Introduction As Emergency Medicine (EM) finds itself in the midst of a pandemic, we are reminded that the practice of medicine is a global endeavour. Alongside the traumatic consequences of COVID-19 will also come opportunities to fundamentally rethink our approach to healthcare, including how to engage with global health. In this article, we report on the formation of the Global Emergency Care Collaborative (GECCo), an initiative that aims to enhance global health interest and capacity within the field of emergency care. RCEM Global Emergency Medicine strategy The Royal College of Emergency ..read more

  This month, we’re opening our blog page up to emergency physicians worldwide to discuss how their hospitals (or countries) are responding to the novel Coronavirus outbreak and the role their emergency department is taking. Are you the “first call” for patients who might have the disease? What type of help are you getting from outside the ED? “What novel innovations has your department come up with to address the potential threat?” How worried are you? We’ve gone through this before – is this much ado about nothing or the real deal? Add a comment below to become part of the conversation ..read more

Welcome to the January edition of the EMJ. A new decade starts a time of heavy clinical activity here in the UK, but despite that workload there is still much to learn and love about emergency medicine. This month sees a range of papers to change or challenge your practice. Which decision aid is best in Coronary Artery Disease? I don’t think there is much controversy about the utility of decision aids to risk stratify patients with chest pain, but which of those available performs best in our populations? Body et al have compared T-MACS, HEART, TIMI and EDACS in just under a thousand patient ..read more

Do we know what older patients want from emergency care? We are increasingly aware of the preponderance of older patients attending our emergency departments as well as the fact that they are often acutely unwell. It is heartening then to see in this month’s issue some excellent papers pertaining to the care and treatment of our older patients highlighting some aspects of care that need improvement. Perhaps contrary to longstanding perceptions, older patients are not a homogenous group but have specific and complex needs that can elude staff in a busy department. Understanding what these need ..read more

Is it OK to close emergency departments? Many emergency physicians would be very concerned by any talk about closing Emergency Departments (EDs). We may have experienced it in our own regions, and we may have our own opinions about its impact on patient care. In this issue, Knowles et al have studied the real-world impact of closing five EDs in England on patient mortality. Read the full paper for details, but the bottom line is that they found no impact on patient mortality. Does this mean that the government should have the green light to close more EDs? Or is there more to the story than t ..read more

Addressing language barriers in the emergency department The ‘Editor’s Choice’ paper covers the critical topic of communication and the concern that patients with a different first language are more likely to experience adverse events and poorer outcomes. How do you communicate with a patient who has a different first language: do you ask a member of the family to translate or a member of staff? Google translate? Attempt some rudimentary translation yourself? Or the recommended methods of using a telephone interpreter service or an in-person professional interpreter (often more challenging du ..read more

Dental radiographs in the ED I expect we’ve all requested panoramic dental radiographs at some point or other. I also suspect that if it’s for anything other than trauma then many of us will be a little lost on the interpretation. Anton Sklavos present a great review paper on interpretation that taught me a lot, especially in the diagnosis of non-traumatic infections that may require intervention. How many of us routinely look for changes in the peri-apical tissue? There is lots of useful information here on artefacts (ghosting is a thing apparently), trauma interpretation and patterns of inj ..read more

In the spring of 2018, an important conversation started in the hallways of the Emergency Department at Campbelltown Hospital – a community hospital on the fringe of Sydney, Australia. Three emergency physicians, the authors, realised we were all following the US-based FemInEM podcast and blog (feminem.org), and each of us was noticing the empowering impact that this was having on our professional and personal lives. We were hearing our own experiences as women in Emergency Medicine being echoed by women across the globe, and were drawing inspiration from their insights and responses to famil ..read more