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 […]

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 […]

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projects I started in 2020 and what is perhaps a damning indictment of my pandemic experience; blog number 5 is a year out of date.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 […]

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) […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

#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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]