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RCEMLearning

@rcemlearning.bsky.social
280 followers 300 following 659 posts

Royal College of Emergency Medicine. ELearning and #FOAMed resource www.rcemlearning.co.uk

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RCEMLearning @rcemlearning.bsky.social · 16h
SUNDAY QUESTION: What is the most likely diagnosis? a). Foreign Body b). Acute Anterior Uveitis c). Bacterial Conjunctivitis d). Microbial Keratitis Answer us below!
SUNDAY QUESTION
A 22-year-old female presents to the Emergency Department (ED) after waking up with photophobia in the right eye.
She states she has also had pain, irritation and a gritty sensation in the same eye for the past two days. She is unsure if her vision is worse or not in the affected eye.
Upon taking a further history she admits to wearing her contact lens at night after a night out a few days ago.
Using a Snellen chart, visual acuity is 6/6 in the left eye and 6/9 in the right eye.
Examination of the right eye and fundoscopy show a hyperaemic conjunctiva, a regular pupil and an opacity on the anterior surface of the cornea.What is the most likely diagnosis?

a). Foreign Body
b). Acute Anterior Uveitis
c). Bacterial Conjunctivitis
d). Microbial Keratitis
TELL US THE RIGHT ANSWER
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RCEMLearning @rcemlearning.bsky.social · 02/10/2026
UPDATE: Tracheostomy emergencies are a relatively common and often alarming occurrence – do you know how to manage a patient presenting with a tracheostomy emergency? #SBA www.rcemlearning.co....
Tracheostomy Emergencies
SBA
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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....
The Value Add
Blog
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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
If you're interested in getting involved, please fill out our Get Involved Survey (under "Content Reviewer"). No experience needed, just you and your passion www.rcemlearning.co....
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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
You can find our Eating Disorder Red Flags guidance, on the RCEM website:
rcem.ac.uk
Clinical Standards and Guidance - RCEM
Clinical Standards and Guidance Topics General Clinical Guidelines Critical Care, Pain & Sedation Management Trauma Infectious Diseases Pediatrics & Child Health Older People’s Emergency Medicine Ethical & Legal Considerations Reducing violence and agression Forensics, Police, Prisoners Social Issues & Special Populations Mental Health Toxicology & Poisoning Clinical Risk & Errors Medication Management & Critical Drug […]
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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....
Major Incidents – Part 1
Blog
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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....
The case of the missing tooth
SBA
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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
She is treated as an anxiety-related hypertensive episode, given benzodiazepines, observed for several hours and discharged after symptomatic improvement. Two weeks later, she re-presents following an intracerebral hemorrhage. www.rcemlearning.co.uk/foamed/pheoc...
rcemlearning.co.uk
Pheochromocytoma in the Emergency Department: - RCEMLearning
Not every patient with palpitations, sweating and hypertension has a panic attack. Could it be pheochromocytoma - the Zebra you cannot afford to miss?
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RCEMLearning @rcemlearning.bsky.social · 08/09/2026
A 38-year-old woman presents to the Emergency Department (ED) with severe headache, palpitations, diaphoresis and anxiety. Her blood pressure is 238/132 mmHg, and she looks visibly distressed.
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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....
Chest pain
SBA
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RCEMLearning @rcemlearning.bsky.social · 25/08/2026
Abstracts are a vital part of RCEM events, providing an excellent opportunity to share your work with the emergency medicine community 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....
Renal Impairment
SBA, UPDATE
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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....
Bone Pain, SBA
UPDATE
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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....
UPDATE, Digoxin Toxicity
Blog
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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....
Uveitis
Learning Session/Reference
NEW
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RCEMLearning @rcemlearning.bsky.social · 29/07/2026
Find the SBA on our website: www.rcemlearning.co.uk/modules/mali...
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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
Malignant Bowel Obstruction
SBA, NEW
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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....
Decision Making in Paeds
UPDATE, Blog
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