EMERGENCY MEDICINE · UK EDITION
EM Evidence Rundown
Week of 2 April 2026 | Issue #4
Jake Turner
Curated with the assistance of AI (Perplexity). All content editorially reviewed.
A UK-wide meningococcal B outbreak has claimed two lives and is now declared a standard incident — but the window for sporadic ED presentations isn't closed yet. Resident doctors strike from 7 April, a landmark UK-led bronchiolitis RCT definitively ends off-label surfactant, and HI-PEITHO reshapes how we think about catheter-directed therapy for PE. Four paediatric items this week, including DKA fluid choice and a data-driven answer to the hardest resuscitation decision in paediatrics.
EVIDENCE TAG LEGEND
THIS WEEK'S CONTENTS
Guidelines & UK Updates
1. UKHSA MenB Canterbury — 21 cases, 2 deaths (UPDATE) 2. UKHSA Legionnaires' Disease — NW/SW London Outbreak 3. Resident Doctors' Strike 7–13 April 2026 4. MHRA Safety Roundup: Ramipril/Amlodipine Mix-Up + Rabies IG Recall 5. FICM/ICS GPICS V3 — Now in Active Implementation
Key Journal Articles & Trials
6. HI-PEITHO Trial — Catheter-Directed Fibrinolysis in Intermediate-Risk PE (NEJM/ACC.26) 7. Rib Fracture Regional Anaesthesia — SR & Network Meta-Analysis 8. PROMINE Trial — Propofol vs Ketamine for ICU RSI
Paediatric EM (Dedicated Section)
9. BESS Trial — Surfactant Does NOT Reduce Ventilation Duration in Bronchiolitis (UK RCT) 10. Phoenix Sepsis Score — External Validation in 25,000+ Children (ADC) 11. Succinylcholine vs Rocuronium in Paediatric RSI — Mortality Signal 12. DFTB 100th Bubble Wrap — DKA Fluids RCT + Croup MDI
FOAMed & Critical Appraisal
13. PulmCrit — HI-PEITHO and the Case for Peripheral Low-Dose tPA 14. St Emlyn's TTL Tips 8 — External Haemorrhage Control 15. SGEM Xtra — ATLS 11th Edition: Five Key Changes
Quick Hits & Action Points
GUIDELINES & UK OFFICIAL UPDATES
UKHSA · 1–2 APRIL 2026
MenB Canterbury Outbreak: 21 Confirmed Cases, 2 Deaths — Downgraded to Standard Incident
As of 1 April 2026, UKHSA has confirmed 21 cases of invasive meningococcal B disease linked to Canterbury/Kent, with 2 deaths. The outbreak strain is P1.12-1,16-183 — all 21 cases were hospitalised. Epidemiological link: attendance at Club Chemistry nightclub or residence at the University of Kent Canterbury campus between 1–26 March, or close contact with a confirmed case. UKHSA has downgraded from enhanced to standard incident management, with no further scheduled updates unless new developments emerge. Genomic sequencing confirms close relatedness of all sequenced strains. A vaccination and prophylaxis programme is underway for close contacts.
Why it matters: Downgraded does not mean risk has resolved — the 7-day window for secondary transmission in close contacts persists. Any patient with meningism, non-blanching rash, fever, or sepsis with a Kent/Canterbury link (or recent nightclub attendance) warrants immediate IV/IM benzylpenicillin or ceftriaxone, blood cultures before antibiotics if this does not delay treatment, and urgent public health notification. Do not wait for results.
Tell your department: "Check all septic/meningitic presentations for Canterbury/Kent epidemiological link — treat first, ask questions second."
UKHSA · ONGOING (HPR VOL 20, ISSUE 3, 24 MARCH 2026)
Legionnaires' Disease Outbreak — NW and SW London: Active Investigation
UKHSA is investigating a cluster of Legionnaires' disease in NW and SW London: 8 confirmed cases sharing the same sequence type, with 13 further under investigation as of 23 March 2026. No common exposure source has been confirmed. Hospital clinicians and GPs have been briefed by the ICB to actively case-find. Case definition: NW/SW London resident, worker, or visitor with severe community-acquired pneumonia.
Why it matters: Any patient in NW/SW London with severe CAP — especially male, >50 years, immunosuppressed, smoker, or with recent hotel/spa/water tower exposure — should have a urinary Legionella antigen sent immediately. Treatment: levofloxacin or azithromycin. No person-to-person transmission; no isolation required, but notify public health on diagnosis. Legionella is not covered by standard beta-lactam empirical CAP regimens.
