EM Skills Academy

11/08/2025

🚨 **FULLY BOOKED!** 🚨

Our **MRCEM OSCE Online Course** is now completely sold out – the last spot went today! 🎉

📢 Don’t miss the next one – follow us:
🌐 **Website:** (http://www.emskillsacademy.com)
💬 **WhatsApp:** +44 7385 107551
📲 **Telegram:** (https://t.me/+SeUUrkS-KlI0NDU0)
📘 **Facebook:** (https://www.facebook.com/EMSkillsAcademy)

02/08/2025

Last few spaces avaliable...Discount code available if you struggling with payment .. contact us for further information

www.emskillsacademy.com

WhatsApp: +44 7385 107551

Telegram:
https://t.me/+SeUUrkS-KlI0NDU0

Facebook:
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01/08/2025

06/07/2025

# # # 🚨 Subarachnoid Haemorrhage (SAH) in the ED: Know What You're Handling 🚨

We often come across patients with **suspected SAH**, but how much do we *actually* know about the condition? Understanding the pathophysiology, diagnostic timelines, and early interventions makes a significant difference—not just for the referral process, but for the patient’s outcome.

Let’s unpack this.

---

# # # 📊 **Epidemiology & The Big Picture**

* **SAH** accounts for \~5% of all strokes, yet it carries **high morbidity and mortality**.
* Majority (\~85%) are due to **ruptured intracranial aneurysms**.
* Peak incidence: **40–60 years**, slightly more common in females.
* Mortality remains high (35–50%), and nearly half of patients die before reaching hospital.

---

# # # 💥 **Ruptured vs Unruptured Aneurysms**

* **Ruptured Aneurysms:**

* Present with a **sudden, severe headache**—described as a "thunderclap" (reaches maximal intensity in 7 mm, posterior circulation location, and family history increase rupture risk.

---

# # # 🧠 **Diagnosis Pathway**

1. **CT Head – Non-contrast**

* Sensitivity highest if done within **6 hours** of headache onset (\~98–100%).
* Sensitivity falls significantly after that—down to \~85% at 12 hours.

2. **Lumbar Puncture**

* If CT is negative but clinical suspicion remains, **LP is warranted**.
* Best performed **≥12 hours after symptom onset** to detect **xanthochromia** (bilirubin breakdown from haemoglobin).
* Remains valid and can detect xanthochromia for up to **2 weeks post-onset**.
* Spectrophotometry is the gold standard; avoid relying on visual inspection alone.

---

# # # 🛏️ **Initial ED Management – Suspected or Confirmed SAH**

While waiting for neurosurgical advice, early interventions matter.

# # # # ✅ **If Suspected SAH (prior to CT or LP):**

* Document the working diagnosis and differential clearly.

* Prescribe **laxatives** to prevent straining.
Encourage fluid po intake

* Analgesia

# # # # ✅ **If CT Confirms SAH:**

* **BP monitoring is critical** – both hypotension and surges are harmful.
* Target:

* **SBP 90 mmHg**
* Avoid dips in MAP to ensure adequate cerebral perfusion.
* If needed, use **metaraminol peripherally** to maintain MAP.

* **Maintain euvolaemia**:

* Aim for isotonic fluid at **125 ml/hour** (Plasmalyte or Hartmann’s – local protocol dependent).

* Start **Nimodipine 60 mg orally/NG every 4 hours** (or IV if NBM) to reduce delayed cerebral ischemia.

* Keep patient **strictly flat**, encourage **bed rest**.

* **CTA ** should be arranged urgently to identify the aneurysm.

---

# # # 🧬 **Grading Systems in NS Communication**

You’ll often see references to SAH grading in neurosurgical feedback—here’s what they mean:

1. **WFNS Grade** – Based on **GCS and motor deficits**, ranges from Grade I (mild) to Grade V (coma). Used for prognosis and triaging urgency.
2. **Fisher Grade** – CT-based grading reflecting the **volume and distribution of blood**. Higher grades indicate higher vasospasm risk.

18/06/2025

Very few slots available..

1st JULY 2025 - 10AM London time MRCEM OSCE Courses are meticulously designed to provide comprehensive preparation for the Membership of the Royal College of Emergency Medicine Objective Structured Clinical Examination (MRCEM OSCE). These courses are delivered by senior emergency medicine physicians...

13/06/2025

🎯 General Approach & Preparation Tips for MRCEM OSCE Exam
By EM Skills Academy

The MRCEM OSCE exam is a comprehensive assessment designed to evaluate a candidate's clinical competence, communication skills, and decision-making ability in a simulated environment. Preparing effectively requires a structured and strategic approach. Below are some key tips to guide your preparation journey:

✅ 1️⃣ Understand the Exam Structure

Familiarize yourself thoroughly with the exam format, number of stations, timing, and marking domains.

Each station typically assesses multiple competencies: history-taking, examination, clinical reasoning, communication, and professionalism.

✅ 2️⃣ Master Core Clinical Knowledge

Ensure a solid foundation in Emergency Medicine protocols and guidelines.

Focus on high-yield topics commonly tested in the OSCE:

Resuscitation scenarios

Trauma management

Paediatrics

ECG interpretation

X-ray and imaging interpretation

Procedures and practical skills

✅ 3️⃣ Develop Systematic Approaches

Train yourself to approach each station with a clear, structured framework.

Practice using mnemonics and checklists to ensure you cover all key components within the allocated time.

