Sicker and longer is the trend in ED stays, and vaping is not just "smoking lite" - EMJ Primary Survey April 2026

This month we've got a few papers on dealing with smoking - and not smoking - in the emergency department. The episode starts off with a discussion of a paper on automating high-flow nasal oxygen, and the importance of titration of oxygen levels - critical for patients with COPD. Then there's a paper questioning, can nicotine replacement therapy in the ED really work? This is followed by a research paper addressing the gaps in tracking of vaping and substance use - should doctors be asking more about use of vapes? To finish off the episode there's an analysis of the shifting trends in ED attendance, with case complexity seeing a dramatic increase.

Read the highlights: Primary survey

• Automated titration of nasal high flow oxygen in the emergency department: a randomised controlled trial
• Emergency department interventions for smoking cessation: a systematic review and meta-analysis
• Assessment of vaping and substance use documentation in the emergency department and acute medical unit
• Shifting patterns in emergency department attendance: a time series analysis

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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