RCEM + NHS ENGLAND · 25–30 MARCH 2026
Resident Doctors' Strike 7–13 April 2026: Operational Guidance for EM
BMA resident doctors have announced strike action from 7am 7 April to 6:59am 13 April 2026, coinciding with Easter — a high-demand period. NHS England guidance requires trusts to maintain emergency care, maternity, critical care, and neonatal services, targeting 95% of normal activity. Striking resident doctors cannot undertake bank or locum shifts at other trusts during the action. RCEM has called for urgent resolution and advised all staff to escalate safety concerns through local processes. Patients should continue to attend for emergency care as normal.
Caution: ST6 registrars and consultants should expect significantly reduced junior cover across the strike period. Know your trust's escalation pathway, safety derogation process, and the NHS England SITREP reporting requirements. Consider early SDEC/ambulatory care expansion to decompress majors. Paediatric emergency and neonatal care are explicitly protected services.
RCEM Statement → NHS England Guidance →
MHRA · SAFETY ROUNDUP MARCH 2026 (31 MARCH 2026)
MHRA Recall: Ramipril Pack Found Containing Amlodipine + Rabies Immunoglobulin Potency Failure
EL(26)A/11 — Crescent Pharma Ramipril 5mg (Class 2 Recall): A sealed Ramipril 5mg capsule carton has been found containing a blister strip of Amlodipine 5mg tablets inside. Patients may unknowingly take amlodipine, causing unexpected peripheral vasodilation, hypotension, peripheral oedema, or reflex tachycardia. ED clinicians should consider this in any cardiac patient presenting with unexplained hypotension or new oedema on recent or newly dispensed antihypertensive treatment.
EL(26)A/18 — Bio Products Laboratory Rabies Human Immunoglobulin 500IU (Class 2 Recall): One batch has failed stability testing with reduced potency. EDs providing post-exposure rabies prophylaxis should verify batch numbers against the recall notice immediately.
Action required: Alert your pharmacy team to both recalls. For cardiac patients presenting with unexplained new hypotension or oedema — ask specifically about recent dispensing of antihypertensives and request they check the pack at home if possible.
MHRA Safety Roundup March 2026 →
FICM / ICS · PUBLISHED 28 JANUARY 2026 — NOW IN ACTIVE IMPLEMENTATION
GPICS Version 3 — New UK ICU Provision Standards with Explicit CQC-Aligned Language
The third edition of GPICS (first update since 2019) is now in active implementation across UK ICUs. Key changes: (1) Standards reworded to explicit 'must-do' language aligned to CQC regulatory framework; (2) new Enhanced Care chapter — a distinct tier between ward and HDU relevant to ED step-up admissions; (3) 24/7 Level 3 outreach requirement now explicit; (4) expanded EDI and sustainability sections; (5) consultant staffing ratios updated with stronger language. For EM: the enhanced care tier may affect how unstable ED patients are escalated and what the ICU will accept.
Why it matters: ICU referrals for borderline patients should now be benchmarked against GPICS V3 enhanced care definitions. Understand the enhanced care tier — it could facilitate earlier ICU outreach review for ED patients who previously weren't quite sick enough for HDU. CQC inspectors will use this document.
KEY JOURNAL ARTICLES & TRIALS
NEJM / ACC.26 · PRESENTED 28–30 MARCH 2026
HI-PEITHO Trial: Catheter-Directed Fibrinolysis Reduces Decompensation in High-Intermediate Risk PE
Rosenfield et al. (544 patients, 59 sites, US + Europe) randomised enriched intermediate-risk PE patients (RV/LV ≥1.0, elevated troponin, ≥2 cardiorespiratory distress criteria — think sick-but-not-crashing, AHA/ACC Category D1–D2) to ultrasound-facilitated catheter-directed thrombolysis (EKOS) + anticoagulation versus anticoagulation alone. Primary composite endpoint (PE-related death, decompensation, or recurrence at 7 days): 4.0% vs 10.3% (RR 0.39, NNT=16, p=0.005), driven by decompensation prevention. No intracranial haemorrhages; major bleeding 4.1% vs 2.2% (NS). 30-day mortality was not significantly different. Critically, 87% of screened patients were excluded — this is a highly selected, enriched population.
