-based palliative care communication skills training workshop - emj.bmj.com/content/37/5/262Inter-rater reliability in a bespoke scoring tool: the Paediatric Observation Priority Score - emj.bmj.com/content/37/5/293Are referrals to hospital from out-of-hours primary care associated with National Early Warning Scores? - emj.bmj.com/content/37/5/279Glucose as an additional parameter to National Early Warning Score (NEWS) in prehospital setting enhances identification of patients at risk of death: an observational cohort study - emj.bmj.com/content/37/5/286Emergency medicine registrar training in Africa: overview of programmes, faculty and sustainability - emj.bmj.com/content/37/5/300 Read the full May issue here - emj.bmj.com/content/37/5

15mins

20 May 2020

Rank #1

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Primary Survey: the highlights of July 2018

Simon Carley, Associate Editor of EMJ, talks through the highlights of the July 2018 edition of the Emergency Medicine Journal, this month, chosen by Deputy Editor, Ian K Maconochie.Read the primary survey here: emj.bmj.com/content/35/7/403Details of the papers mentioned in this podcast can be found below:Do EPs change their clinical behaviour in the hallway or when a companion is present? A cross-sectional survey - emj.bmj.com/content/35/7/406Effects of hallway/corridor and companions on clinical encounters: a possible explanation - emj.bmj.com/content/35/7/404Essential medicines for emergency care in Africa - emj.bmj.com/content/35/7/412End-tidal carbon dioxide output in manual cardiopulmonary resuscitation versus active compression-decompression device during prehospital quality controlled resuscitation: a case series study - emj.bmj.com/content/35/7/428Risk stratifying chest pain patients in the emergency department using HEART, GRACE and TIMI scores, with a single contemporary troponin result, to predict major adverse cardiac events - emj.bmj.com/content/35/7/420 Read the full July issue of EMJ here: emj.bmj.com/content/35/7

10mins

20 Jul 2018

Rank #2

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Primary Survey: the highlights of August 2018

Simon Carley, Associate Editor of EMJ, talks through the highlights of the August 2018 edition of the Emergency Medicine Journal.Read the primary survey here: emj.bmj.com/content/35/8/461Details of the papers mentioned in this podcast can be found below:Fluid therapy in the emergency department: an expert practice review - emj.bmj.com/content/35/8/511Intravenous cefazolin plus oral probenecid versus oral cephalexin for the treatment of skin and soft tissue infections: a double-blind, non-inferiority, randomised controlled trial - emj.bmj.com/content/35/8/492Efficacy of scheduled return visits for emergency department patients with non-specific abdominal pain - emj.bmj.com/content/35/8/499Application of outpatient cardiac testing among emergency department patients with syncope - emj.bmj.com/content/35/8/486Diagnostic yield of an ambulatory patch monitor in patients with unexplained syncope after initial evaluation in the emergency department: the PATCH-ED study - emj.bmj.com/content/35/8/477Prehospital neurological deterioration in stroke - emj.bmj.com/content/35/8/507Development and validation of an admission prediction tool for emergency departments in the Netherlands - emj.bmj.com/content/35/8/464 Read the full August 2018 issue of EMJ here: https://emj.bmj.com/content/35/8

11mins

30 Jul 2018

Rank #3

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Primary Survey: the highlights of June 2018

Simon Carley, Associate Editor of EMJ, talks through the highlights of the June 2018 edition of the Emergency Medicine Journal, this month, chosen by Associate Editor, Edward Carlton.Read the primary survey here: emj.bmj.com/content/35/6/341Details of the papers mentioned in this podcast can be found below:Editor's choice: Comparison of qSOFA with current emergency department tools for screening of patients with sepsis for critical illness - emj.bmj.com/content/35/6/350Editor's choice: qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis - emj.bmj.com/content/35/6/345Editor's choice: Sepsis-3 and simple rules - emj.bmj.com/content/35/6/343MRSA nares swab is a more accurate predictor of MRSA wound infection compared with clinical risk factors in emergency department patients with skin and soft tissue infections - emj.bmj.com/content/35/6/357Outpatient management of children at low risk for bacterial meningitis - emj.bmj.com/content/35/6/361Gender and survival from out-of-hospital cardiac arrest: a New Zealand registry study - emj.bmj.com/content/35/6/367Inter-rater and intrarater reliability of the South African Triage Scale in low-resource settings of Haiti and Afghanistan - emj.bmj.com/content/35/6/379Validity of the Japan Acuity and Triage Scale in adults: a cohort study - emj.bmj.com/content/35/6/384Marauding terrorist attack (MTA): prehospital considerations -emj.bmj.com/content/35/6/389 Read the full June issue of EMJ here: emj.bmj.com/content/35/6

