Saint Emlyn's

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Marching Backwards into the Future. My first blog post in a long time. Challenging the mandatory training system reflex in healthcare @stemlyns stemlynsblog.org/marching-backw… #complexity #psychologicalsafety #cognitiveload

@PacoCampilloPal @docib @stemlyns Una vez más Incrementum no defraudó! Gran trabajo de todo el equipo . Ebhorabuena!!

This was IncrEMentuM 2026. A gift from all the speakers and the audience to all of us. Thanks to @docib and @stemlyns for expressing it this way: “It’s not just what we do, but also who we are.” #EmergencyMedicine stemlynsblog.org/incrementum-20…

🚨 Job advert live 🚨 @airambulancekss and @UHSussex HEMS registrar posts are open now on NHS jobs. uhsussex.nhs.uk/careers/curren…

Day 3 of the RCEM ASC in Birmingham @rcollem stemlynsblog.org/rcem-annual-co…

Definition of trauma cardiac arrest. Zane Perkins @RCEMevents Conference 2026. Define by lack of coronary perfusion. So you can tell time since arrest by changes in cardiac rhythm. At 1 minute heart slows. At 5 minutes bradycardia established. At 10 minutes PEA.

Wes Streeting at @RCEMevents Conference 2026. Showing a great understanding of the system nature of NHS recovery, and the need for system change. But also a good illustration that even the most senior politicians don’t have a magic wand!

A great Maurice Ellis lecture from Ali Saunders. @RCEMevents Conference. New concept for me was ‘flash teams’ - which we often have in EM. Groups of individuals who are not trained as team, but who have to come together and operate as a high functioning team.

Paeds MAGPIE trial of Penthrox. Requirement for full written consent was main barrier. Statistically significant (but relatively small) pain score effect compared to placebo, with much less use of rescue analgesia. Global pain rating showed much more change than formal pain score

Great David Williams lecture from Prof Steve Goodacre @RCEMevents Conference 2026. Clinical prediction scores predict outcome WITH treatment, but often used to identify who NEEDS treatment, which is NOT what they are predicting!

New angioedema guidance @RCEMevents 2026 conference: TXA recommended as primary treatment for isolated angioedema. Immediate escalation to ENT & anaesthetics if any swelling behind the teeth.

1/8 In cardiac arrest, adrenaline reliably improves ROSC - but has not consistently translated into better long-term neurological survival. Our comment asks whether the problem is not adrenaline itself, but how and where we deliver it.. Open access: tinyurl.com/aortic-epi

I enjoyed this lecture in Zermatt. The common mindset in small Rural and Community Hospitals in the US. "We can't do a thoracotomy, even if blatantly indicated because we don't have immediate cardiothoracic backup" Watch this lecture. It can be done.. with good outcomes

@MrDanPerry @stemlyns Curious about pain within the first week. Excellent study btw 👏👏👏👏

We’re proud to share that our Medical Director, Dr Mark Forrest, is currently in Graz - Austria speaking at the Notfall Medizin conference 🇦🇹 Today, he’s delivering a keynote debate on “Resuscitation when the guidelines run out”. Tomorrow, he’ll be presenting on “Simulation the ATACC way”, showcasing our approach to immersive, high-impact training. Wishing him all the best for both sessions - a fantastic opportunity to share expertise on an international stage! #EmergencyMedicine #CriticalCare #Resuscitation #MedicalEducation #SimulationTraining #ATACC #PreHospitalCare #TraumaCare #MedicalConference

Read the full paper in @TheLancet: doi.org/10.1016/S0140-…

What happened to the boy in the post that started this 🧵? He was treated in a cast without fracture reduction, and this is what it looked like at 8 months.

As always, this isn’t one-size-fits-all. But the default approach for many of these injuries may now be less intervention, not more. 👇

So, what does this mean for practice? For most children with displaced distal radius fractures, a cast-first approach is a good starting point. 👇

What about harms? Reduction was associated with: ⚠️ more complications 💰 higher costs All for a very modest early benefit. 👇