A Refresher on Pneumothorax

An update on the 2023 guidelines for management of pneumothorax.
Here are 8 sample SBA questions for the MRCEM exam
A 3-year-old child presents to your emergency department with a rash, fever and vomiting.
A cyanosed young lady sitting comfortably in the waiting room.
A 36-year-old male presents with a 5-day history of sore throat, fever and dehydration.
A man collapses in the bathroom. What was the cause? Is he safe to go home?
A case of breathlessness secondary to deep sea illness.
Diabetic Ketoacidosis, very common presentation to the ED, is a potentially life-threatening complication of type 1 diabetes. The Joint British Diabetes Societies have developed recent consensus guidelines to guide management.
How will you manage a patient presenting with an atraumatic painful swelling of their great toe?
Management of the most common ophthalmic presentation: the acute red eye.
A 53-year-old man presents to the ED with a 12-hour history of impaired sensation to the right side of his face, right arm and right upper torso.
The infant who nearly died in her parents arms.
Is it just another headache, or something more sinister?
An unusual presentation of chest pain to the emergency department following substance abuse at a party.
Diagnosis and management of itchy bedbug bites!
You are called to a pre-alerted 6-day-old baby who has arrived in paediatric resus with rapid breathing. How will you manage this infant?
The boy doesn't look sick but his heart beats fast.
A patient presents with a red eye how do you manage it?
An unusual presentation of leaking gas in the abdomen.
A painful ear in a febrile child
An older woman with a background of alcohol excess has an unusual blood gas. What is causing her drowsiness and how will you treat it?
Elbow injuries are a common presentation to the paediatric emergency department.
A patient presents following a viral illness with RUQ pain, vomiting and confusion.
Tracheostomy emergencies are a relatively common and often alarming occurrence do you know how to manage a patient presenting with a tracheostomy emergency?
EM/PHEM resuscitation during an observer shift
An explosion has occurred at a nearby chemical plant and your emergency department is the nearest healthcare facility. Are you ready to handle this major incident?
Adult Trauma Call: Management of a 28-year-old male with a knife wound to the chest.
A handy reminder that not all carpal bone fractures involve the scaphoid bone.
Shortness of breath is a common occurrence for COPD patients, and were used to putting them on non-invasive ventilation. What happens when we cant?
A child attending Emergency Department with a wheeze
A delayed presentation after trauma with an increasing joint swelling, what gives?
An older patient with acute onset of vertigo. How do you decide if its peripheral or central vertigo?
A 56-year-old plumber attends with lower back pain and urinary incontinence.
Doctor, why is my vision worse after surgery?
Chemical eye injury can be caused by acids or alkali. It is important to know how to manage them in the ED.
A 45-year-old woman presents with loss of vision in her left eye
A young lady presented with abdominal pain, lethargy, (Groin) bone pain, depression and headache.
Another pain in the back SBA
It all started with a headache
Your department is crowded with multiple ambulances arriving, very few empty clinical spaces and multiple boarded patients due to exit block.
A 13-year-old female collapses whilst running. How will you assess and manage this?
Patient with Von Willebrand disease is brought to ED with per rectal bleeding.
A 2-year-old child presents with worsening eczema and parental concerns that she was unwell.
A young man is brought to your ED by police. They suspect he has concealed drugs internally and want you to perform an intimate search and x-ray.
A woman presents with 10/10 eye pain. Consider what could be going on, rule out the red flags and address her urgent concerns!
Management of a patient who reattends the Emergency Department with cyclical nausea and vomiting.
A young pregnant woman attends with severe nausea and vomiting. Shes unable to keep tablets, food or fluids down and looks dehydrated.
A young woman presents with breathlessness. She is profoundly tachycardic. How will you manage this?
A woman attends your ED with severe lower abdominal pain and fullness, with difficulty urinating. She had roughly similar symptoms when she was diagnosed with pelvic inflammatory disease before.
There are three pregnant patients in the department who require consideration of Rhesus status and anti-D immunoglobulin. You must assess each in turn.
A 25-year-old male presents to your ED with central sharp chest pain, shortness of breath and palpitations.
A 45-year-old female attends with grossly swollen lips. She has some important information about her symptoms, can you understand it? ! If not, its time to use some clinical acumen!
An elderly male with a shocking diagnosis.
A young man presents with an acutely red and painful eye on the background of a chronic stable condition.
An elderly woman attends with a vague history of weakness and confusion but an unremarkable clinical examination. How will you proceed?
A young woman, who walks into the ED with Propranolol overdose, suddenly collapses.
A woman presents with breast pain and fever to your emergency department. How will you manage this patient?
A pregnant woman presents with a headache and abdominal pain and suddenly deteriorates. How will you manage this?
A young man presents with auditory hallucinations and paranoid delusions. Test your knowledge on assessment and management of a psychiatric patient.
You think this is a regular day at the office and a very straight forward case, but is it?
A young female patient presents with lower abdominal pain and vaginal bleeding to your ED. How will you manage this patient?
