A new survey has found that less than one third of end-of-life patients in Irish emergency departments have their own room. This is only one of the shortcomings found in end-of-life care, explored in two papers to start this episode. Following on from that is a comparison of video and direct laryngosocopy for intubation outcomes. There's also a "Best Evidence" review of the use of nasal clips for stopping nosebleeds, an approach which appears likely to offer advantages over the hands or inventive tongue-depressor contraptions. The finish up this month's episode, there's a return to a topic previously visited one year ago - the RCEM guidelines on cannabinoid hyperemesis syndrome. A study from Wales follows up on the adherence to this guidance.

Read the highlights: May 2025 Primary Survey

• Dying matters in the emergency department
• Emergency clinician perceptions of end-of-life care in Irish emergency departments: a cross-sectional survey
• Video laryngoscopy may improve the intubation outcomes in critically ill patients: a systematic review and meta-analysis of randomised controlled trials
• Use of nasal clips as first aid for anterior epistaxis
• Awareness and management of cannabinoid hyperemesis syndrome among staff in emergency departments in Wales

The EMJ podcast is hosted by:

Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards)

You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Trauma and paediatrics are the themes for this month's collection of papers. Starting off is a review of the effectiveness of prehospital ultrasound in detecting lung injury, with some surprising statistics. Next is a letter on the topic of self-presentation by paediatric patients with major trauma, which is thankfully a rare occurrence. The third paper looks at prehospital testing of trauma patients for  low fibrinogen levels, a condition which can lead to worse bleeding, increased transfusions, and higher mortality. The final paper discusses the worrying topic of delayed presentation with testicular pain, a phenomenon which leads to significantly lower salvage rates. This can arise from lack of information or embarrassment, particularly in younger males.

Read the highlights: April 2025 Primary Survey

• Diagnostic accuracy of prehospital ultrasound in detecting lung injury in patients with trauma: a systematic review and meta-analysis
• Identifying the walk-in wounded: paediatric major trauma patients self-presenting to a paediatric major trauma centre
• Comparison between point-of-care international normalised ratio, COAST, TICCS and truncated FibAT scores to rule in clinically significant hypofibrinogenaemia in the prehospital setting
• Experiences and perceptions of acute testicular pain, with a focus on reasons for delayed presentation to hospital: a qualitative evidence synthesis

The EMJ podcast is hosted by:

Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)

Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards)

You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Advance clinical practitioners (ACPs) can have a big role to play in the emergency department, but their career paths are not always well understood. This episode features three papers from the journal which begin to address that - a census survey of over 1000 ACPs, a qualitative study on their experiences in emergency care, and a commentary on how to improve ACP training. There is also a paper from Canada discussing considerations to be made for patients living with dementia, as well as their care partners who may be accompanying them to the hospital. A bit of a curveball to close out, with a review on hidradenitis suppurativa, a challenging skin condition which can take years for a diagnosis.

Read the highlights: March 2025 Primary Survey

• Care for older adults living with dementia in the emergency department: a systematic review and meta-synthesis of care partner roles and perspectives
• Emergency medicine advanced clinical practitioners: an English workforce census
• A qualitative study exploring the experiences of advanced clinical practitioner training in emergency care in the South West of England, United Kingdom
• How can we improve on advanced clinical practitioner training?
• Diagnosis and management of hidradenitis suppurativa: a review for the emergency clinician

The EMJ podcast is hosted by:

Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody)

Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards)

You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast iTunes (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.