MEM-EM: The Memorising Emergency Medicine Podcast

MEM-EM
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An educational podcast designed for Emergency Medicine. The primary goal of this project is to accelerate the learning curve and decrease the knowledge translation window for trainees. MEM-EM is designed to complement official resources to help people prepare for examinations in Emergency Medicine and to maintain knowledge during practice. Content is structured to follow the RCEM 2021 curriculum but will be useful for ACEM trainees in Australasia and also portfolio pathway candidates in the UK.

  1. Jun 3

    Approach to Low Back Pain & Cauda Equina Syndrome in the ED

    Mnemonic for BACKPAIN Red Flags & Do Not Miss DDX =BACKPAIN can be CRAFTI Back Pain Red Flags*   Bladder, Bowel & Erectile Dysfunction or Bilateral Sx**   Anaesthesia (saddle)   Cancer or Coagulopathy – Sx or PMH/risk (N.B. Thoracic Back Pain)   Kyphosis, stenosis, achondoplasia, or other pre-existingspinal narrowing.   Pain at Night +/-worse lying down think infection or cancer (USUALLY Discogenic pain is worse with flexion, & pain from spondylolysis is worse with extension)**   Age 50 = think harder about other causes.   IVDU/Immunocompromised/ recent Infection or Intervention(e.g. epidural), chronic steroids, sickle cell, organ failure, DM   Neurology (progressive & bilateral sensory or motor)**   *positive responses to “red flag’ questions for low backpain (e.g. bowel or bladder incontinence, history of cancer, trauma, fever, IV drug use etc) prompt further investigation, negative responses are not sufficient to rule out serious pathology.   ** Retrospective tertiary centre review (U.K.) showed thatbilateral lower extremity pain, dermatomal distribution sensory loss, & loss of bilateral ankle/knee reflexes showed correlation with radiographic diagnosis of cauda equina compression (CEC); while digital rectal examination(DRE) did not demonstrate any benefit. However, individual symptoms showed poor performance in ruling in (or out) CEC. For more on low back pain emergencies see EM CASES Episode 26.         CRAFTI DDx of low back pain to consider:   Compression (CAUDA EQUNIA Compression [CEC], ConusMedullaris, Epidural Haematoma / Cauda Equina) Renal Colic or other abdominal cause e.g. pancreatitis AAA or vascular Dissection Fracture (Trauma / Osteoporotic) Tumour (cancer 1ary or 2ary) Infection/Inflammation (Epidural Abscess, Osteomyelitis,Discitis, Transverse Myelitis)

  2. Apr 6

    Locating the Source of Sepsis: The LUCAS mnemonic

    Clinical Epidemiology and Bedside Identification of Sepsis Sources in the United Kingdom: A Comprehensive Analysis of the Expanded LUCAS Framework and NHS Presentation Trends The clinical management of sepsis within the United Kingdom’s National Health Service (NHS) has undergone a paradigmatic shift over the last decade, transitioning from a reactive physiological response model to a proactive, source-centric diagnostic strategy. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, and it remains a primary driver of morbidity and mortality across all levels of secondary care.[1] Within the high-pressure environment of the Emergency Department (ED), the ability to rapidly identify the infectious focus is as critical as the initiation of early fluid resuscitation and antimicrobial therapy. The LUCAS mnemonic—traditionally Lungs, Urine, CNS, Abdomen, and Skin, but expanded here to include Spine, Septic joints, Septic emboli, and Endocarditis—serves as an essential cognitive aid for clinicians to systematically survey the most prevalent and high-risk anatomical origins of infection in a population increasingly characterized by frailty, multi-morbidity, and advanced age.[2, 3, 4]

  3. Mar 30

    Sepsis resuscitation: Applying the Pathophysiology, Guidelines and future of sepsis care at the bedside.

    Sepsis is a time-critical medical emergency defined as life-threatening organ dysfunction caused by a dysregulated host response to infection [1]. Globally, it remains a leading cause of morbidity and mortality, with an estimated 49 million cases and 11 million deaths annually [8].

  4. Mar 27

    Mental SIM: HALO Procedure - Tracheostomy & Laryngectomy Emergency Mx Algorithm

    What to do in these emergency situations.

  5. Mar 23

    Sepsis in pregnant or recent pregnant patients recognition, Diagnosis & Mx

    Suspected Sepsis in Pregnant and Recently Pregnant People: Recognition, Diagnosis, and Early Management Executive Summary Sepsis in the obstetric population is a life-threatening medical emergency requiring immediate recognition and intervention. This guideline (NICE NG255, 2025) replaces NG51 and provides a tailored framework for pregnant people and those who have been pregnant within the last six weeks.Critical Takeaways: The 6-Week Window: Always consider sepsis in any person who is pregnant or has been pregnant (including miscarriage or termination) within the previous six weeks.High-Risk Criteria: Identify "High Risk" status immediately using the stratified criteria (e.g., RR ≥ 25, HR > 130, SBP ≤ 90, or altered mental state).The 1-Hour Bundle: For high-risk patients, the senior clinical decision-maker must assess, and broad-spectrum antibiotics must be administered within one hour.Source Control: Active search for the infection source (including imaging of the abdomen and pelvis) is mandatory if the source is not immediately apparent.Senior Involvement: Specific clinician grades are defined for senior review (ST3+ for adults, ST4+ for under 18s).

