RCEM Learning February 2026
16 snips
Feb 24, 2026 Becky Maxwell, emergency clinician who co‑reviewed New Zealand chest injury guidance, and Chris Connolly, NZ emergency clinician familiar with local trauma systems, walk through a practical chest injury flowchart, imaging triggers, analgesia escalation and rural transfer considerations. Charlotte Underwood, EM trainee and researcher on gender disparities, discusses how gender influences assessment and analgesic decisions for abdominal pain.
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Guideline Language Reflects Rural Imaging Access
- Rural NZ hospitals may lack onsite CT, so the guideline's wording ('consider CT') balances ideal care with access limitations.
- This context drives early escalation and transfer thresholds rather than mandatory CT for all.
Treat Pain Early And Prescribe Regular Analgesia
- Escalate analgesia proactively and prescribe regular (not PRN) analgesia to protect breathing and enable mobilization.
- The guideline links good pain control to reduced respiratory complications and shorter admissions.
Train ED Clinicians To Provide Single Shot Blocks
- Use regional blocks and PCAs where available, but recognize many EDs rely on anaesthetists for blocks; consider training ED clinicians in single-shot blocks.
- Chris suggests copying Sheffield's recent trainee training to expand ED capability.
