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 Merry Christmas! This month for the December 2025 episode of the RCEM Learning Podcast Andy and Dave are talking about higher MAP targets in sepsis and the routine use of antibiotics for max-fax fractures. Rob attempts a festive round up of the most impactful guidelines of the year. We'll then end with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (03:19) New in EM - Higher MAP targets in Sepsis Efficacy of targeting high mean arterial pressure for older patients with septic shock (OPTPRESS): a multicentre, pragmatic, open-label, randomised controlled trial (Endo et al., 2025) (15:19) Most Impactful Guidelines of the Year European Resucitation Guidelines - Guidelines on Cardiopulmonary Resuscitation (ERC, 2025) NHS England - Urgent and emergency care plan 2025/26 (NHS England, 2025) NHS England - Guidance to support the commissioning and delivery of ambulance services in 2025/26(NHS England, 2025) NICE - NG246 Overweight and obesity management (NICE, 2025) NICE - NG253 - Suspected sepsis in people aged 16 or over: recognition, assessment and early management (NICE, 2025) NICE - NG254 - Suspected sepsis in under 16s: recognition, diagnosis and early management (NICE, 2025) NICE - NG255 - Suspected sepsis in pregnant or recently pregnant people: recognition, diagnosis and early management (NICE, 2025) RCPCH - Facing the Future - standards for children and young people in emergency care settings (RCPCH, 2025) RCEM - GPEMS(RCEM, 2025) (38:07) New in EM - Routine use of antibiotics in facial fractures Prophylactic antibiotic use in trauma patients with non-operative facial fractures: A prospective AAST multicenter trial (Mian et al., 2025) (47:10) New Online – new articles on RCEMLearning for your CPD Is Normalisation of Deviance the "Standard" in Medicine? - Neel Bhandani Mental Illness in Children by Jidhin Davis Rest, sleep, and our breaks - the conversation we cant tire of - Amar Mashru

Happy September! This month for the September 2025 episode of the RCEM Learning Podcast Andy and Dave are talking about AI interpretation of ECG findings and managing acute asthma exacerbations. We are then going back to Becky and Chris rounding off the second part of their guideline on atrial fibrillation. We'll then end with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:13) New in EM - AI vs doctor in cath lab activations Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio) (Shroyer et al., 2025) (18:00) Guidelines for EM - ESC Atrial Fibrillation (Part Two) ESC - 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) (ESC, 2024) (39:03) New in EM - Management of acute asthma exacerbations As-Needed Albuterol–Budesonide in Mild Asthma (LaForce et al., 2025) Combination fixed‐dose beta agonist and steroid inhaler as required for adults or children with mild asthma (Cochrane Library, 2021) (54:00) New Online – new articles on RCEMLearning for your CPD Understanding Medical Cannabis: Mechanisms, Indications and Clinical Integration - David Tang Safe Sedation Procedures in Adults - Duncan Russell and Shobhan B Thakore Unusual Agitation in Final Year Student - Cathy Wield and Mark Horowitz

Happy August! This month for the August 2025 episode of the RCEM Learning Podcast Andy returns to discuss the investigation of acute coronary syndrome in the ED. Becky and Chris begin a two part deep dive through a guideline looking at the management of atrial fibrillation. We then talk to Matt Reed about the RCEM Flagship Conference and we then end with New Online! If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:28) New in EM - Ruling out ACS in the ED Acute coronary syndrome rule-out strategies in the emergency department: an observational evaluation of clinical effectiveness and current UK practice (Trainee Emergency Research Network, 2025) (19:43) Guidelines for EM - Atrial Fibrillation (European Society of Cardiology) European Society of Cardiology - 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): Developed by the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC), with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Endorsed by the European Stroke Organisation (ESO) (ESC, 2025) (47:26) Matt Reed and the Flagship Conference RCEM - Flagship Conference 2026 (58:28) New Online – new articles on RCEMLearning for your CPD Kishan Indrakumar, Thomas Moore, Mayank Nagar, Preetibah Ratenavelu, Dominique Tirian - Chemical Eye Injuries in the ED Katy Guy, Olivia Curtis-Hughes - Sports-Related Concussions in the Emergency Department Susan Elizabeth Dorrian, Sarah Jones - Disturbed or Psychiatric Patients in the ED Additional Links RCEM - SECEM Conference 2025

