EMJ Podcast

A new paper takes a look at fatalities in nightclubs across the UK in the last 15 years, based on media reporting and coroners' reports. It found that physical assault and overdoses of MDMA/ecstasy were the leading causes of deaths. Another paper, from Japan, addresses acute scrotum presentation. It set out to rate the use of the TWIST score and point-of-care ultrasound when identifying testicular...

Access to helicopter emergency services is improving in the UK, a recent study shows. But what impact is that access having? There's a paper for that too, with this episode declaring: "Helicopters for the win!" There's also research on the effect of epinephrine administration for out-of-hospital cardiac arrest in children - does the sequence of treatment affect the outcomes? And finally, how to fi...

This month we've got a few papers on dealing with smoking - and not smoking - in the emergency department. The episode starts off with a discussion of a paper on automating high-flow nasal oxygen, and the importance of titration of oxygen levels - critical for patients with COPD. Then there's a paper questioning, can nicotine replacement therapy in the ED really work? This is followed by a researc...

What happens to an emergency department when staff go on strike? A new study published in EMJ examines this challenging scenario and its impact on patient flow. Another paper looks at the hybrid-warfare attack carried out in Lebanon, where exploding pagers caused a mass casualty incident, and what emergency departments can learn from managing that event. EMJ editor Prof. Richard Body adds some of...

"Should we be giving blood transfusions to patients with traumatic cardiac arrest?" EMJ editor Prof. Richard Body and associate editor Dr. Sarah Edwards talk through some original research on the value of blood transfusions in this difficult situation. Next is the new UNCORKED study from the Trainee Emergency Research Network (TERN), with some sobering statistics on the prevalence of emergency car...

It's the first issue of 2026, and the first with new editor-in-chief Prof. Richard Body heading the journal. He is joined by senior associate editor Dr. Sarah Edwards, as they take a look at some highlights of the issue.  First in the line-up is a paper looking at how "Same day emergency care" units, or SDECs, have come to mean quite different things across the UK. In some cases, the rule-out proc...

One thing you'll never hear in the emergency department is the sound of silence. And if the hubbub should start to lower, woe betide the ED staffer who dares to say, "it's looking quiet tonight." But should we really be so concerned? A paper in this episode's roundup takes a look at superstition versus science. Staffing concerns is another ever-present topic when it comes to the ED, and Rick and S...

Despite what the CPR doll might suggest, cardiac arrest patients are not always white, lean and male. So why is that the case for resuscitation training? The first paper in this episode addresses this lack of representation and the impact it has on resus performance. The next paper is a practice review of functional neurological disorder (FND), highlighting the poor diagnosis rate and history keep...

The atmosphere of the emergency department can be a hard thing to put into words, with intense emotions washing over patients and staff alike. This month we feature a poem, powerfully illustrating the drama and stress inside the ED bubble. One of the recurring sources of uncertainty for patients is the question, “How long until I’m seen, doc?”, and there’s a paper following up on that issue with a...

"What is your understanding of your father's illness?" This is the kind of question that may be posed by emergency clinicians in the context of end-of-life care. But as a survey of Thai and American emergency departments finds, approaches to these conversations can be quite different globally. This episode also features another angle on end-of-life care, highlighting the persistent impact that dep...

A new paper on the challenging diagnosis of acute appendicitis has us wondering, can it be spotted with just a glance? The reality is never so simple. This episode we also discuss low-value overtesting, cardiac arrest trial consent, and patient discharge into police custody. As with many aspects of the ED, they each have a layer of legal pressure to consider.   Read the highlights: August 2025 pri...

The NHS plans to set up mental health emergency departments throughout England. A survey discussed this episode highlights the importance of mental health assessments, finding that nearly a quarter of suicide deaths in a one year period had come after hospital or emergency department contact. Another survey raises the question, "How well is your ED prepared for a major incident?" and the statistic...

