iiinova — where your digital self keeps evolving

RCEMLearning @rcemlearning.bsky.social · 29/09/2026

NEW: Here are a few thoughts on some questions we’ve been asked that we had to pretend we knew the answers to. Send us your questions (and answers) by commenting below and let us know whether these EM aligned thoughts are a useful #blog! www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 28/09/2026

NEW: A 24-year-old man is pre-alerted to Resus with a HR of 180 and “muscle weakness”. On arrival, he describes a 36-hour history of rapidly progressive weakness and aches initially affecting his legs and now his arms. #ClinicalCase www.rcemlearning.co....

I can’t get out of bed
Clinical Case
NEW

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RCEMLearning @rcemlearning.bsky.social · 25/09/2026

NEW: An elderly woman with abdominal pain and normal initial observations develops acute mesenteric ischaemia. This SBA explores recognition and management of this vascular emergency #SBA www.rcemlearning.co....

When the examination does not fit the pain
SBA

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RCEMLearning @rcemlearning.bsky.social · 25/09/2026

RCEMLearning are looking new and enthusiastic collaborators to get involved with the award winning RCEMLearning podcast For those who have new ideas but don't know where to start, or those who are eager to contribute to conversations within emergency medicine community - this opportunity is for you

Are you a fan of the RCEMLearning podcast?
Do you enjoy discussing emergency medicine?
We have an opportunity for you...

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RCEMLearning @rcemlearning.bsky.social · 24/09/2026

Our Safety Flash committee who help inform our members on recent developments with emergency medicine, have recently released their latest safety flash regarding Eating Disorder Red Flags which outlines the importance of increased education and awareness of how eating disorders present in the ED

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RCEMLearning @rcemlearning.bsky.social · 22/09/2026

UPDATE: So, what is a major incident? Simply put, it is any incident that requires an extraordinary response from health services - ambulance services, primary care, community services and hospital Trusts #Blog www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 21/09/2026

NEW: An elderly woman presents with chest discomfort and markedly raised troponin levels. Initial investigations suggest an acute coronary syndrome, but invasive angiography reveals unobstructed coronary arteries, prompting further investigation. #ClinicalCase www.rcemlearning.co....

NEW, The Sinister Sister – A Case of an Acute Coronary Syndrome Mimic
Clinical Case

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RCEMLearning @rcemlearning.bsky.social · 21/09/2026

UPDATE: Many, many moons ago, we put some details about non-technical skills (which we erroneously called “human factors”) together in an iBook. We’re not making iBooks anymore, so here is an entire iBook, as a #blog post. www.rcemlearning.co....

Non Technical Skills
Clinical Case
UPDATE

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RCEMLearning @rcemlearning.bsky.social · 18/09/2026

UPDATE: A 72-year-old man presents to the ED with a 3 week history of intermittent abdominal pain; it is now constant in nature and 8/10 in severity #ClinicalCase www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 17/09/2026

NEW: A 58-year-old man presents to the Emergency Department (ED) with a 3-day history of progressive shortness of breath. He reports that his symptoms have gradually worsened, initially occurring on exertion but now present even at rest. #ClinicalCase www.rcemlearning.co....

The blue man with brown blood: a diagnostic twist
Clinical Case

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RCEMLearning @rcemlearning.bsky.social · 16/09/2026

NEW: A patient presents to the ED following an assault. Where is his missing tooth? #SBA www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 14/09/2026

UPDATE: A 75-year-old man presented to the ED of a District General hospital complaining of severe abdominal pain that followed an episode of vomiting earlier in the day #ClinicalCase www.rcemlearning.co....

Abdominal Pain After Vomiting
Clinical Case

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RCEMLearning @rcemlearning.bsky.social · 10/09/2026

UPDATE: These modules covers the principles of triage in major and mass casualty incidents, including the use of Ten Second Triage (TST) and the Major Incident Triage Tool (MITT) #LearningSession: www.rcemlearning.co.... #Reference: www.rcemlearning.co....

Pre-hospital Mass Casualty Triage
Learning Session/Reference
UPDATE

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RCEMLearning @rcemlearning.bsky.social · 09/09/2026

UPDATE: A conducted energy device (CED) ‘taser’ was discharged into a patient’s shoulder. Before this patient is taken into police custody, you’ve been asked to assess them in your ED #SBA www.rcemlearning.co....

