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This month I interview PEM Physician Dr Wilkin-Marshall, on the new PECARN C-spine rules. Dr Davies and I talk exertional heat stroke, Prof Middleton and I talk Ultrasound in Cardiac Arrest. We look at the literature on induction agent choice to avoid post intubation hypotension and using ‘bubbles’ to diagnose RV Failure. There’s EMCORE Lectures on choosing IV fluids and pressure controlled ventilation. PLUS there’s  the MCQ’s in EM Quiz.

I interview Dr Ben McKenzie on Anaphylaxis and have Mastery sessions on Status Epilepticus, Blowout Fractures and the Oculocardiac reflex and the fragmented QRS. We cover literature on; The DEFI 2022 Study, IM Adrenaline in OHCA, the impact of time to defibrillation on ROSC. We also look at pustules and visicles in children, ‘The Asthma Patient from Hell’ and ‘Pressors in Trauma’.

We look at Acute Aortic Syndrome, Idiopathic Ventricular Tachycardia and the 5 Steps to diagnosing Diplopia. There are EMCORE lectures on ‘Clearing the Adult Cervical Spine’ and ‘Syncope in Children’. In Papercut we look at literature on the PROFUNDUS Study, ‘Is presyncope as serious as syncope’ and do the elderly need a CT Brain in low energy blunt trauma., using D-dimer to diagnose dissection and a new risk score for Vertigo.

The President of RCEM talks about ‘Hapiness in Emergency Medicine’, I discuss ‘Resuscitative Sequence Intubation’ and ‘Stroke Mimics’ and Dr Joe Nemeth, Canadian Emergency Physician talks about ‘Zero Point Survey’. We look at new studies on D-dimer in PE, The ARREST Trial, subsegmental PE and I review 11 studies on sub-clinical AF and anticoagulation. Plus there’s a rashes quiz, and lectures on ‘Hyponatraemia’ and ‘Having the Family Present during Cardiac Arrest’.

We talk about the investigation trends in suspect SAH and then it’s all about haemorrhage with post tonsillectomy, Upper GI and post -partum haemorrhage. The are lectures on ‘Ketamine for Analgesia’ and ‘High quality CPR in Cardiac Arrest’. Then there is an extensive literature review including UK-REBOA Trial, HALT-IT Trial, NICO Trial, PREOXI Trial, Vasopressin initiation timing in septic shock, POCUS pulse checks, early vs late airway in cardiac arrest and the use of nebulised Ketamine.

This is a massive month where we talk about intubation pearls for the obese patient, rashes, the approach to suspected PEA. I talk about ‘Stroke Chameleons’ and how we approach the patient with acute atrial fibrillation. There are EMCORE lectures on ‘Test Ordering’ and ‘Testicular Pain in Kids’. In papercut we look at the CLOVER Trial, The EPIC Trial, The BEST AF Trial, the timing of AF cardioversion, how to cardiovert, subclinical AF, the GARFIELD AF Risk Score, adrenaline vs noradrenaline in post arrest hypotension and ‘Practice Changing Resuscitation Papers’.

We present cases on VT Storm, SCAD and Guillain Barre Syndrome, as well as a case where ‘ICU Won’t Take the Patient’ Dr Davies covers Bell’s Palsy and I talk about BRASH Syndrome and rapid neuro exams for stroke diagnosis. There are EMCORE Lectures on ‘Airway’ and ‘Fluid Resuscitation in Trauma’. In papercut we look at the 4 best cardiac arrest RCT’s of ’23, cardiogenic shock management in the elderly, ‘Adrenaline or Airway First in Cardiac Arrest’, POCUS pulse checks, the accuracy of NIBP measurement, Methylene Blue in Septic Shock and Bronchiolitis.

This month we look at choosing inotropes and pressors, oxygen targets in cardiac arrest, pericardits and a case of atrial flutter with a high degree block. I discuss a case of status epilepticus in a child, a case of chest pain and shock,with a twist, the ‘Spiked Helmet Sign’. In papercut we look at VL vs DL, steroids in commuity acquired pneumonia, capnography in cardiac arrest and smaller BVM’s for ROSC. There’s an EMCORE lecture by Dr Keijzers on ‘Pneumothorax Management’ and I talk about ‘Pregnancy and Trauma’. Plus quizzes.