Ep 296 - Trauma, Systems Thinking and High-Risk PE (April 2026 Round Up)

Iain Beardsell and Simon Carley return for the April 2026 St Emlyn’s podcast update, talking through another busy month of posts from the St Emlyn’s team and guest authors.

This month brings trauma, systems thinking, public health and pulmonary embolism, with plenty of practical ideas to take back to your next shift.

Iain and Simon start with three more of Simon’s Trauma Team Leader Tips.

The first looks at external haemorrhage control. Tourniquets save lives, but they are not the answer to every bleeding wound. Simon describes a practical escalation from accurate direct pressure, through additional dressings and indirect pressure, to haemostatic agents and tourniquets when they are genuinely needed.

The wider lesson applies well beyond major trauma: expose the wound, find where the blood is coming from and apply effective pressure.

They then discuss Simon’s post on chest drains before CT.

A pneumothorax or haemothorax does not automatically mean that a stable trauma patient needs a drain before leaving resus. The important question is whether the intervention is needed immediately, or whether putting in a chest drain will simply delay the CT that defines the patient’s injuries.

As ever, physiology matters more than reflex protocols.

Simon’s final Trauma Team Leader Tip is deceptively simple: put major trauma patients straight onto a portable monitor.

Most major trauma patients will soon be leaving resus for CT, theatre or another clinical area. Preparing for that move from the moment they arrive can remove avoidable delays. Portable monitoring, oxygen, transfer equipment and a consistent transfer checklist all help maintain momentum.

Iain and Simon then turn to two posts from Stefan about some familiar emergency department problems.

The first considers how we explain ED crowding to colleagues who do not work in our environment. Stefan introduces the idea of a “cognitive bridge”: using an anchor, span and landing point to translate an emergency medicine problem into something meaningful to the person you are speaking to.