Happy July! This month for the July 2025 episode of the RCEM Learning Podcast Rob covers for Andy and discussed two PEM papers with Dave - looking at the role of parental concern in predicting paediatric critical illness and one looking at clearing the paediatric C-spine with CT imaging alone. Becky and Chris finish up their two part deep dive through a guideline looking at the management of acute behavioural disturbance and we then end with New Online! If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:39) New in EM - Parental concern and paediatric critical illness Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study (Mills et al., 2025) (18:01) Guidelines for EM - Acute Behavioural Disturbance in Emergency Departments (Part Two) RCEM - Acute Behavioural Disturbance in Emergency Departments (RCEM, 2025) [PDF] (43:37) New in EM - Paediatric C-spine clearance with CT alone An analysis of potential cervical spine clearance in children with computed tomography alone (Russell et al., 2025) (01:04:51) New Online – new articles on RCEMLearning for your CPD Zygomatic Complex and Nasal Injury - Jonathan Whittaker Learning from Deaths - Liz Herrieven Kishan Indrakumar, Thomas Moore, Dominique Tiriant, Mayank Nagar, Preetibah Ratenavelu, Arnav Singh - Prescribing in Pregnancy - A Practical ED Guide

Happy June! This month for the June 2025 episode of the RCEM Learning Podcast Rob covers for Andy and discussed two HALO-heavy papers with Dave - looking at the London HEMS pre-hospital thoracotomy paper and a systematic review looking at resuscitative hysterotomy. Becky and Chris go on the first of a two part deep dive through a guideline looking at the management of acute behavioural disturbance and we then end with New Online! If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:35) New in EM - London HEMS Thoracotomy Outcomes Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest (Perkins et al., 2025) RCEMLearning July 2023 - HALO Procedures with Joseph Mathew and Dave McCreary (15:41) Guidelines for EM - Acute Behavioural Disturbance in Emergency Departments RCEM - Acute Behavioural Disturbance in Emergency Departments (RCEM, 2025) [PDF] (46:00) New in EM - Systematic review of resuscitative hysterotomies ---- 13:49 Maternal and neonatal outcomes following resuscitative hysterotomy for out of hospital cardiac arrest: A systematic review (Leech et al., 2025) (59:48) New Online – new articles on RCEMLearning for your CPD Medics and the Media: The Anti-social Network - Fin McNicol Tracheostomy emergencies in adults - Jonathan Cooper Pelvic Fractures – A guide to treatment within a Trauma Unit - Peter Bates, Paul Harnett, Matt Gee

Happy May! This month for the May 2025 episode of the RCEM Learning Podcast Rob covers for Andy and Dave and discusses a systematic review and meta-analysis looking at the safety of different rate control methods in treating AF with rapid ventricular response. Becky and Chris go on a very deep dive through a guideline looking at the management of patients with suspected but unidentified poisoning and we then end with New Online! If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:04) New in EM - Adverse events in pharmacological treatment of AF with RVR Metoprolol vs diltiazem for atrial fibrillation with rapid ventricular rate: Systematic review and meta-analysis of adverse events (Hintze et al., 2025) Intravenous diltiazem versus metoprolol for atrial fibrillation with rapid ventricular rate: A meta-analysis (Lan et al., 2021) (09:30) Guidelines for EM - Management of unexplained poisoning in the ED RCEM - Management of Patients with Suspected but Unidentified Poisoning in the Emergency Department (RCEM, 2025) [PDF] (01:01:44) New Online – new articles on RCEMLearning for your CPD 24 Hour Ophthalmic Emergencies Part 1 – Acute Red Eye - William Spackman Understanding Informed Consent: A Guide for Healthcare Professionals - Khurram Rasool Advanced Lines - Alexandra Cottrell, Claire Fitzgerald

