"What is your understanding of your father's illness?" This is the kind of question that may be posed by emergency clinicians in the context of end-of-life care. But as a survey of Thai and American emergency departments finds, approaches to these conversations can be quite different globally. This episode also features another angle on end-of-life care, highlighting the persistent impact that deprivation has when it comes to likelihood of hospital conveyance. On a different subject, there is a qualitative study of the management of acute asthma presentations, seeking to find any marginal gains that may present a chance for optimisation. The fourth and final paper is about acute coronary syndromes in the emergency department, presenting some surprising statistics on length of stay.

Read the highlights: September 2025 primary survey

• Deprivation is associated with hospital conveyance among patients who are terminally ill
• Are acute asthma presentations to the emergency department an opportunity for optimising long-term management? A qualitative study on beliefs and behaviours of healthcare professionals
• Comparing approaches to code status conversations between Thai and American emergency clinicians: a survey study
• Acute coronary syndrome rule-out strategies in the emergency department: an observational evaluation of clinical effectiveness and current UK practice

The EMJ podcast is hosted by:

Prof. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Senior 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 paper on the challenging diagnosis of acute appendicitis has us wondering, can it be spotted with just a glance? The reality is never so simple. This episode we also discuss low-value overtesting, cardiac arrest trial consent, and patient discharge into police custody. As with many aspects of the ED, they each have a layer of legal pressure to consider.

Read the highlights: August 2025 primary survey

The EMJ podcast is hosted by:

Prof. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Senior 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.

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 Senior 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.