MEM-EM: The Memorising Emergency Medicine Podcast

Mnemonic for BACKPAIN Red Flags & Do Not Miss DDX = BACKPAIN can be CRAFTI Back Pain Red Flags*   B ladder, Bowel & Erectile Dysfunction or Bilateral Sx**   A naesthesia (saddle)   C ancer or Coagulopathy – Sx or PMH/risk (N.B. Thoracic Back Pain)   K yphosis, stenosis, achondoplasia, or other pre-existingspinal narrowing.   P ain at Night +/-worse lying down think infection or cancer (USU...

Clinical Epidemiology and Bedside Identification of Sepsis Sources in the United Kingdom: A Comprehensive Analysis of the Expanded LUCAS Framework and NHS Presentation Trends The clinical management of sepsis within the United Kingdom’s National Health Service (NHS) has undergone a paradigmatic shift over the last decade, transitioning from a reactive physiological response model to a proactive, s...

Sepsis is a time-critical medical emergency defined as life-threatening organ dysfunction caused by a dysregulated host response to infection [1]. Globally, it remains a leading cause of morbidity and mortality, with an estimated 49 million cases and 11 million deaths annually [8]. 

What to do in these emergency situations.

Suspected Sepsis in Pregnant and Recently Pregnant People: Recognition, Diagnosis, and Early Management Executive Summary Sepsis in the obstetric population is a life-threatening medical emergency requiring immediate recognition and intervention. This guideline (NICE NG255, 2025) replaces NG51 and provides a tailored framework for pregnant people and those who have been pregnant within the last si...

Executive Summary Acute airway obstruction, designated under the Royal College of Emergency Medicine curriculum as clinical presentation RP1, remains one of the most significant challenges in the National Health Service Emergency Department environment. This presentation encompasses two distinct but often related issues: choking (RC1) and stridor (RC2). The management of these conditions requires...

Executive Summary The modern management of resuscitation presentations in the Emergency Department (ED) requires a standardized approach using the Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) framework, integrated with the National Early Warning Score 2 (NEWS2) to drive risk stratification.[4, 5, 7] Significant updates in the 2025 NICE sepsis guidance (NG253) have introduced a...

Executive Summary Tension pneumothorax (TPT) is a life-threatening condition occurring in approximately 1% to 3% of prehospital major trauma and intensive care patients. While traditionally taught as a uniform clinical entity characterized by "classic" signs such as tracheal deviation and jugular venous distention (JVD), evidence indicates that these manifestations are rare and unreliabl...

Executive Summary As the demographic shift continues, older people living with frailty have become the primary user group of NHS Emergency Departments (ED). Frailty is a state of vulnerability resulting from a loss of biological reserves and physiological failure, leading to a high risk of adverse outcomes including functional decline, institutionalisation, and death [5-7]. Current urgent care sys...

Executive Summary The primary mission in the Emergency Department (ED) is the rapid identification of life-threatening organ dysfunction. Clinicians must maintain a high index of suspicion, asking "Could this be sepsis?" for any patient presenting with signs of infection. Critical Window:  For patients meeting any  High Risk  criteria, a senior clinical decision maker (ST4+) must assess...

The management of a paediatric airway in the emergency department (ED) represents one of the most cognitively demanding and high-stakes scenarios in modern emergency medicine. While the incidence of a "Cannot Intubate, Cannot Oxygenate" (CICO) event in children is significantly lower than in the adult population, the physiological margins for error are substantially narrower, necessitati...

These sources compare clinical methodologies for evaluating  acid-base homeostasis , specifically contrasting the traditional  Henderson-Hasselbalch  model with the  Stewart physicochemical approach . The Stewart model identifies  Strong Ion Difference (SID) ,  weak acids  like albumin, and  carbon dioxide  as the three independent variables that govern blood pH. While the traditional method remai...