9mins

17 Jul 2018

Rank #4

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Primary Survey: the highlights of March 2020

Simon Carley, Associate Editor of EMJ, talks through his highlights of the March 2020 edition of the Emergency Medicine Journal.Read the primary survey here - https://emj.bmj.com/content/37/3/117.Predicting abusive head trauma in children https://emj.bmj.com/content/37/3/118 Validation of the PredAHT-2 prediction tool for abusive head trauma https://emj.bmj.com/content/37/3/119 Association of clinically important traumatic brain injury and Glasgow Coma Scale scores in children with head injury https://emj.bmj.com/content/37/3/127 Biological mechanisms and individual variation in fibrinolysis after major trauma https://emj.bmj.com/content/37/3/135 Prehospital critical care is associated with increased survival in adult trauma patients in Scotland https://emj.bmj.com/content/37/3/141 Cranial burr holes in the emergency department: to drill or not to drill? https://emj.bmj.com/content/37/3/151 Cranial burr holes in the emergency department: to drill or not to drill? https://emj.bmj.com/content/37/3/154 Lessons from a pilot for uncontrolled donation after circulatory death in the ED in the UK https://emj.bmj.com/content/37/3/155 Non-invasive techniques for stimulating urine production in non-toilet trained children: a systematic review https://emj.bmj.com/content/37/3/162 Read the full March issue here - emj.bmj.com/content/37/3

11mins

16 Mar 2020

Rank #5

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Primary Survey: the highlights of November 2018

Simon Carley, Associate Editor of EMJ, talks through the highlights of the November 2018 edition of the Emergency Medicine Journal, this month chosen by Associate Editor Professor Rick Body.Read the primary survey here: emj.bmj.com/content/35/11/651Details of the papers mentioned in this podcast can be found below: Managing accidental hypothermia: a UK-wide survey of prehospital and search and rescue providers - emj.bmj.com/content/35/11/652 Managing accidental hypothermia: progress but still some way to go - emj.bmj.com/content/35/11/657 Characteristics and outcomes of accidental hypothermia in Japan: the J-Point registry - emj.bmj.com/content/35/11/659 Indoor accidental hypothermia in the elderly: an emerging lethal entity in the 21st century - emj.bmj.com/content/35/11/667 Paediatric traumatic cardiac arrest: the development of an algorithm to guide recognition, management and decisions to terminate resuscitation - emj.bmj.com/content/35/11/669 Defining significant childhood illness and injury in the Emergency Department: a consensus of UK and Ireland expert opinion - emj.bmj.com/content/35/11/685 Understanding better how emergency doctors work. Analysis of distribution of time and activities of emergency doctors: a systematic review and critical appraisal of time and motion studies - emj.bmj.com/content/35/11/692 Read the full November 2018 issue of EMJ here: emj.bmj.com/content/35/11

9mins

4 Dec 2018

Rank #6

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More evidence needed to divert patients from emergency departments

The systematic review discussed in this podcast outlines inconclusive evidence for the effectiveness of diversion strategies on emergency department use and healthcare utilisation.Dr Brian Rowe, from the Department of Emergency Medicine, University of Alberta, Canada, tells Editor-in-Chief of EMJ Professor Ellen Weber other strategies are needed to address ED overcrowding.Read the paper at http://emj.bmj.com/lookup/doi/10.1136/emermed-2017-207045.Related articles:The patient’s dilemma: attending the emergency department with a minor illness (https://www.bmj.com/content/357/bmj.j1941); Low-acuity presentations to the emergency department in Canada: exploring the alternative attempts to avoid presentation (https://emj.bmj.com/content/34/4/249).

12mins

15 Nov 2018

Rank #7

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Primary Survey: the highlights of April 2020

Simon Carley, Associate Editor of EMJ, talks through his highlights of the April 2020 edition of the Emergency Medicine Journal. Our regular monthly round up of the best and the brightest in the April edition of the EMJ. Read the primary survey here - https://emj.bmj.com/content/37/4/177Impact of emergency care centralisation on mortality and efficiency: a retrospective service evaluation - https://emj.bmj.com/content/37/4/180 Three into one does go - https://emj.bmj.com/content/37/4/178Emergency department visits during the 4/20 cannabis celebration - https://emj.bmj.com/content/37/4/187 Routine alcohol screening in the ED: unscreened patients have an increased risk for hazardous alcohol use - https://emj.bmj.com/content/37/4/206 Inadvertent tissue adhesive tarsorrhaphy of the eyelid: a review and exploratory trial of removal methods of Histoacryl - https://emj.bmj.com/content/37/4/212 Performance of the MEDS score in predicting mortality among emergency department patients with a suspected infection: a meta-analysis - https://emj.bmj.com/content/37/4/232.Read the full April issue here: - https://emj.bmj.com/content/37/4