Why it matters: This is the first RCT to show benefit from CDT in intermediate-risk PE, at 87% selected out. UK PERT services are developing rapidly — this trial will directly influence their protocols. The benefit cannot be extrapolated to lower-acuity PE. Identify the Category D1/D2 patient: normotensive but deteriorating (rising NEWS, worsening hypoxia, clinical distress) with RV strain. Note: for patients outside the trial criteria, anticoagulation-first remains correct.
PAIRED CONTROVERSY: PULMCRIT VS HI-PEITHO
Josh Farkas (PulmCrit) argues: following STRATIFY, catheter-delivered alteplase = peripheral alteplase dose-for-dose — so HI-PEITHO's benefit may be achievable with simpler peripheral administration. If correct, the procedural complexity and access requirements of CDT become unnecessary. This argument is contested but potentially transformative — see FOAMed section below.
PulmCrit (HI-PEITHO Analysis) →
ACADEMIC EMERGENCY MEDICINE · APRIL 2026 · DOI: 10.1111/ACEM.70277
Single-Shot Regional Anaesthesia for Rib Fractures: SR and Network Meta-Analysis (9 RCTs, n=738)
Partyka et al. synthesised 9 RCTs comparing SSRA (ESP block, SAP block, intercostal nerve block) vs standard care for traumatic rib fractures. SSRA significantly reduced pain scores at 4–8 hours (NRS −1.81, moderate certainty) and 24-hour opioid requirements (−9.35 mg morphine equivalents). No single technique was superior to another — ESP and SAP performed similarly. This Bayesian NMA provides the strongest evidence yet for integrating regional anaesthesia into the ED rib fracture pathway, reducing opioid exposure, improving respiratory function and potentially reducing pneumonia rates.
Why it matters: Rib fracture management is a key RCEM quality metric and a common ED presentation. This NMA shifts the needle from "should we consider regional?" to "can we justify not using it?" — where POCUS-trained EM clinicians are available. Consider developing an ESP/SAP block pathway for ≥2 rib fractures presenting to your department.
Tell your department: "Get trained in ESP or SAP blocks — if you have ≥2 rib fractures and POCUS, regional anaesthesia should be your first analgesia escalation step."
INTENSIVE CARE MEDICINE · 23 MARCH 2026 · DOI: 10.1007/S00134-026-08351-3
PROMINE Trial: Propofol vs Ketamine for RSI in Critically Ill Patients
Schmidt et al. (207 critically ill ICU patients, 2 centres, Brazil) compared propofol vs ketamine for RSI. Primary outcome — lowest MAP within 10 minutes post-induction — favoured ketamine by 6 mmHg (borderline non-significant, p=0.050). Cardiovascular collapse occurred in 22% (ketamine) vs 33% (propofol). However, day-7 mortality trended higher with ketamine (33% vs 23.8%) — not statistically significant but a notable signal. Adds to the NEJM RSI trial (ketamine vs etomidate, covered March 12): together, the evidence supports propofol as a reasonable RSI agent in ICU/ED, not inferior to ketamine, particularly relevant in the UK where etomidate is unavailable.
Caution: The mortality signal for ketamine is hypothesis-generating only in this underpowered trial. Do not change practice based on this alone — but it does reinforce that propofol is a valid RSI agent in the UK ED/ICU context and should not be reflexively avoided. Pre-treatment vasopressors remain key for haemodynamically unstable patients regardless of agent.
PAEDIATRIC EM
Dedicated paediatric emergency medicine section — 4 items this week
LANCET RESPIRATORY MEDICINE · 21 MARCH 2026 · DOI: 10.1016/S2213-2600(26)00008-1
BESS Trial: Surfactant Does NOT Reduce Ventilation Duration in Severe Bronchiolitis
Semple et al. (BESS Investigators) randomised 232 mechanically ventilated infants across 15 NHS PICUs in England, Scotland, and Northern Ireland (NIHR/MRC funded, 6 winter recruitment seasons) to endotracheal poractant alfa vs sham procedure. Primary outcome — duration of invasive mechanical ventilation — was identical: median 64.9h surfactant vs 62.0h sham (geometric mean ratio 1.02, 95% CI 0.84–1.24; p=0.86). No safety signals. No deaths. This landmark UK RCT definitively ends the off-label use of surfactant for severe bronchiolitis in UK PICUs.
