Unusual Traveler
A Journal for those who do not take a shortcut
Latest Posts
Major Bleeding in the ED
Ok so I asked some of the nursing team in ED what they wanted to know more about, so this one is for you guys! What do we define as ‘major bleeding’ or major haemorrhage’? For me the way I describe that definition has changed somewhat over the years, in my military days where I […]
2 years ago
Winter is over? Time for a new challenge in ED
Think back to the start of March 2020… Team ED was still dealing with what seemed like the longest winter in the history of the world, Twitter was a-buzz with stories of how “crowding kills”. Corridor care was still a national problem, Staff were tired, and it didn’t look like we were getting any let […]
3 years ago
Between the lines #5
Much like many of the projects I started in 2020 and what is perhaps a damning indictment of my pandemic experience; blog number 5 is a year out of date. What was meant to be a piece extolling the importance of clinical education and teamwork during a crisis, has now turned into a reflection on […]
3 years ago
Rapid Assessment and Triage: my two CENTS worth..
My name is Pete Chessum I’m a Consultant ACP in ED/Acute medicine and also a PhD student studying resilience engineering in emergency departments. In 2013 I helped with a NIHR project called the Emergency Care Handover Project (ECHO). After a decade of ACP life I’ve been asked to share what I think works (or doesn’t) […]
3 years ago
ED BusyBlog
Cast your minds back to February 2020, just 6 weeks ago. Emergency Departments throughout the country were experiencing their worst waiting times on record. Treating patients in the corridor was normal, there were even designated corridor nurses. Staff shortages, not enough beds in the hospital, no social care places to discharge patients- our EDs were […]
4 years ago
Patient assessment
This is the first of our accompanying infographics for each section of the framework. You may have heard we that we released our podcasts finally on iTunes (if you haven’t don’t worry click here) The plan is that for each section we will have a podcast, an infographic, a blog and a video to access […]
4 years ago
Imposter syndrome
This is so important to most of us who work in emergency care where we literally learn new things every day. I am sure you have all that feeling of ‘I just don’t know enough’ or ‘I am never going to get this’ The key points from Harmony’s poster here is that this is NORMAL!! Don’t […]
4 years ago
Foamed, what do I need to know?
This infographic by Harmony gives you the background to #FOAMED If you don’t really get what we mean when we say ‘tweet it’ ‘snap it’ then start here. This really encompasses what we are trying to achieve with this website- to give you guys other ways to improve your skills, knowledge and portfolio in all things #ED […]
4 years ago
Ever fallen in love with someone you shouldn’t have fallen in love with?
With Valentine’s Day just around the corner there are cards and chocolates and flowers galore in the shops, all designed to show how much you care for your loved one and how ros(e)y romantic relations are. It’s often seen as the territory of young love, and that’s all well and good if everything is indeed […]
4 years ago
I feel like my heart is skipping a beat…
Hello all and welcome to the next blog from @ededucate and this one is all about Atrial Fibrillation AF or Fast Atrial Fibrillation F(AF), something we see quite a lot of in ED. The nursing considerations in these patients are important and in the last few months I have been involved in a couple of […]
4 years ago
It’s Ok not to be Ok… but its Ok to be Ok too…
Recently I had a conversation with one of our relatively new-to-ED nurses. We’d had a pretty awful shift with a tragic outcome and that night she text me saying ‘Is it normal to feel upset even when I know I’ve done everything right? It feels like I should be fine but I’m not. I keep […]
4 years ago
RCEM Annual Scientific Conference 2019
Earlier this month I attended the RCEM Annual Scientific Conference in Gateshead. It was a great event, and there is a lot of content to cover. So, I’m just going to focus on a few things that I thought might be of interest. If you want more of a detailed overview of the conference then […]
4 years ago
Between the lines #4 – New student nurse standards; are you prepared?
