The hazards of rapid sodium correction in hyponatraemia are well known, and current guidelines recommend a "slow and steady" approach. But a new systematic review suggests that faster rather than slower may be in truth be safer.

The second paper of this episode returns to the topic of emergency care inequalities. A study from Scotland finds that the level of socio-economic deprivation in the catchment area of an emergency department not only affects presentation rates but also the length of stay of patients, which calls into question the wider strategy of demand management and diversion.

Third, an expert practice review on endovascular resuscitation looks closely at this exciting and potentially revolutionary practice. Three percutaneous interventions are compared: Resuscitative endovascular balloon occlusion of the aorta (REBOA), Selective aortic arch perfusion (SAAP) and Extracorporeal cardiopulmonary resuscitation (ECPR).

The final paper this time is on patient centred care - how well does it translate? A Dutch study takes an Australian system for patient experience reporting and attempts to validate it in their own healthcare system. The study is an excellent example of how to do that.

Read the highlights: Primary survey

• On the optimal sodium correction rate in hyponatraemia and clinical outcome: a meta-analysis
• Association between catchment-area demographics and emergency department presentation rates and delays: a national cross-sectional study
• Endovascular resuscitation: an expert practice review
• Person-centred emergency care: translation and cross-cultural validation of the Australian Emergency Department Patient-Reported Experience Measure (ED PREM) in the Netherlands

The EMJ podcast is hosted by:

Prof. Richard Body, EMJ Editor-in-Chief, 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.

Hip fractures for older people are often severely painful. But, the common treatments like intravenous opioids can cause adverse effects like nausea and delirium. We discuss a new RCT that tests intravenous morphine vs. an ultrasound-guided block of the pericapsular nerve group (PENG), finding the PENG block to be a highly effective and safe alternative. We talk about the ten research priorities for paediatric emergency medicine distilled down by a mixed group of patients, carers, and healthcare professionals.

Paediatrics sticks around with a Delphi approach study that delivers another ten pressing research questions for better ways to procedurally sedate kids. And, from the North West of England, we hear about a trial of reflective practice (Balint) groups with protected clinical time for resident doctors in emergency medicine training.

• Refreshing the paediatric emergency medicine research priorities across the UK and Ireland
• Ultrasound-guided pericapsular nerve group block versus intravenous morphine for pain management in older adults with hip fractures: a randomised controlled trial in the emergency department
• Research priorities for paediatric procedural sedation in emergency medicine
• Qualitative study of reflective practice groups for emergency medicine resident doctors

The EMJ podcast is hosted by:

Prof. Richard Body, EMJ Editor-in-Chief, 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.

What social dynamics can be observed in the administration of bystander CPR? New research from Korea shows a reluctance to assist when the patient and bystander were of different sex. In the UK, a five year review of knife crime involving children and young people looks for trends in the background of the 145 victims who passed away in that period. From France, we have a study looking at the geographic distribution of cardiac arrest events, and to finish there is a scoping review highlighting the value of access to good translation.

• We have recognised inequalities: now we must act
• Focusing on health inequalities in emergency care
• Impact of bystander and patient sex on cardiopulmonary resuscitation provision in out-of-hospital cardiac arrest
• Preinjury, injury and post-injury factors leading to death in children and young people who were victims of knife crime in England between 2019 and 2024: a review of the National Child Mortality Database
• Spatial clustering of out-of-hospital cardiac arrest in northern France and its association with social deprivation: a population-based registry study
• Understanding how language barriers in the paediatric emergency care setting influences safety of care delivery: a scoping review

The EMJ podcast is hosted by:

Prof. Richard Body, EMJ Editor-in-Chief, 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.