Paediatric context: Bronchiolitis is the leading cause of paediatric hospital admission in UK winters. Off-label surfactant has been used by some PICUs in desperate cases — this RCT, the largest ever of its kind, shows no benefit at this dose and route. Surfactant should not be used for bronchiolitis in the ED or PICU. The focus returns to supportive care optimisation: gentle MV, avoid intubation where possible with HFNC/CPAP, early PICU review.
Tell your department: "The BESS trial closes the door on surfactant for bronchiolitis — UK RCT, 15 NHS PICUs, no benefit. Update your bronchiolitis protocols if surfactant is mentioned."
Lancet Respir Med: BESS Trial →
ARCHIVES OF DISEASE IN CHILDHOOD · FEBRUARY 2026 · PMID: 41760137
Phoenix Sepsis Score: External Validation in Over 25,000 Children with Suspected Infection
Chong et al. externally validated the Phoenix Sepsis Score in a retrospective cohort of over 25,000 children with suspected infection (published in ADC — the primary UK paediatric clinical journal). The Phoenix criteria replaced SIRS-based paediatric sepsis definitions in 2024 and incorporate four domains: respiratory, cardiovascular, coagulation, and neurological. This large external validation confirms the score as a highly specific predictor of in-hospital mortality in children with infection. ADC publication signals direct relevance to UK paediatric clinical practice.
Paediatric context: Many UK hospitals are still using SIRS-based paediatric sepsis screening. The Phoenix Score's validation in this large cohort supports the clinical transition. Check whether your hospital's paediatric sepsis pathway has been updated — if it still uses SIRS criteria for organ dysfunction classification, it is out of date. ADC is the journal your paediatric team reads.
Tell your department: "Has your paediatric sepsis pathway been updated to Phoenix criteria? This ADC validation confirms it's time."
JOURNALFEED SPEEDREAD · 2 APRIL 2026 (RETROSPECTIVE PROPENSITY-MATCHED COHORT)
Succinylcholine vs Rocuronium for Paediatric RSI: Mortality Signal Favours Succinylcholine
This retrospective propensity-matched database study of paediatric ED RSI found that succinylcholine was associated with a lower rate of in-hospital death compared to rocuronium. The finding is clinically striking given ongoing adult data driving rocuronium/sugammadex adoption, but design limitations (retrospective, potential confounding by indication, sugammadex access not captured) preclude definitive conclusions. The JournalFeed editorial appropriately cautions against over-interpretation but notes the mortality signal is significant enough to warrant prospective evaluation.
Paediatric context: The sux vs roc debate in paediatric RSI is live. Succinylcholine's rapid offset remains its key theoretical advantage — the "cannot intubate, cannot oxygenate" scenario. Rocuronium's reversibility with sugammadex is compelling in adults, but sugammadex availability and dosing familiarity in paeds varies across UK EDs. This study supports continued succinylcholine availability and should not accelerate a move away from sux in paediatric RSI based on adult trial extrapolation alone.
DON'T FORGET THE BUBBLES · 30 MARCH 2026 · 100TH EDITION
DFTB 100th Bubble Wrap: DKA Fluids RCT (RL Faster Than Saline) + Croup MDI Adrenaline
The landmark 100th edition covers two directly practice-relevant items:
DKA Fluids (RCT, n=67): Agarwal et al. (BMJ Open Diabetes Res Care, 2025) — double-blind RCT in 67 children with DKA. Ringer's Lactate resulted in significantly faster DKA resolution (12.9 ± 7.9h vs 16.8 ± 9.0h with 0.9% saline) and better initial bicarbonate recovery. Limitations: small, single centre (India). But this adds to growing evidence against the hyperchloraemic acidosis burden of normal saline, reinforcing the BSPED guideline evolution toward balanced crystalloids. Croup — MDI Adrenaline (retrospective, n=325): Novi et al. (J Emerg Med, 2025) — MDI-delivered L-epinephrine produced equivalent Westley Croup Score improvement at 30 minutes to nebulised racemic epinephrine, with similar admission and re-attendance rates and no adverse events. MDI delivery may be viable in low-resource or pre-hospital settings where nebulisers are unavailable.
Paediatric context: DKA and croup are among the most common serious paediatric presentations to UK EDs. For DKA: check your local protocol — does it specify fluid type? This RCT supports balanced crystalloids. For croup: the MDI data is relevant to pre-hospital responders and resource-limited settings. Also in this edition: academic pressure data (ALSPAC) showing each additional pressure point at age 15 associates with persistent depressive symptoms to age 22 — relevant to adolescent mental health presentations in your ED.