12mins

15 Apr 2020

Rank #8

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Primary Survey: the highlights of February 2020

Simon Carley, Associate Editor of EMJ, talks through his highlights of the February 2020 edition of the Emergency Medicine Journal.Read the primary survey here - https://emj.bmj.com/content/37/2/55.Details of the papers mentioned in this podcast can be found below:‘Stealth trauma’ in the young and the old: the next challenge for major trauma networks? - https://emj.bmj.com/content/37/2/56 Massive transfusion in The Netherlands - https://emj.bmj.com/content/37/2/65 Blunt chest trauma in the elderly: an expert practice review - https://emj.bmj.com/content/37/2/73 How can pain management in the emergency department be improved? Findings from multiple case study analysis of pain management in three UK emergency departments - https://emj.bmj.com/content/37/2/85 Read the full February issue here - emj.bmj.com/content/37/2

10mins

12 Mar 2020

Rank #9

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Covid-19 challenges in a Singapore paediatric emergency department

Dr. Khai Pin Lee and Dr. Gene Yong-Kwang Ong, from the Department of Paediatric Emergency Medicine, Kandang Kerbau Hospital, Singapore, tell Editor-in-Chief of EMJ, Dr. Ellen Weber, how the novel coronavirus is changing their ED and the Singaporean society in general.They are two of the authors of “Dynamic adaptation to COVID-19 in a Singapore paediatric emergency department”, a paper which will be published in the next few days by EMJ in the following address:dx.doi.org/10.1136/emermed-2020-209634

31mins

3 Apr 2020

Rank #10

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BMJ Emergency Medicine Award: the HECTOR project

The Heartlands Elderly Care Trauma and Ongoing Recovery Programme is the BMJ 2018 award winner for Emergency Medicine.Dr David Raven, the National Course director for the HECTOR project and emergency medicine consultant at the Heartlands Hospital, Birmingham, UK, tells EMJ’s Editor-in-Chief Ellen Weber what makes this project unique.Read the paper on the EMJ website (https://emj.bmj.com/content/early/2019/12/11/emermed-2019-209143) and on the February 2020 issue of the journal.

15mins

9 Jan 2020

Rank #11

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Primary Survey: the highlights of January 2020

Simon Carley, Associate Editor of EMJ, talks through his highlights of the January 2020 edition of the Emergency Medicine Journal.Read the primary survey here - emj.bmj.com/content/37/1Details of the papers mentioned in this podcast can be found below:Comparison of four decision aids for the early diagnosis of acute coronary syndromes in the emergency department https://emj.bmj.com/content/37/1/8 The incidence of airway haemorrhage in manual versus mechanical cardiopulmonary resuscitation https://emj.bmj.com/content/37/1/14 Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017 -https://emj.bmj.com/content/37/1/25 Blood Glucose Reduction in Patients Treated with Insulin and Dextrose for Hyperkalemia - https://emj.bmj.com/content/37/1/31 No rest for the weary: A cross-sectional study comparing patients sleep in the emergency department to those on the ward https://emj.bmj.com/content/37/1/42 Thromboprophylaxis in Lower Limb Immobilisation after Injury (TiLLI) https://emj.bmj.com/content/37/1/36Emergency Medicine: let’s feed the good wolf - https://emj.bmj.com/content/37/1/52 Read the full January issue here - https://emj.bmj.com/content/37/1

13mins

7 Jan 2020

Rank #12

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Primary Survey: the highlights of October 2019

Simon Carley, Associate Editor of EMJ, talks through his highlights of the October 2019 edition of the Emergency Medicine Journal.Patients don’t have language barriers; the healthcare system does - https://emj.bmj.com/content/36/10/580 Observational study to understand interpreter service use in emergency medicine: why the key may lie outside of the initial provider assessment - Editor's Choice - https://emj.bmj.com/content/36/10/582 Framing of clinical information affects physicians’ diagnostic accuracy - https://emj.bmj.com/content/36/10/589Impact of the caller’s emotional state and cooperation on out-of-hospital cardiac arrest recognition and dispatcher-assisted cardiopulmonary resuscitation - https://emj.bmj.com/content/36/10/595 Diurnal, weekly and seasonal variations of chest pain in patients transported by emergency medical services - https://emj.bmj.com/content/36/10/601Pulmonary embolism following complex trauma: UK MTC observational study - https://emj.bmj.com/content/36/10/608 Adapting the Canadian CT head rule age criteria for mild traumatic brain injury - https://emj.bmj.com/content/36/10/617 Read the full October issue here - emj.bmj.com/content/36/10.

