This month, we start with a systematic review on smart ways to cut down unnecessary X-rays in kids with limb injuries. We also look at why subarachnoid haemorrhages get missed or diagnosed late, from both patient and doctor perspectives. A Best Evidence Topic (BET) review asks if simple haematoma blocks are as good as procedural sedation for resetting broken wrists. And finally, we dive into a UK study exploring what life is really like for early-career academic doctors in emergency care.

Read the highlights: Primary survey (https://emj.bmj.com/content/43/7)

• Interventions to reduce imaging in children with upper or lower extremity injuries: a systematic review and meta-analysis 
  (https://emj.bmj.com/content/43/7/435)
• Prospective patient-reported reasons for delayed diagnosis of spontaneous subarachnoid haemorrhage
  (https://emj.bmj.com/content/43/7/390)
• Haematoma block versus sedation for manipulating distal radius fractures in the emergency department
  (https://emj.bmj.com/content/43/7/448)
• Balancing act of academic clinical fellows in UK emergency medicine: a qualitative study 
  (https://emj.bmj.com/content/43/7/419)

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)

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