Managing the ‘Tasered’ Patient – Conducted Energy Devices
SBA
update

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RCEMLearning @rcemlearning.bsky.social · 08/09/2026

NEW: Not every patient with palpitations, sweating and hypertension has a panic attack. Could it be pheochromocytoma - the Zebra you cannot afford to miss? #Blog Edited by Charlotte Davis

Pheochromocytoma in the Emergency Department:
The zebra you cannot afford to miss
Blog

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RCEMLearning @rcemlearning.bsky.social · 07/09/2026

NEW: A 13-year-old girl is brought into the Paediatric Emergency Department (ED) after review in the outpatient clinic, where on auscultation air entry on the right side of her chest is noted to be significantly reduced #ClinicalCase

Paediatric Spontaneous Pneumothorax in the Background of Asthma Exacerbation
Clinical Case
NEW

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RCEMLearning @rcemlearning.bsky.social · 06/09/2026

SUNDAY QUESTION: Which of these is true of pre-eclampsia? a). It is thought to be caused by vasodilation b). It is a multi-system disease c). The pathophysiology is clearly understood d). The cause is not thought to be related to genetics

Which of these is true of pre-eclampsia?

a). It is thought to be caused by vasodilation
b). It is a multi-system disease
c). The pathophysiology is clearly understood
d). The cause is not thought to be related to genetics

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RCEMLearning @rcemlearning.bsky.social · 04/09/2026

NEW: A 50-year-old female patient re-attends to the Emergency department (ED) with left shoulder pain 10 days after a fall. She initially attended another ED shortly after the injury where she was reviewed by an ED consultant and discharged with analgesia. #ClinicalCase www.rcemlearning.co....

A re-attender with shoulder pain
Clinical Case
NEW

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RCEMLearning @rcemlearning.bsky.social · 02/09/2026

UPDATE: Urgh...another pain in the back #SBA "A resident doctor asks for your advice in managing patients presenting with acute back pain in your emergency department (ED). How will you manage each patient?" www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 30/08/2026

SUNDAY QUESTION, tell US the right answer: During which stage of labour does the delivery of the placenta and membranes occur? a). Third stage b). Active second stage c). Established first stage d). Dormant second stage

SUNDAY QUESTION
During which stage of labour does the delivery of the placenta and membranes occur?

a). Third stage
b). Active second stage
c). Established first stage
d). Dormant second stage
TELL US THE RIGHT ANSWER

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RCEMLearning @rcemlearning.bsky.social · 28/08/2026

UPDATE: Learn how to recognise and manage silver trauma in emergency medicine, including assessment, treatment, and key clinical considerations #Blog www.rcemlearning.co....

Trauma in the Older Adult: Silver Trauma
Blog

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RCEMLearning @rcemlearning.bsky.social · 27/08/2026

NEW: These sessions focus on white-eye blowout fractures, often subtle but serious orbital injuries most commonly seen in, but not exclusive to, paediatric and adolescent patients #LearningSession #Reference LS 🔒: www.rcemlearning.co.... Ref: www.rcemlearning.co....

White Eye Orbital Blowout Fracture
Learning Session/Reference

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RCEMLearning @rcemlearning.bsky.social · 26/08/2026

UPDATE: A 25-year-old male presents to your ED with central sharp chest pain, shortness of breath and palpitations #SBA www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 25/08/2026

NEW: This #blog has been developed with research abstracts in mind; however, many of the principles discussed can also be applied to other types of abstracts, including quality improvement projects and case reports

How to write an excellent abstract
Blog, NEW

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RCEMLearning @rcemlearning.bsky.social · 24/08/2026

UPDATE: A 25-year-old obese female, who is 1-week post-partum, presents with worsening shortness of breath on minimal exertion, orthopnoea, pedal oedema and a dry cough #ClinicalCase www.rcemlearning.co.... #breathlessness, post-partum, shortness of breath, #cough

Doc, I can't breathe. Clinical Case. UPDATE.

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RCEMLearning @rcemlearning.bsky.social · 21/08/2026

UPDATE: A patient with “kidney troubles” now has acute kidney injury. How will you identify and manage her AKI? #SBA www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 20/08/2026

NEW: A 54-year-old woman presents with postprandial abdominal pain and weight loss. CT angiography confirms Median Arcuate Ligament Syndrome #ClinicalCase www.rcemlearning.co....