12mins

2 Oct 2019

Rank #13

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Primary Survey: the highlights of September 2019

Simon Carley, Associate Editor of EMJ, talks through his highlights of the September 2019 edition of the Emergency Medicine Journal.Read the primary survey here - https://emj.bmj.com/content/36/9/517Details of the papers mentioned in this podcast can be found below:The Panoramic Dental Radiograph for Emergency Physicians - https://emj.bmj.com/content/36/9/565Exploring the characteristics, acuity and management of adult ED patients at night-time - https://emj.bmj.com/content/36/9/554Evaluation of the criteria for trauma activation in the paediatric emergency department - https://emj.bmj.com/content/36/9/529Why are people increasingly attending the emergency department? A study of the French healthcare system - https://emj.bmj.com/content/36/9/548Location of arrest and effect of prehospital advanced airway management after emergency medical service-witnessed out-of-hospital cardiac arrest: Nationwide observational study - https://emj.bmj.com/content/36/9/541Phenomenological study exploring ethics in prehospital research from the paramedic’s perspective: experiences from the Paramedic-2 trial in a UK ambulance service - https://emj.bmj.com/content/36/9/535Process conformance is associated with successful first intubation attempt and lower odds of adverse events in a paediatric emergency setting - https://emj.bmj.com/content/36/9/520Triaging the triage: reducing waiting time to triage in the emergency department at a tertiary care hospital in New Delhi, India - https://emj.bmj.com/content/36/9/558 Read the full September issue - https://emj.bmj.com/content/36/9

13mins

23 Aug 2019

Rank #14

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Primary Survey: the highlights of August 2019

Simon Carley, Associate Editor of EMJ, talks through his highlights of the August 2019 edition of the Emergency Medicine Journal.Read the primary survey here - emj.bmj.com/content/36/8/451Details of the papers mentioned in this podcast can be found below:First responder communication in CBRN environments: FIRCOM-CBRN study - https://emj.bmj.com/content/36/8/456Impact of emergency physician experience on decision-making in patients with suspected community-acquired pneumonia and undergoing systematic thoracic CT scan - https://emj.bmj.com/content/36/8/485Meta-analysis of the accuracy of termination of resuscitation rules for out-of-hospital cardiac arrest - https://emj.bmj.com/content/36/8/479Potential added value of the new emergency care dataset to ED-based public health surveillance in England: an initial concept analysis - https://emj.bmj.com/content/36/8/459Paracetamol versus other analgesia in adult patients with minor musculoskeletal injuries: a systematic review - https://emj.bmj.com/content/36/8/493Recognising bias in studies of diagnostic tests part 2: interpreting and verifying the index test - https://emj.bmj.com/content/36/8/501Man versus machine: comparison of naked-eye estimation and quantified capillary refill - https://emj.bmj.com/content/36/8/465 Read the full August issue - https://emj.bmj.com/content/36/8

13mins

6 Aug 2019

Rank #15

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Primary Survey: the highlights of July 2019

Simon Carley, Associate Editor of EMJ, talks through his highlights of the July 2019 edition of the Emergency Medicine Journal.Read the primary survey here - https://emj.bmj.com/content/36/7/385Details of the papers mentioned in this podcast can be found below:Epidemiology of traumatic injuries presenting to an ED in Central Haiti: a retrospective cohort study - https://emj.bmj.com/content/36/7/389 Prehospital tranexamic acid shortens the interval to administration by half in Major Trauma Networks: a service evaluation - https://emj.bmj.com/content/36/7/395Confirmed cardiac output on emergency medical services arrival as confounding by indication: an observational study of prehospital airway management in patients with out-of-hospital cardiac arrest - https://emj.bmj.com/content/36/7/410Driving stroke quality improvement at scale in EDs across a nationwide network of hospitals: strategies and interventions - https://emj.bmj.com/content/36/7/423The association of paramedic rapid sequence intubation and survival in out-of-hospital stroke - https://emj.bmj.com/content/36/7/416 Reducing repeat paediatric emergency department attendance for non-urgent care: a systematic review of the effectiveness of interventions - https://emj.bmj.com/content/36/7/435 Read the full July issue here - emj.bmj.com/content/36/7.