Prioritize safety, communication, and patient-centered care in every scenario.

✅ 4️⃣ Simulate the Exam Environment

Engage in frequent mock OSCE sessions under timed conditions.

Practice with peers or under supervision to receive constructive feedback.

Focus on time management and maintaining composure under exam pressure.

✅ 5️⃣ Strengthen Communication & Soft Skills

Pay attention to your non-verbal communication, empathy, and patient engagement.

Practice breaking bad news, difficult conversations, and explaining procedures in simple, understandable language.

✅ 6️⃣ Review RCEM Curriculum and Feedback Domains

Align your preparation with the RCEM OSCE marking criteria.

Review common pitfalls and examiner expectations.

✅ 7️⃣ Join a Structured Revision Course

Enroll in a reputable preparation course to benefit from expert guidance, structured practice, and targeted feedback.

🎓 Final Tip:
Consistency and practice are the keys to success. The MRCEM OSCE exam not only tests knowledge but also your ability to demonstrate safe and effective clinical practice under pressure. Build confidence through repeated practice, stay calm, and approach each station as a real clinical encounter.

🩺 At EM Skills Academy, we are committed to supporting candidates at every step of their MRCEM OSCE preparation journey. Explore our upcoming courses for structured teaching, real-time feedback, and focused exam practice.

🌐 Visit:

EM Skills Academy - Your journey to MRCEM and FRCEM exams starts here

07/06/2025

🚨 Last Few Slots – MRCEM OSCE Polishing Course | 1st July 🚨

At EM Skills Academy, we understand that exam and course fees can be a real burden — especially in the final stretch before your big day.

If you’re preparing for the MRCEM OSCE in July and need a last-minute rescue and polishing course, don’t wait — limited spaces remain for our upcoming course on 1st July.

💬 Struggling with course fees? Don’t let that stop you — reach out to us directly. We’ll do our best to support you.

✅ We’re here to help. Always.
✅ Expert consultant-led teaching
✅ Exam mock stations & personalised feedback

Wishing you all the best in your exam preparation –
EM Skills Academy Team

www.emskillsacademy.com

WhatsApp: +44 7385 107551

Telegram:
https://t.me/+SeUUrkS-KlI0NDU0

Facebook:
https://www.facebook.com/EMSkillsAcademy

We provide valuable assistance to our Emergency Medicine colleagues as they prepare for MRCEM and FRCEM exams.

In addition,we are dedicated to facilitating a comprehensive understanding of emergency medicine practices in the UK.

EM Podcast (EM بالعربي)

04/06/2025

Very limited seats available…

https://www.emskillsacademy.com/book-our-courses/mrcem-osce-online-one-day-course-1st-july-2025

03/06/2025

Is Language a Challenge in the OSCE Exam?

When I did my OSCE exam 11 years ago, I was working in a non-English-speaking country. I was confident in my medical knowledge and clinical skills, but I was really worried about speaking to patients and actors in English. I could express everything easily in my own language, but using a second language—especially for medical conversations—wasn’t easy.

Here are some simple tips that helped me and can help you too:
1. Focus on communication skills – In stations like trauma and resus, language is more straightforward because we often use common, direct terms.
2. Prepare useful phrases – For common cases (like history taking or psychiatry), have clear and simple phrases ready. This helps you and the patient understand each other better.
3. Practice, practice, practice! – The more you speak and role-play, the more confident and fluent you’ll become.

At EM Skills Academy, our courses are designed to guide you through this. We’ll help you improve the way you ask questions, suggest useful phrases, and boost your confidence in communication.

🎥 Keep an eye on our YouTube channel – I’ll be joining Dr. Mo soon for a special episode in Arabic where we talk more about this challenge.

Wishing you all the best with your exam preparation!

www.emskillsacademy.com

WhatsApp: +44 7385 107551

Telegram:
https://t.me/+SeUUrkS-KlI0NDU0

Facebook:
https://www.facebook.com/EMSkillsAcademy

YouTube:
https://youtube.com/?si=InD8nseAE9l_iFv6

جهد قليل اتمني ان يتقبله الله مني وان ينفع كل الزملاء .. اعتذر عن اي تقصير I hope this will help all doctors attending the MRCEM/FRCEM OSCE

02/06/2025

🚨 In Response to High Demand
We’re pleased to announce:

🎯 MRCEM OSCE Online One-Day Preparation Course
📅 Date: 1st July 2025
🧪 For candidates sitting the July MRCEM OSCE Diet

🩺 EM Skills Academy brings you:

✅ Highly experienced consultant instructors
✅ Small group practice for maximum interaction
✅ 20 unique exam-style stations
✅ Proven success – very high pass rate among previous candidates

💡 Boost your confidence. Sharpen your skills. Succeed in your OSCE – from the comfort of your home!

📍 To register, visit:
🌐 www.emskillsacademy.com → Upcoming Courses section

26/05/2025

Highlights from our MRCEM OSCE Face-to-Face Course – Burnley Hospital!
Delivered by EM Skills Academy, this course helped polish skills and boost confidence ahead of exams.

Stay tuned for more exciting upcoming courses!
Visit www.emskillsacademy.com for details and registration.

25/05/2025

Wonderful MRCEM OSCE Face-to-Face Course!
Wishing all our candidates the very best in their exams!

EM SKILLS ACADEMY
Stay tuned for our upcoming courses.
www.emskillsacademy.com