A conducted energy device (CED) taser was discharged into a patients shoulder. Before this patient is taken into police custody, youve been asked to assess them in your ED.
A young woman is pre-alerted to the emergency department with increasing drowsiness and confusion.
The Police have brought a patient to your ED that has had a controlled energy device discharged into their upper back. You are called to assess this patient.
Refresh your knowledge on this latest outbreak.
Test your knowledge on managing an animal bite!
Preparing for exams and trying to find an SBA on organ donation? The law around organ donation has changed; refresh your knowledge with this SBA.
A woman with diplopia needs your help. Can you identify the cause and include or exclude any red flags?
Your patients x-ray shows his heart is almost the whole size of his chest. Whats going on? And what are you going to do about it?
Trauma Pre-alert for a 35-year-old gentleman who sustained injury to head and back after diving into the shallow end of a swimming pool.
Do we always behave as we should?
A young man presents with fever, headache, photophobia and vomiting. Can you interpret the findings to diagnose and treat him appropriately before its too late?
Functional Seizures arent managed with benzodiazepines but how do you tell functional seizures from epileptic ones?
Just because we can incise an abscess, should we?
A 14-year-old girl presented at the ED after falling into a tree and impaling her cheek with a large twig, just below her right eye, obscuring her vision.
This SBA will test your knowledge on worrying presentations to ED, and when fevers come and go.
Small magnets in small people.
Theres a lot to know about PEM. Can you answer our questions on some of the more common PEM?
Using PoCUS to identify the abdominal aorta is an important skill and a curriculum requirement for completion of EM training. Can you identify all the relevant structures using ultrasound?
Adult asthma patient with breathlessness
A patient with kidney troubles now has acute kidney injury. How will you identify and manage her AKI?
Man with a productive cough and fever -and its not Covid!
A patient is bradycardic. They might need pacing. They might not.
Can you recognise acute kidney injury and prevent its deadly complications?
A 4-year-old with a persistent cough
A drowsy marathon runner presents after training in the sun, with a significantly raised temperature and dry skin too hot to touch.
Good supportive care makes a difference in sickle cell disease
A neonate that suddenly collapses leaves us all with dread.
How will you manage the absconding patient?
An elderly lady gardening in the hot summer sun becomes unwell soon after midday. How will you manage her heat stroke?
Burnout is increasing but is it what you think?
Managing the paediatric c-spine
How will you manage your absconding patient with suicidal intent who has gone absent without leave?
Identifying aortic dissection is difficult, but the management doesnt stop there.
NIV not indicated for every situation.
Here comes the Summer Sunand Heat Stroke.
How will you manage the absconding patient?
Complaints are unfortunately common but how do you reply to them?
Learn more about the Multi Agency Risk Assessment Conferences (MARACS) and their role managing in domestic abuse.
Teaching and thinking about teaching
12% of ED attendances are related to domestic abuse. How will you identify & manage these cases?
A recently widowed 36-year-old female presents with chest pain and shortness of breath. Her ECG features diffuse ST elevation.
Life threatening complications of cancer more than neutropenia.
Communicating with little people?
12% of ED attendances are related to domestic abuse. ED physicians are in a unique position to identify these cases.
This SBA will test your knowledge about bronchiolitis are you ready?
A young man presents with superficial wounds on his forearm from a dog bite. You know what you have to do. Clean the wound, give a tetanus shot and prescribe antibiotics. Right?
What are potential causes for blood in a neonates nappy?
Are you supporting your overseas team as much as you could? Inspired by the RCEMLearning blog, here are some questions.
Buckle / Torus fractures in children
We perform fascia iliaca blocks with ease but do you really remember the anatomy?
Children can be distracting, but how can we also distract them?
DNA CPR confuses many but is a very important area to get right.
Imaging and management in paediatric trauma
Explore your understanding further of how hypnosis can help in Emergency Medicine
Are inequalities part of our every day work, and what can we do about them?
Unwell neonate with an umbilical hernia
When will you admit a patient with PID?
A patient presents with sudden, painful loss of vision. Can you diagnose the problem and provide emergency management?
Differential diagnosis of knee pain in the limping older child
1 in 300 people will experience anaphylaxis at some point in their lives. The 2021 anaphylaxis guidelines provide an updated consensus for the recognition and management of anaphylaxis in all age groups.
A painful rash and a febrile illness -but could it be necrotising fasciitis? How can you tell?
A third of deaths from food anaphylaxis occur despite appropriate early management. Consequently, the RCUK have recognised a need for standardised algorithms for ongoing resuscitation in cases of refractory anaphylaxis.
This SBA addresses an important time-critical complication of wound infection where early diagnosis and management can save a patients limb.
A 43-year-old man is hypotensive, tachycardic and febrile barn door sepsis or something else? The devil is in the detail!
A bleeding patient on anticoagulation
A 2-year-old boy is brought to the Emergency Department with a barking cough and noisy breathing. Can you diagnose and treat him before he deteriorates?
Intermittent abdominal pain in infants
A 92-year-old man attends the emergency department complaining that his right shoulder "looks a funny shape".