At the beginning of this year I dipped my toe into Masters level study by undertaking my Practice Teachers Course. Thankfully, after 6 months of solid teaching, mentoring students and completing a difficult essay on adult learning theories I am pleased to say that I passed. Sadly, this was one of the last NMC validated […]
4 years ago
To err is human: surviving humanity
Have you ever made a mistake? Have you ever made a mistake that harmed a patient? Do you still think about that mistake, even if it’s years ago? Me too. We all do it – mistakes range from the generally minor, like calculating a NEWS wrong, requesting an X-ray on the wrong limb (or the […]
4 years ago
Don’t fear the Reaper – Death: our oldest colleague in A&E
RCN Curriculum and Competency Framework for Emergency Nursing: CD2 2.2.8 & CD2 2.2.9. When I disclose to new acquaintances that I’m an Emergency Care Nurse, conversation tends to drift toward the courageous, life-saving experiences they imagine I must partake in daily. These perceptions are swiftly corrected; I personally view my predominant role in A&E is […]
4 years ago
Transgender Sim A&E 2019
Competency Framework: GNP3 – Communication, GNP 5.2.3, GNP 7.1.3, GNP 7.1.7, GNP 8.2.2, GNP 8.2.3, CCT 6.1.3. Written by Sarah Perkins, foreword by Siobhan Cockram, Staff Nurse, A&E, Royal London Hospital and LGBTQ+ co-site lead RLMEH and Prescott Street. Sarah Perkin is one of our fantastic Registrars who at the time (of this SIM) was […]
4 years ago
Crossing the line
Competency Framework: CD2.7 Central Venous Catheter (CVC): insertion & care in A&E Hello! Welcome to A&E in the depths of winter. You’ve become well acquainted with the art of corridor care and doorway triage, and now it’s time to see critical care overflow from the ICU! You take handover in a busy resus room and […]
5 years ago
Behind the Guidelines
As ED staff we all know that in an emergency we have our trusty guidelines to turn to. This helps with cognitive off-load in stressful situations, but are these guidelines always up to date with the evidence? This post aims to look at some of the most current research, and make you question the guidelines […]
5 years ago
The secret to happy nurses? Pathway to Excellence
In the words of Monty Python (well sort of): ‘what has pathway ever done for me?’ This is what I hear when I walk around the hospital chatting to nurses and other staff about our journey on the pathway to excellence. There is an air of suspicion still that this will mean extra work for […]
5 years ago
Call the Midwife….
Situation A 32 year old female presents to the ED with PV bleeding 8 hours post delivering a healthy baby girl at home. It’s her second pregnancy, and second child. She had no complications with her first pregnancy, or with this one, and was deemed low risk for a home delivery. Initially she just noticed […]
5 years ago
Neuro obs: A right headache?
Situation How often do you take handover of a patient and get told “they’re on neuro obs?” Or get asked by the assessing clinician “can we start this lady on neuro obs please?”. Yet I recently had a conversation with one of our healthcare assistants who said she wasn’t trained to do neuro obs, only […]
5 years ago
Merry Christmas and Thank you 2018!
Hey Folks! This is a blog to accompany our latest podcast available here. So here we are and Christmas is almost upon us and that means it’s nearly 2019 and that is scary!! The last 12 months have been a bit of whirlwind for me to be honest and amongst that whirlwind, was the creation […]
5 years ago
Merry Christmas and Thank you!!!
Liz (@SisterScrappy) and I (@ashleighlowther) having another chat…. so we just wanted to get something out to you guys about why we have been so quiet but to recognise what we have achieved this year (8 months) thanks to your support. So firstly sorry this isn’t a specific learning podcast and more of a […]
5 years ago
#ASPiH2018
It’s been a busy month of Conferences for me. So, as I get ready to go to Cardiff for #EMTA18 this week, here is a short summary of my key learning points from #ASPiH2018 A bit of background for those of you who don’t know, #ASPiH2018 was the annual conference of the Association for Simulated […]
5 years ago
What’s the Plan D?
Hi Folks I am sat here excitedly as I finally get to write a blog on one of my favourite subjects, the Rapid Sequence Induction (RSI) of a patient in ED. This also applies to any patient who is anaesthetised in an emergency, or out-with the anaesthetic room in a planned procedure. If I told […]
5 years ago
St.Emlyn’s LIVE
Last week was the first ever, and much anticipated, St.Emlyn’s Conference. The programme was ram packed with talks, which left my head spinning a little as there was so much to take in. So, I am delighted to say that Dr Carrie Thomas has helped to compile some notes from the day. Many of the […]
5 years ago
Between the Lines #2 – The Sedated Patient
Patients discharged from critical care who go on to be discharged home are offered the chance to return to the critical care environment for their psychological rehabilitation. Better understanding their journey of care helps some to contextualise the often disturbing memories they have of their care experience. For others, it is simply an opportunity for […]
5 years ago
Between the Lines #1- Inotropes
Inter-departmental banter and rivalry between ICU and ED nurses is as old as the NHS is still young. If you happen to have been working under a rock or never ventured outside of your department, I highly recommend finding a friend from another ward. Go for a cup of tea and call it clinical supervision […]
5 years ago
Arterial Blood Gases
Hey everyone this is a link to an absolutely awesome presentation by my mate Scott Hawkins who is an experienced ACP in EM and is now specialising in cardio-thoracic anaesthetics and ICU (yeh he is pretty clever). So he created this for paramedics who asked him for some teaching about what the gases meant in […]
5 years ago
Emergency Nursing- maybe the best job in the world….