The management of allergic disease within the United Kingdom's National Health Service (NHS) Emergency Department (ED) environment requires a sophisticated synthesis of immunological theory, rapid clinical assessment, and adherence to evolving evidence-based guidelines. The Royal College of Emergency Medicine (RCEM) Advanced Clinical Practitioner (ACP) curriculum identifies several core presen...

Comprehensive Expert Guide to Emergency Airway Management: The I'D SOAP ME UP2 Mental Model The practice of emergency airway management has evolved from a purely technical procedure into a sophisticated cognitive and physiological intervention. In the modern Emergency Department (ED), the goal is no longer simply to "get the tube," but to achieve a Definitive Airway Sans Hypoxia, Hyp...

Tips and Tricks to be mentally ready to perform emergency decompression of the pleural cavity in chest trauma.

How do you prepare for the worst day on shift when you have to act now? Using AI to simulate and stimulate a mental workout for HALO procedures.

Diagnostic error represents the most significant, yet historically overlooked, threat to patient safety in contemporary medicine. In the high-velocity, information-scarce environment of the emergency department (ED), the stakes of clinical decision-making are uniquely amplified. Recent evidence suggests that approximately 5.7% of all emergency department patients—equivalent to one in 18—receive an...

The provided text explains that  lactate  is a vital metabolic fuel and carbon source for the  heart and brain , rather than just a waste product of oxygen deprivation. Clinicians categorize  lactic acidosis  into two types:  Type A , which stems from inadequate tissue oxygenation, and  Type B , which occurs due to metabolic triggers like medications, toxins, or systemic diseases. The  liver and k...

Executive Summary This briefing document synthesizes the NICE NG253 (2025) guidelines for the recognition, assessment, and early management of suspected sepsis in individuals aged 16 and over. The central shift in practice is the mandatory use of the National Early Warning Score 2 (NEWS2) for risk stratification in acute hospital settings, ambulances, and acute mental health facilities. Critical T...

The United Kingdom’s National Health Service has transitioned from a fragmented approach to a  sophisticated regional network  designed to deliver critically injured patients to the most appropriate level of care. This tiered architecture utilizes  Major Trauma Centres  as specialized hubs for severe injuries, supported by smaller units that stabilize patients and adhere to strict  evidence-based...

This strategic framework outlines the evolution and operational standards of  major trauma services  within the UK, specifically detailing how regionalized networks have significantly increased patient survival since 2012. The text focuses on the critical mechanism of  Trauma Team Activation (TTA) , advocating for a  tiered response system  that balances urgent multidisciplinary care with the effi...

Executive Summary Achieving Specialty Learning Outcome (SLO) 12 requires a transition from clinical competency to system leadership. This document synthesizes the  RCEM CARES  strategic framework (addressing system pressures) with the  EMLEADER  development programme (building personal capability). Critical Takeaways: Strategic Alignment:  Operational decisions must align with the RCEM CARES pilla...

Executive Summary This briefing document provides a comprehensive guide to the Royal College of Emergency Medicine (RCEM) Quality Improvement (QI) assessment, a core component of the 2021 curriculum. Specialty Learning Outcome (SLO) 11, "Participate in and promote activity to improve the quality and safety of patient care," represents a fundamental shift from a single examination hurdle...

Executive Summary Specialty Learning Outcome (SLO) 11 represents a fundamental shift in the Royal College of Emergency Medicine (RCEM) curriculum, moving away from a single examination hurdle to a continuous, longitudinal assessment of Quality Improvement (QI) and patient safety. Critical Takeaways: Continuous Assessment:  QI is no longer an isolated event; it is "spiralled" through trai...

Acute wound management in the emergency department (ED) focuses on two primary goals: avoiding infection and achieving a functional, cosmetically acceptable scar. Effective management requires a deep understanding of the physiological phases of wound healing—hemostasis, inflammation, proliferation, and maturation. Practitioners must distinguish between wounds suitable for primary closure and those...