A-a gradient

March 25, 2018

A-a gradient = Alveolar Oxygen – arterial Oxygen This is “relatively” simple way of working out if the paO2 on a ABG is normal, and demonstrates… Read more

AAGBI – Intubation Check List

April 2, 2019

Simple pre-intubation checklist for the whole team to be aware of so we can make intubation in ED as safe as possible. PDF: Full Version… Read more

Acute Behavioural Disturbance / Excited Delirium

December 24, 2017

Most of us will have seen patients like this – agitated, aggressive and often with police or security pinning them down. High risk of Cardiovascular… Read more

Anion Gap & Metabolic Acidosis

March 26, 2018

The anion gap (AG) represents the amount of unmeasured anions in the plasma. AG =([Na]+[K]) – ([HCO3]+[Cl]) The main contributor to the AG is albumin… Read more

Aortic Dissection

June 16, 2018

Aortic Dissection (AD), is uncommon (1 AD:200 ACS) but is…Rapidly FATAL!  Unfortunately recognising aortic dissection is difficult with a clinician pickup rate of 15-43%. Read more

Are You CO Aware?

October 24, 2018

With the onset of colder weather, many households in the UK are turning on their heating for the first time in months. Heating appliances need… Read more


August 12, 2018

ALS Bradycardia Algorithm – Adult Causes Cardiac: Heart Block, Myocardial infarction, Myocarditis Metabolic: Hypothermia, Hyperkalaemia, Hypokalaemia, Hypothyroid, Hypoxia Toxin: digoxin, B-blocker Treatment For ALL conditions… Read more

C-Spine Injury

September 4, 2018

C-spine injury ranges from the obvious fracture-dislocation to the less obvious ligamentous injury, affecting about 2.5% of blunt trauma patients. However, ALL of them are… Read more

COPD think VBG

February 18, 2018

We have recently introduced the use of VBG in COPD. Why Change? Pain – we all know and warn our patients ABG’s are painful. Patients… Read more

Devastating Brain Injury?

February 15, 2018

Scenario (Not uncommon) A patient either post arrest or head injury has a CT demonstrating significant brain injury and Leeds says “No” What do we… Read more

DVLA – Driving & Medical Conditions

May 8, 2018

For many conditions the patient should be informed to stop driving and inform the DVLA of their condition. It is the patients responsibility to inform the… Read more

Emergency General Anaesthetic Checklist

February 13, 2018

PREPARE or prepare to fail Read more


December 22, 2017

Remove COLD, Add WARM, Don’t SHAKE Use common sense, and do basics <32’C CORE temperature  probe (skin temp inaccurate) Active renaming (warm fluids etc) Don’t… Read more

Lateral Canthotomy

May 7, 2019

Retrobulbar Haematoma secondary to blunt eye injury is a a rare but potentially sight threatening injury. Blood collects in the retrobulbar space Pushing the eye… Read more

Major Incident/MAJAX Guide

January 23, 2019

NHS England have published this fantastic resource [Click here] covering Major Incidents including; gunshot, crush, nerve agents and much more. This is not to replace… Read more

Major Trauma Network

February 16, 2018

We are part of the West Yorkshire Major Trauma Network with our MTC at LGI WYMTN: Guides We know that from time-time patient are brought to… Read more

Myocardial Infarction (MI) – PPCI/Thrombolysis

June 22, 2018

PPCI (Leeds PPCI Pathway) Target: Door to balloon 90min Criteria: Time: Chest pain within 12hrs (or worsened within 12hrs) ECG:  ST elevation MI (1mm Limb… Read more

NEW: Burns Referral Pathway

May 8, 2019

A new burns referral pathway has been developed with Mid Yorks to securely send images of the patients burn. Allowing the burns team to arrange… Read more

Octaplex – work fast its an EMERGENCY!

December 16, 2017

In recent incidents we have had significant delays in giving OCTAPLEX. So  we have developed this advice. Activate EARLY in head injury patients on warfarin.… Read more

Pre-Arrival Blood (O-ve)

March 13, 2019

On rare occasions you may receive a pre-alert, where you want blood available for the patient when they arrive (for example in major haemorrhage). This… Read more

Purple Glove Syndrome – Case

September 23, 2018

Is a rare complication of I.V. Phenytoin, which presents with a triad of: Pain, Oedema & Discolouration, typically in the hand. In our case a… Read more

RCEM CPD Conference Day 3

April 4, 2019



January 15, 2019

We often worry about patients developing rhabdomyolysis and consequently developing AKI. However, there is much debate and little consistency in the published data, over how… Read more

Scombroid Poisoning- NOT another fishy allergy

April 19, 2018

Scombroid poisoning (AKA – Histamine fish poisoning) is apparently more common than we think and accounts for 40% of seafood related illness in the USA… Read more


March 13, 2018

Background Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Sepsis can lead to… Read more

SUDIC – Sudden Unexpected Death In Child

March 13, 2018

Occasionally children (<18 yrs) unfortunately will either die in ED or be brought in dead, this is obviously a terrible time for the child’s family… Read more