A Gut Feeling: A curious case of attacking meals
Clinical case, new

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RCEMLearning @rcemlearning.bsky.social · 18/08/2026

NEW: A 54-year-old man presents with tearing chest pain and an ECG suggesting STEMI, but imaging reveals aortic dissection, highlighting the need to exclude dissection before anticoagulation #ClinicalCase www.rcemlearning.co....

A Diagnostic Challenge: Aortic Dissection Mimicking STEMI
Clinical Case

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RCEMLearning @rcemlearning.bsky.social · 17/08/2026

NEW: A patient presents with bilateral painful red feet and minimal inflammatory markers. This case explores key differentials and highlights an important non-infectious cellulitis mimic in emergency practice. #SBA www.rcemlearning.co....

Hot, Red Feet Bilaterally: What Is Happening?
SBA

NEW

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RCEMLearning @rcemlearning.bsky.social · 16/08/2026

SUNDAY QUESTION Intermittent recording of foetal heart rate using handheld Doppler or POCUS is useful in the assessment of the patient in labour. What would count as a “normal”/“reassuring” foetal heart rate? a). 80-100bpm b). 180-200bpm c). 100-109bpm d). 110-160bpm

Intermittent recording of foetal heart rate using handheld Doppler or POCUS is useful in the assessment of the patient in labour. What would count as a “normal”/“reassuring” foetal heart rate?

a). 80-100bpm
b). 180-200bpm
c). 100-109bpm
d). 110-160bpm

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RCEMLearning @rcemlearning.bsky.social · 11/08/2026

UPDATE: A young lady presented with abdominal pain, lethargy, (Groin) bone pain, depression and headache #SBA www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 11/08/2026

UPDATE: Your patient is a 70-year-old lady with a history of type 2 diabetes and Parkinson’s disease, for which she is on a number of medications #Blog www.rcemlearning.co....

Managing Parkinson's in the ED
Blog, UPDATE

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RCEMLearning @rcemlearning.bsky.social · 10/08/2026

NEW: A young patient presents to the ED with a swollen finger, but things are not as straightforward as it seems. #ClinicalCase www.rcemlearning.co....

A Case of Digital Misdirection
Clinical Case

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RCEMLearning @rcemlearning.bsky.social · 04/08/2026

UPDATE: Why digoxin? Digoxin has a narrow therapeutic index and digoxin toxicity can be a life-threatening condition #Blog www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 03/08/2026

NEW: As voted by you, we have a new Curriculum Cup: Obstetrics & Gynaeocology 30 questions. 30 minutes. Test yourself against your colleagues and the clock to see if you can top the Leaderboard! Winner to be announced at the end of the month on our social media www.rcemlearning.co....

Curriculum Cup: Obstetrics & Gynaeocology
NEW

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RCEMLearning @rcemlearning.bsky.social · 02/08/2026

SUNDAY QUESTION What is the best next management step?

Jeremy is a patient who has been admitted with shortness of breath. He currently has RR32, SpO2 78% RA, HR 120, BP 120/80, Temp 38.2.
His ABG on room air shows pH 7.25, pO2 7.1 pCO2 7.4.
His chest sounds bilaterally wheezy. He has already been treated with salbutamol, ipratropium, steroids, antibiotics and fluids. Jeremy has been medically optimised and you wish to start him on NIV. The ultrasound scanner and chest x-ray are currently unavailable.

What is the best next management step?

A). Contact ITU to review the patient in case he requires invasive ventilation.
B). Start BIPAP, and observe carefully for deterioration.
C). Start CPAP, and observe carefully for deterioration.
D). Wait for a chest x-ray before commencing BIPAP

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RCEMLearning @rcemlearning.bsky.social · 30/07/2026

NEW: This session delves into the definition, pathophysiology, clinical assessment, investigations and management of uveitis and potential pitfalls in assessment and management. #LearningSession #Reference #Uveitis, #inflammation, #steroids LS: www.rcemlearning.co.... Ref: www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 29/07/2026

NEW: A 49-year-old lady with a background of stage IV ovarian cancer experiences sudden onset episodes of vomiting and spasmodic abdominal pain Which of the following would be the most appropriate choice of analgesia for this lady? #SBA

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RCEMLearning @rcemlearning.bsky.social · 28/07/2026

NEW: A practical guide to recognising and managing acute compartment syndrome in the ED — covering pathophysiology, red flags, pressure thresholds, and why early fasciotomy can save a limb #Blog www.rcemlearning.co.... Compartment Syndrome, fasciotomy, Orthopaedics, Limbs, Trauma

NEW, Acute Compartment Syndrome: Limb-Saving Diagnosis in the ED
Blog

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RCEMLearning @rcemlearning.bsky.social · 27/07/2026

UPDATE: A 2-year-old female presents to your Emergency Department after biting into a liquid detergent capsule. #ClinicalCase www.rcemlearning.co....

