January 2015’s primary survey

Simon Carley, EMJ associate editor, talks you through the highlights of January's EMJ, including pulmonary embolism in pregnancy and the post partum period, the causes of suffering in the ED, and how to diagnose a patient by their facial expressions. For all the content from the issue, see: http://emj.bmj.com/content/32/1.toc Listen to a podcast on diagnosis by face: http://goo.gl/0ackZw Listen to a podcast on suffering in the ED: http://goo.gl/JhGa7P

Not all suffering is pain

Provision of prompt, effective analgesia is rightly considered as a standard of care in the emergency department (ED). However, much suffering is not ‘painful’ and may be under-recognised.

A recent paper in EMJ looked to describe the burden of suffering in the ED and explore how this may be best addressed from a patient centred perspective. Ellen Weber talks to lead author Richard Body, Emergency Department Research Office, Manchester Royal Infirmary, to hear what they found.

Read the full paper:


DRC to Dar: one physician’s journey to emergency medicine

Dr Mundenga Mutendi Muller is a young doctor from Kindu province in the Democratic Republic of Congo (DRC), currently training in the Emergency Medcine Residency at Muhimbili National Hospital in Dar es Salaam, Tanzania. He was interviewed in Dar es Salaam by Ellen Weber, EMJ Editor. This is an excerpt of their conversation.

An edit of the conversation is also available as a EMJ article: http://emj.bmj.com/content/31/8/611.full

Diagnosis by face

Clinicians use nonverbal cues from patients, including their facial expression content and variability, to make inferences about how ill a patient is. However the diagnostic accuracy of facial expressions as a method of physical diagnosis hasn't previously been scientifically examined.

Research just published in EMJ is the first to examine this question, and provides proof of concept that patients with serious cardiopulmonary disease processes manifest facial expressions with decreased variability and emotional content than patients with no serious cardiopulmonary diagnosis.

EMJ editor Ellen Weber discusses the findings with lead author Jeffrey Kline, professor in the Department of Emergency Medicine, Indiana University School of Medicine.

Read the full paper: http://goo.gl/MFvaxC