Should we be bringing preventative medicine into the emergency department, or is it just using up valuable time? Our first paper this month looks at the "Cessation of Smoking Trial in the Emergency Department (COSTED)" trial, which presents the case for opportunistic smoking cessation intervention. Next up is a topical research paper on interpreting CT scans with artificial intelligence, and how machine assessment measures up against experienced physicians. Then there's a trio of troponin papers, discussing high-sensitivity testing. The final paper this time is not a paper but a guideline from the Royal College of Emergency Medicine, setting out best practices for dealing with suspected cannabinoid hyperemesis syndrome. Articles discussed in this episode: Cessation of Smoking Trial in the Emergency Department (COSTED): a multicentre randomised controlled trial. Pope I, Clark LV, Clark A, et al

Using an artificial intelligence software improves emergency medicine physician intracranial haemorrhage detection to radiologist levels. Warman P, Warman A, Warman R, et al

External validation of a rapid algorithm using high-sensitivity troponin assay results for evaluating patients with suspected acute myocardial infarction. Cullen L, Greenslade JH, Stephensen L 2022 SAMIE study group, et al

High-sensitivity troponin testing at the point of care for the diagnosis of myocardial infarction: a prospective emergency department clinical evaluation. Curran JM, Mergo A, White S, et al

Determination of a whole-blood single-test low-risk threshold for a point-of-care high-sensitivity troponin assay. Pickering JW, Hamill L, Aldous S, et al

RCEM best practice guideline: suspected cannabinoid hyperemesis syndrome in emergency departments. Humphries C, Gillings M

The EMJ podcast is hosted by:

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

Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, 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.

“Social distancing is a privilege,” is the core message underlying the first paper brought by Sarah to this month’s roundup, as it unpacks the stark differences in COVID-19 outcomes across the spectrum of racial and ethnic groups in the United States. A second paper examines the returning rates of COVID patients across a large group of emergency departments in Canada, and the factors at play there. The final topic is one of Rick’s favourites, focusing on troponin testing in ambulances.

Articles discussed in this episode:

Pandemic phase-related racial and ethnic disparities in COVID-19 positivity and outcomes among patients presenting to emergency departments during the first two pandemic waves in the USA. Khosla S, Del Rios M, Chisolm-Straker M, et al.

Characteristics and outcomes of patients with COVID-19 who return to the emergency department: a multicentre observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). Rosychuk RJ, Khangura JK, Ortiz SS, et al.

Perceived barriers and opportunities to improve working conditions and staff retention in emergency departments: a qualitative study. Daniels J, Robinson E, Jenkinson E, et al.

The EMJ podcast is hosted by:

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

Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, 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.

A feast of aortic papers this month, including a study on missed aortic dissection diagnoses and an analysis of coroners' reports. Rick runs through the findings of an interesting study from the Trainee Emergency Research Network (TERN), and Sarah finishes off with a paper on predicting adverse outcomes in elderly patients with orthopaedic trauma.

Articles discussed in this episode:

Ohle R, Savage DW, Caswell J, et al. Mortality and risk factors associated with misdiagnosis of acute aortic syndrome in Ontario, Canada: a population-based study.

Hodgson S, O'Mahony K, Nicholson J, et al. Thematic analysis of ‘Prevention of Future Deaths’ reports related to emergency departments in England and Wales 2013–2022.

McLatchie R, Reed MJ, Freeman N on behalf of the DAShED investigators, et al. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome.

Isaac CJ, Moore L, Bérubé M, et al. Predictors of adverse outcomes in elders hospitalised for isolated orthopaedic trauma: a multicentre cohort study.

Related links:

RCEM Learning: Aortic Dissection podcast.

Trainee Emergency Research Network.

The EMJ podcast is hosted by:

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

Dr. Sarah Edwards, EMJ Social Media Editor, Leicester Royal Infirmary, 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.