Can salbutamol be used be used to relieve pain in renal colic patients? Starting off this month's episode, a randomised trial seeks to find the answer. Then a topic of interest for anyone seeing patients with a phobia of needles, namely a study comparing coolant spray with topical anaesthetic cream for reducing pain from intravenous cannulation. Next, randomisation is a necessary tool for many tri...

A new survey has found that less than one third of end-of-life patients in Irish emergency departments have their own room. This is only one of the shortcomings found in end-of-life care, explored in two papers to start this episode. Following on from that is a comparison of video and direct laryngosocopy for intubation outcomes. There's also a "Best Evidence" review of the use of nasal clips for...

Trauma and paediatrics are the themes for this month's collection of papers. Starting off is a review of the effectiveness of prehospital ultrasound in detecting lung injury, with some surprising statistics. Next is a letter on the topic of self-presentation by paediatric patients with major trauma, which is thankfully a rare occurrence. The third paper looks at prehospital testing of trauma patie...

Advance clinical practitioners (ACPs) can have a big role to play in the emergency department, but their career paths are not always well understood. This episode features three papers from the journal which begin to address that - a census survey of over 1000 ACPs, a qualitative study on their experiences in emergency care, and a commentary on how to improve ACP training. There is also a paper fr...

Another packed issue of the journal this month, and a podcast to match. Starting off with the Editor's Choice paper, on the important topic of sex and gender disaggregation in emergency medicine trials. Sex and Gender Equity Reporting (SAGER) guidelines were introduced in 2016 but poor adherence is still found in current publications. Next is a paper with high seasonal relevance, addressing the se...

A special bonus podcast this time, on the perennial issue of crowding. Rick and Sarah are joined by Royal College of Emergency Medicine president Dr. Adrian Boyle, and EMJ's editor-in-chief Prof. Ellen Weber. They address recent evidence for crowding's harmful impact, the arm-twisting needed to shape policy, how it shapes patient confidence, and what the future of crowding looks like.   Links: Ass...

It's a celebration of qualitative research to start the new year, with a collection of papers offering new perspectives on emergency department issues. First is a pair of papers centred on the theme of pre-alerts to the emergency department. Setting the scene for a patient's arrival is a vital process, yet it can generate fear of criticism for getting the balance wrong, when it comes to over- and...

Subarachnoid haemorrhage is a diagnosis that can't be missed, but it is not a simple process to detect it. The first paper for discussion this month questions if a CT scan within 6 hours is sufficient for exclusion in patients with acute headache. Then there is a large-scale analysis of over 400 million ED visits in the USA, focussing in on the significant issue of self-harm in the homeless popula...

Upper limb injuries make up about three-quarters of the limb injuries to children seen in the emergency department. But when it comes to the elbow, just how good are clinicians at diagnosing based on radiography? The first paper this month is a study putting over 300 global participants to the test. There's also a practice review highlighting the concept of shared decision making with frail elderl...

There's a whole pile of blocks in this month's papers, with the first being a trial of Erector-Spinae Plane (ESP) blocks, not for rib fractures as you might expect but Hepato-Pancreato-Biliary (HPB) pain instead. Following on from that is a retrospective study comparing the resource utilisation of haematoma blocks, Bier’s blocks and procedural sedation for patients with forearm fractures. The next...

Being fallible was one of the most valued characteristics in a consultant, according to new doctors going through their induction - that's the subject of the first paper this month. Next up is a study on the impact of noise on hospital staff, which includes some simple interventions with measurable impact. There's also a discussion on pain relief for rib fractures, and how frailty scores are linke...

The recovery of laceration repair patients is the topic of this month's first paper, looking at behavioural disturbances in children following these difficult medical procedures. The second paper deals with pre-hospital use of tranexamic acid for trauma, and surfaces some demographic discrimination in its rates of application. Next there is an observational study which has developed a score for in...

What might yawning and sneezing be signs of in a patient? This month's podcast features new RCEM and NPIS guidance on acute opioid toxicity, outlining a number of symptoms to stay alert to. Before getting to that there's a paper on bypassing hospitals for patients needing mechanical thrombectomy, a study on how austerity affected emergency admissions across a range of UK local authorities, and som...