FOAMED & CRITICAL APPRAISAL HIGHLIGHTS
PULMCRIT / EMCRIT · JOSH FARKAS · 30 MARCH 2026
PulmCrit: HI-PEITHO and the Case That Peripheral Low-Dose tPA May Do the Job
Farkas's analysis of HI-PEITHO leads with a central argument: CDT delivers alteplase at the same dose as a peripheral low-dose tPA infusion (established in the STRATIFY trial, covered March 12). If the pharmacological effect is equivalent and the EKOS catheter adds no incremental benefit beyond drug delivery, then the decompensation reduction seen in HI-PEITHO could theoretically be achieved with peripheral low-dose tPA — a far simpler intervention available in every ED and hospital, without interventional radiology access. This remains hypothesis-generating but directly challenges the infrastructure requirement of PERT services.
Counterpoint: The EKOS ultrasound-facilitated system may enhance fibrinolysis locally beyond simple drug delivery. HI-PEITHO was not designed to test this comparison. Until a trial directly comparing peripheral vs catheter-delivered low-dose tPA is conducted, this remains an interesting hypothesis. Current UK practice: anticoagulation-first for intermediate-risk PE; discuss PERT for deteriorating cases.
PulmCrit: HI-PEITHO Analysis →
ST EMLYN'S BLOG · SIMON CARLEY · 2 APRIL 2026
TTL Tips 8: External Haemorrhage Control — Direct Pressure, Tourniquets, Haemostatics
Published today — directly on the TTL (Trauma Team Leadership) curriculum used in UK training. Key messages: direct pressure remains first-line and failure is almost always technique, not indication. Reassess all prehospital haemorrhage control devices on ED arrival — tourniquets should be noted for time of application, checked for haemostasis adequacy, and not removed without senior review. Data from the Russo-Ukrainian war reinforces the harm of prolonged tourniquet ischaemia. Topical haemostatics (Celox, QuikClot) for junctional/deep wounds — packed firmly, not applied superficially. "Blood on the floor is no more — all bleeding matters."
Why it matters: External haemorrhage control is a core FRCEM and TTL competency and an area where technique matters more than equipment. The dynamic reassessment message — checking prehospital devices on arrival — is a practical habit that saves lives. UK trainees preparing for TTL examinations should read this series.
SGEM XTRA · 28 MARCH 2026
ATLS 11th Edition — Five Changes Every EM Clinician Should Know
The 11th Edition of ATLS formalises five key changes: (1) xABCDE — exsanguinating haemorrhage now formally precedes Airway, codifying practice most UK trauma teams already follow; (2) haemodynamic optimisation before RSI — resuscitate before intubation to avoid peri-induction arrest; (3) new penetrating trauma chapter — mechanism-specific evaluation; (4) systems expansion — new chapters on trauma systems, injury prevention, trauma-informed care; (5) S-xABCDE-BAR — updated transfer communication mnemonic (Situation, xABCDE primary survey findings, Background, Assessment, Recommendation). SGEM guest Dr Leeper notes that "standardised flexibility" is now explicit — adapt ATLS principles to resource context.
Why it matters: ATLS underpins UK TARN data coding, trauma team communication, and inter-hospital transfer protocols. The xABCDE resequencing is confirmatory rather than revolutionary for most UK trauma teams, but the new transfer mnemonic S-xABCDE-BAR is worth adopting. If you are an ATLS instructor, update your course materials.
SGEM Xtra: ATLS 11th Edition →
QUICK HITS / ALSO NOTABLE
- SAFETY ALERT PAEDS UKHSA Measles Resurgence: MMR uptake is at a 10-year low in England (2,911 confirmed cases in 2024 — highest in decades). An Enfield cluster is ongoing. From January 2026 MMRV replaces MMR in the childhood schedule. Clinical recognition: prodromal 3Cs (cough, coryza, conjunctivitis) + Koplik spots → morbilliform rash. Airborne precautions; notify public health. Check vaccination status and update opportunistically. UKHSA Measles Guidance →
- GUIDELINE MHRA-NICE Aligned Approval Pathway (1 April 2026): New simultaneous MHRA/NICE assessment pathway launches today — new medicines available up to 6 months sooner in England. Clinicians may encounter patients on newly approved therapies with limited real-world data. MHRA Roundup →
- EXPERT OPINION NHS England 2026/27 GP Contract (1 April 2026): Mandatory same-day urgent access for all GP practices + mandatory A&G before 10 planned care specialties. If implemented effectively, this may reduce ED avoidable attendances — if not, expect increased walk-in demand as patients default to ED when GP access fails. Watch your referral pattern data over the next quarter.
