Emergency medicine journal
Audio Summaries

Management of patients with suspected but unidentified poisoning in the emergency department: a joint Royal College of Emergency Medicine and National Poisons Information Service best practice guideline

May 8, 2026

The authors aim to address the challenges in managing patients with suspected but unidentified poisoning in the emergency department by providing a best practice guideline. This guideline outlines a generalized clinical approach for initial assessment, identification of potential toxic agents, and emergency management, utilizing a toxidromic framework while emphasizing the importance of toxicokinetics. It is intended to complement existing poison-specific resources rather than replace them.

On the optimal sodium correction rate in hyponatraemia and clinical outcome: a meta-analysis

May 7, 2026

The authors aimed to determine the optimal sodium correction rate in hyponatraemia and its impact on clinical outcomes, particularly mortality and the incidence of osmotic demyelination syndrome (ODS). Their meta-analysis of 11 studies involving 27,672 cases found that rapid sodium correction (at thresholds of 8, 10, and 12 mmol/L/24 hours) was associated with significantly lower mortality rates, although it also correlated with a higher incidence of ODS. The findings suggest that while a more liberal approach to sodium correction may improve survival, the risk of ODS, albeit rare, remains a concern.

Prehospital prediction of clinical course in patients with suspected sepsis: a prospective cohort study

May 6, 2026

The authors aimed to determine how prehospital variables observed by ambulance personnel can predict the clinical course of patients with suspected sepsis. Their study found that while certain factors like oxygen saturation and qSOFA scores were associated with sepsis severity and outcomes, no single variable predicted all outcomes consistently. The findings suggest that while prehospital scoring systems may aid in decision-making, they should be used cautiously alongside established clinical tools.

Clinical decision rules for obtaining chest radiography in adult patients presenting to the emergency department with non-traumatic chest pain: a systematic review and meta-analysis

May 6, 2026

The authors aimed to evaluate existing clinical decision rules (CDRs) for obtaining chest radiography in adult patients with non-traumatic chest pain, given the high rate of non-actionable imaging results. Their systematic review and meta-analysis of seven studies found that while the Hess CDR demonstrated higher sensitivity, neither rule effectively reduced unnecessary imaging, indicating a need for the development of more robust prospective CDRs. The findings were limited by high heterogeneity and a small number of studies, underscoring the necessity for further research.

Understanding how language barriers in the paediatric emergency care setting influences safety of care delivery: a scoping review

May 4, 2026

This scoping review investigates how language barriers impact the safety of care delivery in paediatric emergency settings and identifies strategies to mitigate these risks. The authors found that language barriers pose significant safety risks at various stages of care, particularly during discharge, and emphasized the need for effective interventions, such as professional interpreter services. Future research should explore the potential of technology, including artificial intelligence, to address these communication challenges.

Endovascular resuscitation: an expert practice review

Apr 30, 2026

This practice review aims to equip emergency physicians with a comprehensive understanding of endovascular resuscitation (EVR) techniques, particularly in the context of out-of-hospital cardiac arrest and non-compressible hemorrhage. The authors explore the rationale, physiology, and safety of various EVR interventions, emphasizing the importance of vascular access and the potential benefits for critically ill patients.

Are rapid diagnostic tests reliable for the detection of malaria in the emergency department?

Apr 24, 2026

The authors conducted a systematic review to evaluate the diagnostic accuracy of rapid diagnostic tests (RDTs) for malaria in febrile adults from malaria-endemic regions. Out of 138 papers identified through database searches, six met the inclusion criteria for analysis. The review aims to determine the reliability of RDTs in emergency department settings for malaria detection.

Management and outcomes of critically ill patients admitted to a critical care resuscitation unit: a retrospective cohort study

Apr 24, 2026

The authors aimed to evaluate the management and outcomes of critically ill patients admitted to a critical care resuscitation unit (CCRU) and assess its impact compared to a historical control group. Their findings indicate that the CCRU effectively managed a diverse range of emergencies, with less than half of the patients requiring subsequent ICU admission, and demonstrated a significant reduction in both ICU admission rates and the time to initiate critical care for emergency department patients following CCRU implementation.

External validation of the emergency CT head score to reduce non-trauma imaging: a multicentre retrospective study

Apr 24, 2026

This study aimed to externally validate the Emergency CT Head Score (ECHS) in a French population to determine its effectiveness in reducing unnecessary cerebral CT scans in emergency departments. The results indicated that the ECHS demonstrated high sensitivity (100%) for detecting abnormalities, suggesting that nearly half of the scans could be avoided without adverse outcomes. The authors conclude that while the ECHS shows promise, further prospective studies are necessary for implementation.

Pragmatic medicine, n=1

Apr 24, 2026

The authors explore the limitations of evidence-based medicine and question its applicability in diverse clinical settings. They argue that the absence of evidence for certain interventions does not imply a lack of benefit and advocate for a pragmatic approach to medicine that incorporates clinical judgment and patient preferences. The paper emphasizes the need for sufficient solutions that address the specific context of individual patients rather than strictly adhering to existing evidence.