Happy April! This month for the April 2025 episode of the RCEM Learning Podcast we have Andy and Dave talking about the use of beta-blockers in sepsis. Becky and Chris talking about mortality reviews in the ED. In a similarly patient-safety aligned topic I speak to Maegan Ladell talking about patient safety culture and then finally, as always, New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (01:47) New in EM - Beta blockers in sepsis Landiolol for heart rate control in patients with septic shock and persistent tachycardia. A multicenter randomized clinical trial (Landi-SEP) (Rehberg et al., 2024) (16:34) Guidelines for EM - Mortality reviews in the ED RCEM - Mortality Reviews in the ED (RCEM, 2025) [PDF] (49:26) Patient Safety Culture - Meagen Ladell The problem with how we view medical (and diagnostic) error in emergency medicine (Ladell et al., 2025) SEIPS 101 and seven simple SEIPS tools (Holden and Carayon, 2021) (01:12:16) New Online – new articles on RCEMLearning for your CPD Combatting the Crowd - Peter Fielding Ovarian Hyperstimulation Syndrome - Thomas Mac Mahon Curriculum Cup: Ophthalmology - RCEMLearning

Happy March! This month for the March 2025 episode of the RCEM Learning Podcast starts with an update from Rob. We have Andy and Dave talking about oxygen targets in trauma in the TRAUMOX2 RCT. Becky and Chris talk about a BOAST orthopaedic guideline for the management of lateral patella dislocation. We interview Raine Astin-Chamberlain about sex, gender and pregnancy in research and then finally, as always, New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:26) New in EM - Oxygen targets in trauma Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Randomized Clinical Trial (Arleth et al., 2025) (18:59) Guidelines for EM - BOAST guidelines for lateral patella dislocation BOAST - Assessment and Management of First Time Lateral Patellar Dislocation (FTLPD) (BOAST, 2024) (45:09) Sex, gender and pregnancy in research - Raine Astin-Chamberlain Sex and gender reporting in UK emergency medicine trials from 2010 to 2023: a systematic review (Astin-Chamberlain et al., 2025) (01:03:37) New Online – new articles on RCEMLearning for your CPD Psychological support in the ED - Charlotte Davies Beyond the Tick Box - Embracing Reflective Practice - Chris Walsh Foreign Bodies in Ears and Noses: Practi cal Tips for ED Management - Charlotte Davies and Olu Adenugba Retaining ED staff: Policy, practice and research perspectives Retaining ED staff: Policy, practice and research perspectives - book your tickets

Happy Valentine's Day! This month for the February 2025 episode of the RCEM Learning Podcast, we have got a new in EM segments looking at the assessment of PE in younger patients. Becky and Chris detail a guideline on acute adrenal insufficiency, before ending with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! Buy tickets to the EMTA Conference in Bristol, February 26 & 27! (03:06) New in EM - Using the PERC-35 Rule for PE Failure rate of the pulmonary embolism rule-out criteria rule for adults 35 years or younger: Findings from the RIETE Registry (Jossein et al., 2024) Age and sex-dependent trends in pulmonary embolism testing and derivation of a clinical decision rule for young patients (Mongan et al., 2015) (22:35) Guidelines for EM - Glucocorticoid-induced adrenal insufficiency European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and therapy of glucocorticoid-induced adrenal insufficiency (ESE & ESJ, 2024) (01:04:32) New Online – new articles on RCEMLearning for your CPD How to Nail Your Consultant Interview - Hannah Bell Assessing (de)Hydration in Children - Nikki Abela Medical Assessment of the Pregnant Patient in the Emergency Department - Charlotte Davies, Mark Chester