- EXPERT OPINION St Emlyn's Ep 289 + EM Cases Ep 215 — DSED/Refractory VF Double Feature: Sheldon Cheskes (DOSE VF PI) appears on both shows this week. Key messages: DSED (not vector-change) is the preferred intervention for refractory VF when two defibrillators are available. DOSE VF NNT=6 for neurologically intact survival (27% vs 11%). ETCO₂ nuance: do not chase a number, watch the trend. St Emlyn's Ep 289 → | EM Cases Ep 215 →
- EXPERT OPINION EMCrit — ECGs in Acute PE: Comprehensive review of S1Q3T3, T-wave inversions, RBBB, and sinus tachycardia in PE — what each finding means mechanistically and prognostically. Useful pre-reading alongside the HI-PEITHO discussion. EMCrit ECG in PE →
- SR/MA Gabapentinoids for Pain (JournalFeed, 31 March): Narrative review confirms that gabapentinoids seldom help and often harm in off-label pain indications. Small pain reductions, increased sedation/falls/respiratory depression risk, especially in the elderly. UK-relevant given Schedule 3 controlled drug status since 2019 — re-examine discharge prescribing for MSK/back pain presentations.
- SR/MA US-Guided Peripheral IV Access (JournalFeed POCUS, 2 April): SR/MA (n=1,477) — 80% increased first-attempt success rate with ultrasound guidance for difficult IV access in the ED. Consider this your evidence base for training and equipment investment in your department. JournalFeed →
ACTION POINTS THIS WEEK
| 1. | Brief your team NOW on the Resident Doctors' strike (7–13 April) — ensure safety escalation pathways are clear, and senior cover plans are in place for your ED over Easter weekend. |
| 2. | MenB Canterbury: Ensure all ED staff know the epidemiological link (Club Chemistry/University of Kent) and the clinical recognition criteria. Display the UKHSA case definition at the nurses' station for the next two weeks. |
| 3. | Alert pharmacy to the Ramipril/Amlodipine packaging recall (EL(26)A/11) and the Rabies IG batch recall (EL(26)A/18). Flag for any cardiac patients presenting with unexplained new hypotension. |
| 4. | PAEDS — Update bronchiolitis protocol: Surfactant should no longer appear as a management option. Share the BESS trial with your paediatric colleagues. If your PICU protocol still includes it, escalate for removal. |
| 5. | PAEDS — Check your paediatric sepsis pathway: Confirm whether your hospital has transitioned from SIRS-based to Phoenix Sepsis Score criteria. If not, raise at the next governance meeting. |
| 6. | Start a conversation about SSRA for rib fractures: Review who in your department can perform ESP or SAP blocks. If no one, identify training opportunities. This NMA provides the evidence base to build a pathway. |
| 7. | For the next intermediate-risk PE that deteriorates: Know the HI-PEITHO inclusion criteria (RV/LV ≥1.0, elevated troponin, ≥2 distress criteria) and have a clear escalation path to your PERT service or on-call haematologist/cardiology for discussion of CDT or low-dose peripheral tPA. |
SOURCES CHECKED THIS WEEK
RCEM · RCUK · RCOG · RCPCH · NICE · MHRA · NHS England · UKHSA · FICM/ICS · AHA/ACC · ACEP · ESC · SSC/SCCM
- ILCOR · NEJM · Lancet (+ Lancet Respir Med) · JAMA · Annals of EM · EMJ · Resuscitation · Crit Care Med · Acad EM · Intensive Care Med · SJTREM · Arch Dis Child · Pediatric Emergency Care · European J Pediatrics · REBEL EM · St Emlyn's · SGEM · EMCrit/PulmCrit · DFTB · LITFL · EM Cases · JournalFeed (including paediatrics category + Gmail SpeedRead emails) · PEM Playbook · ALiEM PEM · The Bottom Line
Next briefing: Thursday 9 April 2026 at 18:00 BST
This newsletter is a curated educational summary for qualified healthcare professionals. It is not clinical guidance and does not replace individual clinical judgement, local protocols, or national guidelines. Always verify information against primary sources before applying to patient care. Links were verified at time of publication. DOIs and PMIDs are provided where available — some publisher links may require institutional access.
Jake Turner
Curated with the assistance of AI (Perplexity). All content editorially reviewed.