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NEW A Vague Pain with a Serious Secret Clinical Case

NEW: A 91-year-old man presents with persistent groin and hip pain that doesn’t fit a typical musculoskeletal pattern. Bedside imaging reveals an unexpected and potentially life-threatening diagnosis. #ClinicalCase

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SUNDAY QUESTION

Which of the following options is the immediate first step in the management of this patient?

ANSWER BELOW

UPDATE: An elderly man presents to the ED with dizziness associated with movement of his left arm.
Which of the following is the most likely diagnosis in this case?

a) Cardiac arrhythmia
b) Subclavian Steal Syndrome (SSS)
c) Coarctation of the aorta

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#ClinicalCase

Feeling Short of Breath SBA UPDATE

UPDATE: Your patient’s x-ray shows his heart is almost the whole size of his chest. What’s going on? And what are you going to do about it? #SBA

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Irritable Bowel Syndrome in the Emergency Department Blog UPDATE

UPDATE: 50% of patients, their symptoms are relatively mild... the remainder, symptoms can be much more intrusive and unfortunately it is not generally appreciated just how severe they can be

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#IBS #Blog

A Painless, Swollen Upper Limb NEW Clinical Case

NEW: A 31-year-old male presents to your Emergency Department (ED) with a 2-day history of swelling, prominent veins and some purplish discolouration of his right arm. The swelling is painless, but the medial aspect of the upper arm is mildly tender on palpation #ClinicalCase
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A 70-year-old chronic smoker presents with polyuria, polydypsia and abdominal pain. There is no family history of diabetes. Examination was unremarkable. The blood glucose was 4.5 mmol/l. What is the most appropriate next line of investigation? a). Urinalysis b). Serum calcium level c). Erect chest x-ray d). An arterial blood gas ANSWER BELOW

SUNDAY QUESTION

A 70-year-old chronic smoker presents with polyuria, polydypsia and abdominal pain. There is no family history of diabetes. Examination was unremarkable. The blood glucose was 4.5 mmol/l.
What is the most appropriate next line of investigation?

That’s a rare “…itis” Clinical Case UPDATE

UPDATE: A 51-year-old female presents to the Emergency Department (ED) with a sudden onset epigastric pain that started 6 hours ago. She then developed left sided facial droop and left arm and leg weakness about an hour later. #ClinicalCase

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Stuffy Nose, New Clinical Case RCEMLearning

NEW: A 56-year-old man presents to the Emergency Department with nasal obstruction and intermittent fever. He reports a minor fall at work six days prior to the presentation

How do you distinguish between a septal hematoma and a turbinate/deviated nasal septum? #ClinicalCase
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The Headache, SBA, UPDATE

UPDATE: A 20-year-old man presents with a headache that has been on-going for the past three weeks. He reports that he has vomited on most days. He has photophobia and neck stiffness. In addition, he is febrile and complains of night sweats and weight loss. #SBA

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SUNDAY QUESTION Helicobacter pyloris a). is a gram-negative, motile, spiral-shaped bacterium b). is a Gram-positive, motile, spiral shaped bacterium c). multiplies optimally at pH 4-6 d). produces ammonia preventing the G cells from sensing the true pH ANSWER BELOW

SUNDAY QUESTION - Tell us, what is 'Helicobacter pyloris'?

Scoring Upper Gastrointestinal Haemorrhage SAQ UPDATE

UPDATE: A 41-year-old gentleman presented to the Emergency Department (ED) with a three-day history of vomiting blood and the passage of dark black stool rectally. He complained of moderate epigastric pain and had called 999 after collapsing whilst on the toilet. #SAQ

A Swollen Red Eye in a 5-Year-Old SBA

NEW: A 5-year-old boy is brought to the ED by his mother. He has a swollen, red left eye that started this morning. He has mild fever (37.8 °C) and nasal congestion for a few days. His mother states he gets frequent colds and ear infections but nothing affecting his eye #SBA
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Say hello to our new logos EMTA logo - shield with the rod of asclepius EMSAS - tower with pillars with the rod of asclepius EMACP - icon of four hands holding together with the rod of asclepius

We’ve introduced new logos for the EMTA, EMSAS and EMACP Forum.

