The NHS plans to set up mental health emergency departments throughout England. A survey discussed this episode highlights the importance of mental health assessments, finding that nearly a quarter of suicide deaths in a one year period had come after hospital or emergency department contact. Another survey raises the question, "How well is your ED prepared for a major incident?" and the statistics do not inspire confidence. Two more papers in this episode offer potential bulwarks against burnout of ED staff: global health outreach work, and self-rostered rotas. But there may be some downsides to watch out for too. Finally, a look at pulse oximetry for testicular torsion diagnosis.

Read the highlights: July 2025 Primary Survey

• Contact with emergency departments and hospitals in England before suicide death: a retrospective cohort study
• Global health experience of staff working in UK emergency care: a reflexive thematic analysis
• A survey of major incident preparedness in English type 1 emergency departments
• In emergency settings, does the use of testicular pulse oximetry aid diagnosis of testicular torsions?
• Investigating the impact of self-rostering on EM trainee wellbeing and recovery: a national survey

The EMJ podcast is hosted by:

Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards)

You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Can salbutamol be used be used to relieve pain in renal colic patients? Starting off this month's episode, a randomised trial seeks to find the answer. Then a topic of interest for anyone seeing patients with a phobia of needles, namely a study comparing coolant spray with topical anaesthetic cream for reducing pain from intravenous cannulation. Next, randomisation is a necessary tool for many trials, but what if you want something that's less high-tech, and more high-street? That's right, scratch cards! And finally, fear of not making the right decision dominates when it comes to  paramedic conveyance to the paediatric emergency department. "We just take them in," "parents know best," and "if only they could talk" are some of the revealing quotes found in the study wrapping up this month.

Read the highlights: June 2025 Primary Survey

• Salbutamol for analgesia in renal colic: a prospective, randomised, placebo-controlled phase II trial
• Comparison of the effects of vapocoolant spray and topical anaesthetic cream (lidocaine–prilocaine) on pain of intravenous cannulation: a randomised controlled trial
• Letter: Allocation concealment using scratchcards in an emergency department drug trial
• Factors influencing paramedic conveyance decisions when attending children with minor head injury: a qualitative study

The EMJ podcast is hosted by:

Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards)

You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

A new survey has found that less than one third of end-of-life patients in Irish emergency departments have their own room. This is only one of the shortcomings found in end-of-life care, explored in two papers to start this episode. Following on from that is a comparison of video and direct laryngosocopy for intubation outcomes. There's also a "Best Evidence" review of the use of nasal clips for stopping nosebleeds, an approach which appears likely to offer advantages over the hands or inventive tongue-depressor contraptions. The finish up this month's episode, there's a return to a topic previously visited one year ago - the RCEM guidelines on cannabinoid hyperemesis syndrome. A study from Wales follows up on the adherence to this guidance.

Read the highlights: May 2025 Primary Survey

• Dying matters in the emergency department
• Emergency clinician perceptions of end-of-life care in Irish emergency departments: a cross-sectional survey
• Video laryngoscopy may improve the intubation outcomes in critically ill patients: a systematic review and meta-analysis of randomised controlled trials
• Use of nasal clips as first aid for anterior epistaxis
• Awareness and management of cannabinoid hyperemesis syndrome among staff in emergency departments in Wales

The EMJ podcast is hosted by:

Dr. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Semior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards)

You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.