13mins

25 Jul 2019

Rank #16

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Primary Survey: the highlights of May 2019

Simon Carley, Associate Editor of EMJ, talks through his highlights of the May 2019 edition of the Emergency Medicine Journal.Read the primary survey here - emj.bmj.com/content/36/5/257Details of the papers mentioned in this podcast can be found below:Could this be Measles? - https://emj.bmj.com/content/36/5/310 Randomised controlled trial of simulation-based education for mechanical cardiopulmonary resuscitation training - https://emj.bmj.com/content/36/5/266 Preferred learning modalities and practice for critical skills: a global survey of paediatric emergency medicine clinicians - emj.bmj.com/content/36/5/273Immune checkpoint blockade toxicity among patients with cancer presenting to the emergency department - emj.bmj.com/content/36/5/306 Major incident triage and the evaluation of the Triage Sort as a secondary triage method - https://emj.bmj.com/content/36/5/281 Distributions of the National Early Warning Score (NEWS) across a healthcare system following a large-scale roll-out - https://emj.bmj.com/content/36/5/287 A mixed methods study of the impact of consultant overnight working in an English Emergency Department - https://emj.bmj.com/content/36/5/298 Read the full May issue here - emj.bmj.com/content/36/5.

10mins

3 May 2019

Rank #17

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Taking the stage: a development programme for women speakers in emergency medicine

The Speaker Development Programme (SDP) is a prize-winning year-long curriculum aimed at developing women speakers as a step on the journey towards academic recognition. Editor-in-Chief of the Emergency Medicine Journal Professor Ellen Weber talks to Dr Dara Kass, the founder of this program. They also discuss the project FemInEm, an organisation dedicated to gender equity in emergency medicine.Read the related article on the EMJ website: (https://emj.bmj.com/content/early/2019/01/10/emermed-2018-207818). The commentary mentioned in the podcast will be published with the April issue of the journal.More papers mentioned in the podcast: - Are there too few women presenting at emergency medicine conferences? (https://emj.bmj.com/content/33/10/681) - When will we have enough women speakers in emergency medicine? (https://emj.bmj.com/content/33/10/680)

17mins

28 Feb 2019

Rank #18

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Primary Survey: the highlights of February 2019

Simon Carley, Associate Editor of EMJ, talks through the highlights of the February 2019 edition of the Emergency Medicine Journal.Read the primary survey here - emj.bmj.com/content/36/2/63Details of the papers mentioned in this podcast can be found below:A simple clinical assessment is superior to systematic triage in prediction of mortality in the emergency department - emj.bmj.com/content/36/2/66A systematic review examining the impact of redirecting low-acuity patients seeking emergency department care: is the juice worth the squeeze? - emj.bmj.com/content/36/2/97From ED overcrowding to jail overcrowding: a cautionary tale of a Serial Inebriate Programme (SIP) - emj.bmj.com/content/36/2/92UK’s initial operational response and specialist operational response to CBRN and HazMat incidents: a primer on decontamination protocols for healthcare professionals - emj.bmj.com/content/36/2/117Implementation of tranexamic acid for bleeding trauma patients: a longitudinal and cross-sectional study - emj.bmj.com/content/36/2/78Emergency medical services oxygen equipment: a fomite for transmission of MRSA? - emj.bmj.com/content/36/2/89Factors influencing variation in investigations after a negative CT brain scan in suspected subarachnoid haemorrhage: a qualitative study- emj.bmj.com/content/36/2/72 Prolonged length of stay in the emergency department and increased risk of hospital mortality in patients with sepsis requiring ICU admission - emj.bmj.com/content/36/2/82Approach to syncope in the emergency department - emj.bmj.com/content/36/2/108 Read the full February issue here - emj.bmj.com/content/36/2.

12mins

29 Jan 2019

Rank #19

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Primary Survey: the highlights of January 2019

Simon Carley, Associate Editor of EMJ, talks through the highlights of the January 2019 edition of the Emergency Medicine Journal, this month, chosen by Editor-in-Chief Ellen Weber.Read the primary survey here: emj.bmj.com/content/36/1/1.Details of the papers mentioned in this podcast can be found below:The view from here: on the other side of the curtain - emj.bmj.com/content/36/1/52Accuracy of NEXUS II head injury decision rule in children: a prospective PREDICT cohort study - emj.bmj.com/content/36/1/4Side effects of decision rules, or the law of unintended consequences - emj.bmj.com/content/36/1/2 Analgesia in the emergency department: why is it not administered? - emj.bmj.com/content/36/1/12Urgent care axis for the older adult: where is best to target interventions? - emj.bmj.com/content/36/1/22Exploring parents’ reasons for attending the emergency department for children with minor illnesses: a mixed methods systematic review - emj.bmj.com/content/36/1/39 Read the full January issue here: emj.bmj.com/content/36/1

10mins

10 Jan 2019

Rank #20