The St.Emlyn’s Podcast

Ep 283 - Best Bits of 2025 — Bonus: Clinical Pearls

Jan 2, 2026
A rapid collection of clinical pearls covering practical triage wording to prompt earlier action. Time-critical decisions in pre-hospital thoracotomy and resuscitation targets focused on diastolic pressure. Real-world IO safety data and analgesia options for rib fractures. Warnings on hydrofluoric acid care, recognising decompression illness, cognitive prep for high-load moments, and building excellence with compassionate pauses.
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ADVICE

Use 'Severe' To Trigger Earlier Action

  • Use the word "severe" to describe bleeding to lower the threshold for intervention and prompt action.
  • Saying severe reduces hesitation and increases early, potentially life-saving responses.
ANECDOTE

Speedy Thoracotomy Can Save Tamponade Arrests

  • Pre-hospital thoracotomy can save patients in tamponade if performed extremely quickly, with near 50/50 survival if within about 60 seconds.
  • The clinician recounts a recent survivor who arrested in front of them and subsequently walked out of hospital well.
INSIGHT

Diastolic Pressure Predicts Coronary Perfusion

  • Coronary perfusion depends on diastolic blood pressure and diastolic pressure under ~35 mmHg greatly reduces ROSC chances.
  • Targeting diastolic pressure and using invasive monitoring matters more than trusting oscillometric readings.
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