Happy New Year! This month for the January 2025 episode of the RCEM Learning Podcast, we have got two new in EM segments looking at staff turnover and mortality and the assessment of febrile infants. Becky and Chris detail a guideline on acute kidney injury, before ending with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! Buy tickets to the EMTA Conference in Bristol, February 26 & 27! (03:55) New in EM - Staff turnover and mortality Nurse and doctor turnover and patient outcomes in NHS acute trusts in England: retrospective longitudinal study (Moscelli et al., 2024), PDF (20:03) Guidelines for EM - NICE Guidelines on Acute Kidney Injury Acute kidney injury: prevention, detection and management (NICE, 2024), PDF (59:36) New in EM - Assessment of febrile infants Performance of clinical decision aids (CDA) for the care of young febrile infants: a multicentre prospective cohort study conducted in the UK and Ireland (Umana et al., 2024), PDF Optimizing Management of Febrile Young Infants Without Serum Procalcitonin (Burstein et al., 2025), PDF (01:17:19) New Online – new articles on RCEMLearning for your CPD Vasopressors - Alasdair Munro, Simin Nikou, Charlotte Davies The Limping Child, by Charlotte Davies and Nikki Abela Testicular Pain, by Kellie Bateman

Merry Christmas! This month for the December 2024 episode of the RCEM Learning Podcast, we have got a new in EM segment looking at the surgical management of haemorrhagic stroke. Becky and Chris talk gift us with a big discussion around the management of pain in the ED. Rob talks to Laura Howard and Gregory Yates about reviving the BestBETS project, before ending with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (04:29) New in EM - Surgery for haemorrhagic stroke Trial of Early Minimally Invasive Removal of Intracerebral Hemorrhage (Pradilla et al., 2024) (15:45) Guidelines for EM - RCEM Management of Acute Pain in Adults in the ED RCEM Management of Acute Pain in Adults in the ED (RCEM, 2024) (01:12:43) Laura Howard and Gregory Yates - BestBETs BestBETs Get Involved with BestBETs (Email link) Best Evidence Topic report: Is a CT head required for patients who present to the emergency department with a first seizure? (Yates & Williams, EMJ, 2024) (01:23:20) New Online – new articles on RCEMLearning for your CPD The Forgotten Tribe - Lauren Fraser and Michelle Jacobs Surgical Management of Acute Wounds in the ED - Olajide Kamal Badmus, Riad Hosein Curriculum Cup (Respiratory) - RCEMLearning

This month for the November 2023 episode of the RCEM Learning Podcast we're focusing on the RCEM ASC. Rob and Liz talk through their favourite talks from the conference and then we move on to our RCEM ASC Interview Megamix where I speak with thirteen presenters about their work from the RCEM ASC. This is going to be a mix of paediatric and adult EM, so feel free to have a look at the timestamps if you want to get to the stuff that is most relevant to you - I'd recommend you listen to it all! If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! Submit an abstract to the EMTA Conference EMTA Conference 2025 - Bristol, 26-27th February 2025 Submit an abstract here (direct link) by 27th November (07:54) RCEM ASC Interview Megamix (07:54) Cath Taylor - Using livestreaming phones in the ambulance service (17:10) Phil Cowburn - The Major Incident Ten Second Triage Tool (23:25) Mark Macmillan - Whole-body CT scanning in older injured patients (29:42) Leilah Dare - Using GIRFT data to implement change (38:10) Ben Clarke - TERN Update and the UnCORKED study (49:38) Alison Porter - Using qualitative research in emergency medicine (58:10) Christopher Humphries - Cannabinoids and tailoring your anti-emetic selection (01:05:42) Steve Goodacre - Diagnosing acute aortic syndrome and the ASES study (01:10:57) Tom Waterfield - PERUKI Update (01:20:18) Shrouk Messahel - CRESCENT Study (01:29:16) Damian Roland - Bronchstart, bronchiolitis, and vaccination (01:39:34) Dave McCreary - Introducing a culture of paediatric point of care ultrasonography (01:50:10) Emma Lim - Spotting Sepsis in the PED Further Links and Reading Cath Taylor - The SEE-IT Trial: emergency medical services Streaming Enabled Evaluation In Trauma: a feasibility randomised controlled trial Phil Cowburn - National Ambulance Resilience Tool - Ten Second Triage Leilah Dare - Getting It Right Time - SEDIT Ben Clarke - TERN Research Ben Clarke - TERN UNCORKED Expression of Interest Form Christopher Humphries - RCEM Guideline - Suspected Cannabinoid Hyperemesis Syndrome in Emergency Departments Steve Goodacre - The ASES Study Tom Waterfield - PERUKI Shrouk Messahel - The CRESCENT Trial Damian Roland - Bronchstart David McCreary - ResearchGate Emma Lim - RCPCH Paediatric Sepsis Podcasts Emma Lim - Lancet Paediatric Sepsis Series