  6. Mar 19

    RCEM Syllabus Summaries - Acute Airway Obstruction (RP1), Choking (RC1), Stridor (RC2)

    Executive Summary Acute airway obstruction, designated under the Royal College of Emergency Medicine curriculum as clinical presentation RP1, remains one of the most significant challenges in the National Health Service Emergency Department environment. This presentation encompasses two distinct but often related issues: choking (RC1) and stridor (RC2). The management of these conditions requires a synthesis of rapid clinical gestalt, anatomical precision, and adherence to the latest Resuscitation Council UK and Difficult Airway Society guidelines. Choking, or foreign body airway obstruction, presents a high risk of morbidity and mortality, particularly at the extremes of age. In the United Kingdom, specific peaks in incidence are noted during mealtimes, and the elderly population remains particularly vulnerable due to factors such as poor dentition and neurological impairment.[1, 2, 3] Stridor, characterized by abnormal respiratory sounds, serves as a cardinal warning of critical upper airway narrowing. In paediatric populations, viral croup remains the most frequent cause, whereas in adults, the clinician must prioritize the exclusion of malignancy and acute supraglottitis.[4, 5]The core of management across both presentations is the preservation of oxygenation and the anticipation of a "difficult airway" scenario. For choking, the shift from basic first aid to advanced life support occurs the moment a patient loses consciousness, necessitating immediate cardiorespiratory resuscitation with an emphasis on rescue breaths to potentially displace the obstruction.[6, 7] In stridor, pharmacological temporization using high-dose corticosteroids and nebulized adrenaline is standard practice, allowing time for senior anaesthetic and ear, nose, and throat specialist intervention.[8, 9] If non-invasive methods fail, the Emergency Department must be prepared for a surgical front-of-neck airway, with the scalpel-bougie cricothyroidotomy now established as the gold standard in the United Kingdom.[9] This briefing document provides an exhaustive framework for the assessment and management of these conditions, aligning with the specialty learning outcomes required of high-level emergency physicians.

  7. Mar 19

    RCEM Syllabus Summaries - Resus Overview

    Executive Summary The modern management of resuscitation presentations in the Emergency Department (ED) requires a standardized approach using the Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) framework, integrated with the National Early Warning Score 2 (NEWS2) to drive risk stratification.[4, 5, 7] Significant updates in the 2025 NICE sepsis guidance (NG253) have introduced a more conservative fluid resuscitation protocol—utilizing 250ml boluses—to mitigate the risks of fluid overload while maintaining a focus on delivering broad-spectrum antibiotics within one hour for high-risk patients.[5, 8] In the realm of anaphylaxis, the 2021 RCUK guidelines reinforce intramuscular (IM) adrenaline as the definitive first-line intervention, significantly reducing the reliance on corticosteroids and antihistamines in the acute phase.[4, 9]Major trauma care continues to be optimized through regional networks, prioritizing the ABCDE sequence and permissive hypotension in hemorrhagic shock.[10, 11] The curriculum also emphasizes the ethical and legal complexities of end-of-life care, particularly the "whole hospital" approach to organ donation, where timely referral to a Specialist Nurse for Organ Donation (SNOD) is now a quality standard for patients with devastating brain injuries.[6, 12, 13] Finally, pediatric presentations like Brief Resolved Unexplained Events (BRUE) and the Sudden Unexpected Death in Infancy and Childhood (SUDIC) protocol require a meticulous, sensitive, and multi-agency approach to ensure patient safety and legal compliance.[14, 15]

  8. Mar 19

    Identification of Tension Pneumothorax

    Executive Summary Tension pneumothorax (TPT) is a life-threatening condition occurring in approximately 1% to 3% of prehospital major trauma and intensive care patients. While traditionally taught as a uniform clinical entity characterized by "classic" signs such as tracheal deviation and jugular venous distention (JVD), evidence indicates that these manifestations are rare and unreliable. The clinical presentation of TPT is fundamentally dictated by the patient’s ventilatory status. Patients breathing unassisted typically undergo a progressive respiratory deterioration, while those receiving assisted ventilation (positive pressure) face rapid, sudden cardiovascular collapse. Emergency decompression must be prioritized based on these distinct physiological trajectories, often before radiological confirmation in ventilated or unstable patients. Indications for Emergency Decompression Emergency thoracic decompression is indicated when a patient presents with significant respiratory or hemodynamic compromise that is suspected to be secondary to an expanding pneumothorax. Immediate Decompression (Without Radiography) Decompression should be performed immediately, without waiting for a chest X-ray (CXR), in the following scenarios: Ventilated Patients: Any sudden, unexplained deterioration in oxygen saturation (SpO2) followed by hypotension or a marked decrease in cardiac output.Unstable Unassisted Patients: If a CXR is not immediately available and the patient exhibits:Deferred Decompression In stable, unassisted patients not in extremis, it is appropriate to obtain a CXR or perform thoracic ultrasonography to confirm the diagnosis and lateralize the disease before intervention.Tension pneumothorax—time for a re-think?S Leigh-Smith, T Harris. Emerg Med J 2005;22:8–16. doi: 10.1136/emj.2003.010421 Clinical Presentation of Patients With Tension Pneumothorax A Systematic Review. Roberts et al., 2014

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An educational podcast designed for Emergency Medicine. The primary goal of this project is to accelerate the learning curve and decrease the knowledge translation window for trainees. MEM-EM is designed to complement official resources to help people prepare for examinations in Emergency Medicine and to maintain knowledge during practice. Content is structured to follow the RCEM 2021 curriculum but will be useful for ACEM trainees in Australasia and also portfolio pathway candidates in the UK.

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