Some of the hardest moments in emergency medicine aren’t hard because they’re complicated. They’re hard because they’re rare — and when they arrive, you’re relying on things you last thought about a long time ago.

This final episode in the Best Bits of 2025 series is the “file it away” collection: rare, high-stakes situations where preparation is largely cognitive, decisions are time-critical, and there may be no second chance.

The clips in this episode are drawn from full St Emlyn’s episodes released during 2025 and focus on recognition, decision-making, and human factors in uncommon but consequential scenarios.

• How community response and live video have changed what happens before patients reach hospital

• Recognising and acting on decompression illness, even when presentations are subtle

• Cognitive HALOs — what happens to our thinking in rare, high-acuity situations

• Junctional haemorrhage and the role of the abdominal aortic junctional tourniquet

• Human decision-making under extreme pressure, illustrated through aviation medicine

This episode is designed to be listened to slowly, and returned to when needed — the kind of learning that pays off long after you first hear it.

Clips in this episode are taken from the following full St Emlyn’s episodes:

• Episode 262 — GoodSAM Update with Mark Wilson (London Trauma Conference)

• Episode 263 — Hyperbaric Medicine with Jeff Kerrie (London Trauma Conference)

• Episode 277 — Cognitive HALOs and Advanced Simulation Training with Halden Hutchinson-Bazely (BASICs)

• Episode 273 — Abdominal Aortic Junctional Tourniquet with Ed Barnard

• Episode 276 — Ejection Seats and the Injured Pilot with Phil Lucas (BASICs)

All full episodes are available in the podcast feed.

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