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.

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.

This bonus episode is a quick-fire collection of clinical pearls drawn from across the St Emlyn’s podcast in 2025.

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 listeners.

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? A small perturbation downstream, such as a driver braking slightly too hard, propagates backwards through the coupled queue, as each following driver reacts with a slight lag. In turn, the next vehicle slows down slightly more than the one in front of it.

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 reappointment as Dean of the Royal College of Emergency Medicine, before reflecting on recent conferences including IFEM in Hamburg and Don’t Forget The Bubbles in Glasgow.

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 VF trial has changed in practice. It’s about understanding why defibrillation fails, how vector and energy delivery matter, and when a different approach might improve outcomes.

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.

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.

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.alo

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.

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 medicine education, MRCEM examinations and patient safety.

Evidence from academic studies, professional bodies, coroners, NHS trusts and patient-safety investigators increasingly links corridor care and prolonged emergency department boarding with avoidable harm. Stevan Bruijns asks whether the evidence now warrants a formal public inquiry.

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.

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 medicine. Anna reflects on six years as Clinical Lead for London HEMS, sharing lessons on leadership, culture, psychological safety, difficult conversations, managing strong personalities, and supporting clinicians to do their best work.

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 cannot be fixed pre-hospital. I’m joined by Harriet Tucker , consultant at London’s Air Ambulance, HEMS Governance Lead at Air Ambulance Kent Surrey Sussex, and Trauma Team Leader at St George’s Major Trauma Centre to talk about damage control pre-hospital care.

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 we know and more about how we think.

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, crowding and why surviving difficult systems depends not only on resilience, but on having colleagues who have our back.

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 clinical syllabus domains in the RCEM curriculum. Designed for trainees, consultants and educators in emergency medicine, this interactive radar tool helps identify strengths, knowledge gaps and learning needs across the breadth of emergency medicine practice.

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 profile using an interactive radar chart. It's not an RCEM product but relates to the curriculum.

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

Does early vasopressor therapy improve outcomes in septic shock? We review the ARISE-FLUIDS trial presented at Critical Care Reviews 2026.

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 care.

ICEM 2026 in Hamburg brought together more than 3,300 emergency clinicians from around the world. Beyond an excellent scientific programme, the conference fostered connection, collaboration and advocacy. Key themes included crowding, workforce challenges, emergency medicine specialty recognition and the importance of speaking up for patients.

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 during trauma resuscitation.

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 excellence.

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

A critical appraisal of a RCT comparing REBOA and standard ALS for OHCA

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.

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 HEMS crews, and optimise patient safety in major trauma.

This is the eleventh in a series of blog posts on new research in emergency toxicology. The last post was about smoking cessation and can be found here. We deal with all sorts of poisons in Virchester, so be prepared for anything. Almost half of the drug-related deaths in the UK involve an opioid. Heroin is usually the cause. However, with…

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 audience created a learning experience that felt connected to the realities of Emergency Medicine.

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

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

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

Pulmonary Embolism is awful. You don't need me to tell you. Just read the news. However, the evidence-based fight to improve care continues and the Greek goddess rages on, with publication of PEITHO, PEITHO 2 and with PEITHO 3 in the wings for completion by June 2026. In addition, we now have a short interlude for HI PEITHO, published last month in the…

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.

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

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 here or on your favourite podcast platform. “We look at the present through a rear-view mirror. We march backwards into the future.” Marshall McLuhan…

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