The St.Emlyn’s Podcast

Making decisions with incomplete information is part of everyday emergency and trauma care. But when the stakes are particularly high, how do you know when you have enough information to act? Waiting too long may cost lives. Acting too soon may put patients, colleagues or yourself at unnecessary risk. For our 300th St Emlyn’s podcast, Iain Beardsell revisits conversations he and Liz Crowe recorded...

Chest pain that sounds like indigestion, feels mild or seems “atypical” can still be myocardial infarction. The difficult question is not whether troponin is useful, but which patients actually need testing — and how much weight we should give symptoms, cardiovascular risk factors and clinical judgement. Professor Rick Body looks at the evidence behind those decisions, drawing on his own research...

Recorded at Trauma 2030 at the Royal College of Surgeons in London in December 2025, this short St Emlyn’s podcast looks at one of the most challenging situations in prehospital and emergency care: traumatic cardiac arrest. Iain is joined by Laura Kocierz, a Consultant with London’s Air Ambulance and a Consultant in Critical Care Medicine and Anaesthesia in the Midlands. In this conversation, Laur...

When does a raised troponin become a myocardial infarction? What has happened to “type 2 MI”? And how certain can we be about the diagnosis without imaging? Iain Beardsell introduces Professor Rick Body for a practical guide to the Fifth Universal Definition of Myocardial Infarction. Rick explains the changes in terminology, troponin interpretation and diagnostic criteria, focusing on what they me...

Iain Beardsell and Simon Carley return for the April 2026 St Emlyn’s podcast update, talking through another busy month of posts from the St Emlyn’s team and guest authors. This month brings trauma, systems thinking, public health and pulmonary embolism, with plenty of practical ideas to take back to your next shift. Iain and Simon start with three more of Simon’s Trauma Team Leader Tips. The firs...

In this month’s St Emlyn’s podcast, Iain Beardsell and Simon Carley work through some of the most interesting recent posts and papers from the blog. The conversation ranges from the latest pulmonary embolism guidance to the persistent problem of emergency department crowding, and from pre-hospital whole blood to the uneven availability of enhanced critical care across the UK. They also look at whe...

What does it really mean to become an expert in resuscitation and critical care? 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 abou...

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. The cli...

In this episode of the St Emlyn’s Podcast, Iain Beardsell speaks with Anna Dobbie, consultant in emergency medicine and pre-hospital care, and Clinical Lead for London HEMS. 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...

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. Some are familiar. Some are uncomfortable. All of them feel relevant on shift. We start with the RSI trial — ketamine versus etomidate. A study that generated a lot of noise, and perhaps more certainty than it deserved. We move through trauma team leadership....

Shock is one of the most used words in emergency medicine. It’s also one of the most misunderstood. 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. We disc...

What do we really know about treating refractory ventricular fibrillation? And why are we still waiting to use strategies that might actually work? 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 compare...

You’re about to hear a conversation that ranges widely — from training reform and trauma leadership to ondansetron, paracetamol protocols, and artificial intelligence. But it isn’t really about any single topic - It’s about where emergency medicine is heading. And whether we are ready for it. This is our November and December 2025 round-up, and revisits the blog posts from the end of last year. A...

You’re about to hear a conversation about doing less. But it isn’t really about doing less. It’s about time. 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 a...

In this episode of the St Emlyn’s Podcast, we’re joined by Nigel Ruddell, Medical Director of the Northern Ireland Ambulance Service, recorded live at the BASICS Conference. This is a conversation about Helicopter Emergency Medical Services (HEMS) — but not in the way you might expect. It’s not really about aircraft. It’s about people. Nigel talks us through the long, often uncomfortable journey t...

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. This is a calm, evidence-led discussion of a rare, high-stakes intervention that most clinicians will encounter once, if at all — and still need to get right. What we cover Why the term resuscitative hysterot...

In this (rather delayed!) October round-up, Iain Beardsell and Simon Carley catch up on recent St Emlyn’s blog posts and papers that continue to shape emergency and resuscitation practice. The discussion moves across trauma, analgesia, cardiac arrest physiology, emergency department systems, and antimicrobial stewardship—less about novelty, more about what actually holds up on shift. Trauma and ha...

This bonus episode is a quick-fire collection of clinical pearls drawn from across the St Emlyn’s podcast in 2025. Short, practical, and deliberately focused, these are the moments that make you stop and think: “That’s useful — I want that in my head.” There’s minimal commentary and no deep dives. Each clip stands on its own as a clear takeaway, designed to be listened to in one go or dipped back...

Some of the hardest moments in emergency medicine aren’t hard because they’re complicated. They’re hard because they’re rare — and when they arrive, you’re relying on things you last thought about a long time ago. This final episode in the Best Bits of 2025 series is the “file it away” collection: rare, high-stakes situations where preparation is largely cognitive, decisions are time-critical, and...

January often brings pressure to improve — to fix gaps, sharpen skills, and somehow be better than the year before. Done badly, that drive can become another source of burnout. This third episode in the Best Bits of 2025 series focuses on how improvement actually works in emergency and acute care — and how to do it in a way that is realistic, sustainable, and kind to the people doing the work. The...

Winter pressure doesn’t just affect patient flow. It affects people. This second episode in the Best Bits of 2025 series focuses on the human side of emergency medicine: culture, moral injury, compassion, and the small but meaningful behaviours that help clinicians stay grounded when work is relentless. The clips in this episode are drawn from full St Emlyn’s podcast episodes released during 2025...

Emergency medicine strips decision-making back to its essentials when departments are full and time is short. This first episode in the Best Bits of 2025 series brings together some of the most practically useful moments from the St Emlyn’s podcast this year — focusing on how clinicians make good decisions under pressure, when conditions are far from ideal. Each clip comes from a full episode rele...

Join Iain Beardsell and Hutch as they review key insights from the Trauma 2030 conference hosted by the Institute of Pre-Hospital Care , part of London's Air Ambulance . The discussion highlights the emphasis on speed in damage control resuscitation, the ongoing debate on 'scoop and run' versus 'stay and play' approaches, and the nuanced use of resuscitative thoracotomy. The episode delves into ad...

Recorded at the BASICS Conference 2025, Iain talks with Haldon “Hutch” Hutchinson-Basley about the idea of a “cognitive HALO” — those rare moments where your mental bandwidth hits maximum power. Hutch describes a traumatic cardiac arrest he encountered alone, with no warning and no crewmate to share the load. He explains how he recognised cognitive overload and used simple strategies — “lighting a...

In this St Emlyn’s podcast, Ian Beardsell and Simon Carley speak with RAF GP Phil Lucas from the Royal Air Force Centre of Aerospace Medicine at the BASICS conference in Leicestershire. They explore what really happens when a pilot pulls the ejection handle, and what this means for pre-hospital and Emergency Department teams who may be the first to see an ejectee. Phil explains: • Why the aviation...