Sensitivity is the number of people who have a test that is positive that have the thing you are looking for. In medicine, this is usually a disease. We like sensitive tests in medicine…

Survive:ED

27.02.2024

SENSITIVITY, SPECIFICITY AND YOUR INDEX OF SUSPICION | Survive:ED

As an EM Doc you do a lot of tests. You know about them, and you know that negative tests don’t always rule out a disease, you know that positive tests can be false positives (patients don’t have …

Survive:ED

22.02.2024

Slow is smooth, Smooth is fast | Survive:ED

Speed and efficiency for doctors and AHPs starting out in ED. Lots of people are worried about their speed in EM. This is the time it takes to see a patient. In the bad old days (maybe …

Survive:ED

19.02.2024

FAST… | Survive:ED

We have all experienced the ED in the dire state it is in in the morning with a dejected broken night team filing into the handover room, giant waits on the tracker screen, apologies, unsaid recrim…

Survive:ED

30.11.2022

Catheter changes | Survive:ED

So an elderly gentleman comes into the department. He lives in a care home, he has a catheter, and he’s got a mild pyrexia, slightly more muddled than normal and some suprapubic tenderness. …

Survive:ED

30.11.2022

Delirium: the forgotten medical emergency. | Survive:ED

We have all seen a little old lady crumpled onto a hospital trolley. Referred in eye-rollingly from their family who visited the nursing home and meekly say ‘she is more confused than normal&…

Survive:ED

30.11.2022

The Lactate Conspiracy: Part 1 | Survive:ED

What is lactate? A good medical student will tell you something along the lines of “Lactate is a byproduct of anaerobic respiration that is produced in response to cellular hypoxia secondary to in…

Survive:ED

30.11.2022

Sodium | Survive:ED

An old man is wheeled into resus. His GCS hovers around 10. No carers have come with him, you find out from the paramedics that the care home staff were alerted to a thump as he fell out of bed. …

Survive:ED

30.11.2022

HEART SCORE | Survive:ED

My department has just started using the HEART score to help risk stratify chest pain patients. Now chest pain/ACS rule out is a large portion of the ED’s workload, with that workload spilli…

Survive:ED

30.11.2022

Should we care if Mavis has crackles? | Survive:ED

Presentations to the ED with acute dyspnoea are a bit of challenge. History, examination and tests are used to decide if people have heart failure, pneumonia, COPD, or something else. I think dia…

Survive:ED

30.11.2022

Suspicious Histories | Survive:ED

Ask any medical student (when they are sober) the clinical features of an Acute Coronary Syndrome they’ll look at you funny for a bit, then talk of severe, left sided chest pain radiating th…

Survive:ED

30.11.2022

Crispy… | Survive:ED

There’s a lady in Resus, she’s 46, she’s got a history of mental health problems. Her husband tells you she’s been gradually more lethargic over the last few days. He called the ambulance today b…

Survive:ED

30.11.2022

Missing things: Addisons | Survive:ED

Recently missed an Addisonian crisis. Here’s a brief summary of the case. 61 y o female attended the ED after seeing her GP with vaginal bleeding. GP sent the patient to the ED fo…

Survive:ED

30.11.2022

The Lactate Conspiracy: Part 2 | Survive:ED

So in the last post I established: Lactate is a base. Lactate production retards cellular acidosis. Lactate is produced all the time. Lactate is fuel. I have suggested that the traditional lactate …

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The Sensitivity trap | Survive:ED

SENSITIVITY, SPECIFICITY AND YOUR INDEX OF SUSPICION | Survive:ED

Slow is smooth, Smooth is fast | Survive:ED

FAST… | Survive:ED

Catheter changes | Survive:ED

Delirium: the forgotten medical emergency. | Survive:ED

The Lactate Conspiracy: Part 1 | Survive:ED

Sodium | Survive:ED

HEART SCORE | Survive:ED

Should we care if Mavis has crackles? | Survive:ED

Suspicious Histories | Survive:ED

Crispy… | Survive:ED

Missing things: Addisons | Survive:ED

The Lactate Conspiracy: Part 2 | Survive:ED

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