UPDATE: Eye want to go home
Clinical Case

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RCEMLearning @rcemlearning.bsky.social · 26/07/2026

SUNDAY QUESTION: How much oxygen should Arwa be placed on, and through what delivery device? a). 2L via paediatric face mask b). High flow nasal cannula c). Non re-breathe mask d). Room air oxygen (21%)

Arwa is a nine month old baby, who has come in a bit wheezy and short of breath.
She was born at term, with no problems, and has been well since. She has no siblings. There is no other family history. Mum is a smoker.
Her observations are:
RR 28, SpO2 95%, dipping occasionally to 93%, HR 148, Cap refil < 2 seconds. She has fed as much as normal, and has had lots of wet nappies. How much oxygen should Arwa be placed on, and through what delivery device?

a). 2L via paediatric face mask
b). High flow nasal cannula
c). Non re-breathe mask
d). Room air oxygen (21%)

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RCEMLearning @rcemlearning.bsky.social · 24/07/2026

UPDATE: EM physicians need to be decision makers, quick thinkers and risk balancers. This is what we are good at. In fact, many will tell you that the purpose of the PEM rotation is to learn to spot the sick child #Blog www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 23/07/2026

NEW: A patient with recurrent back pain and sciatica presents with evolving neurological symptoms—are all red flags being recognised? #ClinicalCase www.rcemlearning.co....

NEW, When sciatica isn’t sciatica: a missed malignancy, Clinical Case

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RCEMLearning @rcemlearning.bsky.social · 22/07/2026

UPDATE: Preparing for exams and trying to find an SBA on organ donation? The law around organ donation has changed; refresh your knowledge with this #SBA www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 21/07/2026

UPDATE: The alert phone goes: the ambulance team are bringing in a 2 year old girl who has fallen down a flight of stairs #Blog www.rcemlearning.co....

Paediatric Trauma Anatomy – Easy as AcBC
Blog
UPDATE

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RCEMLearning @rcemlearning.bsky.social · 19/07/2026

SUNDAY QUESTION; What is the correct answer?

A 62-year-old female with chest pain and shortness of breath was seen in your Emergency Department (ED), admitted to the cardiology ward and treated for acute coronary syndrome.
During her recent hospital admission, she was also treated for heart failure and given doxycycline for a lower respiratory tract infection.
Her past medical history includes diabetes, hypertension and a previous c-section.
Two weeks after her hospital discharge, she returns to your ED with worsening confusion and is drowsy. She has a significantly reduced oral intake and is not passing urine. Her initial blood tests results show a raised serum creatinine and hyperkalaemia.

Which of the following conditions in this patient is most likely to have caused her acute kidney injury (AKI)?

a). B-Blocker
b). Bed rest
c). Dehydration
d). Doxycycline

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RCEMLearning @rcemlearning.bsky.social · 17/07/2026

NEW: An 8-year-old boy presents with vomiting, abnormal movements and acute behavioural change. He is markedly agitated and combative, with fluctuating drowsiness and episodes of confusion, which are out of keeping with his baseline. #ClinicalCase www.rcemlearning.co....

NEW
Acute onset agitation and bizarre behaviour – a puzzling presentation
Clinical Case

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RCEMLearning @rcemlearning.bsky.social · 15/07/2026

UPDATE: There are three pregnant patients in the department who require consideration of Rhesus status and anti-D immunoglobulin. You must assess each in turn. #SBA www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 14/07/2026

NEW: The SO SOLID framework provides a simple structure for the EPIC role, helping maintain oversight of the whole department, patient flow and safety throughout the shift #Blog www.rcemlearning.co....

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RCEMLearning @rcemlearning.bsky.social · 13/07/2026

NEW: A 75-year-old patient presents with rapidly worsening lower limb pain, swelling, skin discolouration, bullae, crepitus, hyponatraemia and elevated lactate #ClinicalCase www.rcemlearning.co....

A Surgical Emergency in Disguise
Clinical Case, NEW

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