Designed with Forum Chairs, they bring a more consistent RCEM identity while keeping each Forum distinct. Each includes the Rod of Asclepius, a shared symbol of medicine.

Take a look at the new designs across our platforms today

Sight for Sore Eyes Blog

UPDATE: The RCEM curriculum tells us that EM clinicians are expected to be able to manage red and/or painful eyes, sudden vision loss and facial trauma. Thankfully, the majority of eye conditions we see are not immediately sight-threatening, but what happens when they are?

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March 2026, Podcast - NEW

NEW: Today is #Podcast day at RCEMLearning

Topics this month include:
New in EM - Ibuprofen plus opiates in paediatric injury
Guidelines for EM - Sexual Assault in the ED

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A 63-year-old female presents to the Emergency Department (ED) complaining of piercing pain in her right eye and blurred vision with an associated right sided headache. She is vomiting at triage. She cannot read any line on the Snellen chart with her right eye and can only appreciate hand movements. The patient’s eyes are as shown in the image. Her right pupil is mid-dilated and non-reactive. She has no known medical history.

What is the most likely diagnosis? a). Anterior uveitis b). Central retinal artery occlusion c). Acute angle closure glaucoma d). Retinal detachment ANSWER BELOW

SUNDAY QUESTION
What is the most likely diagnosis?

a). Anterior uveitis
b). Central retinal artery occlusion
c). Acute angle closure glaucoma
d). Retinal detachment

ANSWER BELOW

Can this be PE? Clinical Case What is the most likely diagnosis?

NEW: A 44-year-old male is brought into Resus after collapsing. He reports sudden-onset chest tightness and sweating, preceded by progressive shortness of breath over the past 24 hours.

What is your most likely diagnosis?
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#ClinicalCase

The Acutely Injured Knee UPDATE Learning Session

UPDATE: This module includes ten SAQs on knee injuries. Each SAQ features a knee x-ray image for interpretation, along with questions regarding Emergency Medicine (ED) management of the injury.

#LearningSession

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Fever in the Pregnant Returning Traveller SBA NEW

NEW: A 34-year-old pregnant woman presents to the Emergency Department (ED) after returning from Zambia. She has a four-day history of fever and dark urine. #SBA

What is the most likely diagnosis?

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TB in the ED: Still Here, Still Sneaky – Think TB! Blog

NEW: It's time to 'Think TB' for World Tuberculosis Day. Today was created to raise public awareness for the disease as TB is very much still present in the emergency department #Blog

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It’s Never Lupus, Clinical Case, UPDATE

UPDATE: A 33-year-old female presents to the Emergency Department (ED) with a three month history of worsening atraumatic right hip pain. Pain is exacerbated by weightbearing and movement, and current analgesia from her GP is no longer effective. #ClinicalCase

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SUNDAY QUESTION

The fetal circulation maximises oxygen delivery by which of the following?

Answer below!

Undermining in the Emergency Department Blog RCEMLearning UPDATE

UPDATE: Have you ever experienced consistent dismissive tones from that same colleague? Or the predictable sigh whenever you ask a question? What about that person who always talks over you in meetings?

This is undermining #blog

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RCEMLearning, Why is air in there? Clinical Case, NEW

NEW: A 50-year-old man presents to the Emergency Department (ED) with sudden onset of severe central chest pain radiating to the left side, following multiple episodes of forceful vomiting after eating pork meat

What is the most likely diagnosis? #ClinicalCase

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Facial Injury, SBA. UPDATE (RCEMLearning)

UPDATE: A 14-year-old girl presents at the Emergency Department (ED) with a foreign body impaled below her right eye following a fall into a tree

How should this be managed in the ED?

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Can we safely rule out DVT in low-risk patients using age-adjusted D-dimer NEW Journal Club

NEW: We have a new Journal Club study available, this edition is an overview of the ADJUST-DVT study by Dr Wahaballah Abdullah and Prof. Rob Galloway

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Neuroprognostication following Cardiac Arrest Learning Session/Reference UPDATE

...to potentially enable early withdrawal of life-saving treatment (WLST) in those patients predicted to have a poor outcome.

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#Reference www.rcemlearning.co....

This is associated with high mortality, but a considerable proportion of those who survive the event have a poor neurological recovery. It is therefore essential to predict neurological outcome in this group of patients as early as possible... [cont.]