Happy October! This month for the October 2024 episode of the RCEM Learning Podcast, We have got two new in EM segments looking at the use of peripheral hypertonic saline and defibrillation strategies in refractory VF. Rob and I will then be discussing the RCEM Toolkit for caring with patients with learning disability. Rob then talks to the EM at the Deep End team, before ending with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:52) New in EM - Peripheral use of hypertonic saline Safety and Effect on Intracranial Pressure of 3% Hypertonic Saline Bolus Via Peripheral Intravenous Catheter for Neurological Emergencies (Khasiyev et al., 2024) (14:33) Guidelines for EM - RCEM Learning Disabilities Toolkit Learning Disabilities Toolkit (RCEM, 2024) (39:10) EM at the Deep End Open Teams Meeting to EM at the Deep End - 4th October 2024 13:30 EM at the Deep End (55:46) New in EM - Defibrillation strategies in refractory ventricular fibrillation Defibrillation Strategies for Refractory Ventricular Fibrillation (Cheskes et al., 2024) - link to the paper coming soon (01:10:31) New Online – new articles on RCEMLearning for your CPD Coughing, wheezy, and stridulous children - Edward Snelson Hypertensive Disorders in Pregnancy… HELLP! - Jenni Cooper, Naomi Primrose Frailty-associated pneumonia - David G Smithard

Happy September! This month for the September 2024 episode of the RCEM Learning Podcast, we have a new in EM section looking at the use of NIV for preoxygenation in RSI. We then have Becky and Chris going over a new Guidelines for EM looking at the NICE Guidelines for meningitis. Rob puts on his TERN hat and speaks to the two former TERN Fellows and Dan Horner about the results of the Subarachnoid Haemorrhage in the ED Study before ending with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:30) New in EM - NIV for preoxygenation in RSI Noninvasive Ventilation for Preoxygenation during Emergency Intubation (Gibbs et al., 2024) (20:47) Guidelines for EM - NICE Guidance for Meningitis Meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management (NICE, 2024) (01:05:00) The TERN SHED Study - 36:30 Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study (The Trainee Emergency Research Network, 2004) - link to the paper coming soon The TERN Website TERN on Twitter/X (01:41:35) New Online – new articles on RCEMLearning for your CPD Training for Research in Emergency Care (TREC) - The TREC Team Delivering Bad News - Charlotte Davies Ocular trauma - Deepa Elsa George, Sophie Seguin-Greenstein

Happy August! This month for the August 2024 episode of the RCEM Learning Podcast, we have two new in EM sections looking at the use of high flow nasal cannula vs. NIV for COPD and clinical gestalt for predicting sepsis. We then have Becky and Chris going over a new Guidelines for EM looking at opioid toxicity before ending with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (03:21) New in EM - High-flow nasal cannula vs. NIV for COPD High flow nasal cannula oxygen therapy versus non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: a randomized controlled non-inferiority trial (Tan et al., 2024) Probing the efficacy of high-flow nasal cannula in the treatment of acute exacerbations of COPD with acute-moderate hypercapnic respiratory failure (Pantazopoulos and Mavrovouni, 2024) (19:19) Guidelines for EM - RCEM and NPIS Opioid Toxicity RCEM and NPIS - Guideline for the Assessment and Management of Acute Opioid Toxicity in Adults in the Emergency Department (PDF) (RCEM & NPIS, 2024) (54:26) New in EM - Clinical Gestalt for Predicting Sepsis Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients (Knack et al., 2024) (01:06:35) New Online – new articles on RCEMLearning for your CPD PEM and Ex-Prems - Katie Knight Curriculum Cup (Infectious Disease) - RCEMLearning) Induction - RCEMLearning