This is slightly different to our previous podcasts- Liz (@SisterScrappy) and I (@ashleighlowther) having a chat about how we got into being an ED Nurse and what the current situation is. This was sparked by a conversation I had with an amazing ED nurse talking about leaving the job and I found myself trying […]
5 years ago
Pain assessment in the ED
Hi lovely people, Welcome to our 3rd podcast and we actually forgot to say on the podcast that we have a new jingle!! Thanks to Nigel (@Nrtaylor101) from the @RCEMLearning team for his help with that. Ok so we are pretty chuffed with the support you guys have given us so far and we want to keep […]
5 years ago
Workshops at the EMEC Clinical Decision Making – How to Teach Expertise
he EMEC always has a stellar line up of workshops and this year was no exception. It was a difficult choice to decide which workshops to go to – you get to choose to attend 2 out of 4 possible options, resulting in major FOMO for the workshops you miss. However, even after just a […]
5 years ago
Only ‘Human’
Hi guys! Slight confession to this blog, it may cause you to open the proverbial can of worms that is Human Factors and Non-Technical Skills and make you want to delve more into it! This is ok…. but it may take up some of your time. A few links within this blog to other amazing […]
5 years ago
Patient assessment
This episode is the first ‘proper’ one and we are discussing triage and assessment at the front door in line with the framework CCT1- the whole part of CCT1 knowledge and skills. We have mentioned a few documents in the podcast so they are linked below for your viewing pleasure. We are still trying to get the […]
5 years ago
The Introduction
This podcast links very nicely to everything already on the website and is a guide to ‘what we are trying to achieve’ We hope you like it! Jingle to be changed and sound quality to be worked on.. bear with us For Apple users For Android users
5 years ago
EDeducate on tour – the EMEC
So, our first conference report on EDeducate. On June 11th Harmony, Liz, Ashleigh, Kirsten and I descended on Birmingham for the Emergency Medicine Educators Conference organised by Scott Carrington. It was an excellent programme: so I’ll try to summarise some of the educational pearls I, as a non-educationalist ED person, brought from it. Our own […]
5 years ago
Raising the (S)BAR on Handovers…
t’s widely recognised that those of us who choose to spend our working hours in an Emergency Department are easily distracted. We thrive on the adrenaline, the chaos, and the fast change of pace. But if you’re anything like me, those traits make stringing a coherent handover together a bit tricky. I regularly find myself […]
6 years ago
Casey and the case of the missed diagnosis
Meet Casey. She arrived at your emergency department one Saturday afternoon a few weeks ago. She’s a cheerful, previously healthy 19 year old part way through her second year at your local Higher Education institution. She’s also just spent 4 days on Critical Care, and is the subject of a Serious Untoward Incident/Level 3 investigation […]
6 years ago
A right pain in the… chest!
Situation Chest pain is one of the most common ED presentations, accounting for between 5 and 8% of ED attendances in the US every year[1]. Chest pain can have numerous causes and it’s important for us to distinguish between the life threatening and the not-so-much. As an ED nurse your assessment of the patient may […]
6 years ago
Between the Lines #3 – Caring for Arterial Lines
Good news, my writers block is cured! Bad news, it took a patient incident to unblock it; let me tell you a little story about my recent night shift… Startled from my note writing by loud shouts for help from my colleague who was stuck in a lonely side room, my usually cucumber cool colleague […]
6 years ago
Self Development is the way to go
Hi Everyone well this is the first post for the website and its mostly an introduction as to what we are trying to achieve. What you can expect from this website is a one stop shop for all things ED education, this is going to be mostly aimed at nurses/HCA’s/ODP’s working in ED as oppose […]
6 years ago
Horses and Zebras and Flesh-eating Bacteria…oh my!!
Situation It’s a well-known observation that some staff, more commonly new doctors, jump to a farfetched diagnosis when often the simplest is the most likely. Hence the phrase “hear hooves: think horses not zebras”. Think back to the patient with a rattly cough who has a differential of something obscure like lymphangioleiomyomatosis when actually they […]
6 years ago
Abominable Abdominal pain
Situation Abdominal pain is a common presentation to the ED roughly 7% of all ED attendances.[1] There remains to be a substantial proportion of these patients who remain undiagnosed. On the flip side of this the most common surgical emergency to present to the ED is appendicitis. Image courtesy of theplaguedoctor.blog @theplaguemd Abdominal pain can […]
6 years ago