"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)

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