MD · Emergency Medicine

Emergency Medicine thesis topics, with the design and feasibility for each

The emergency department generates more eligible patients in a week than most departments see in a month, so the constraint is never recruitment; it is that consent, measurement and follow-up all have to happen in the middle of resuscitation, and anything requiring a calm conversation will be missed on the busiest nights. The usual design therefore rests on something recorded anyway, a triage category, a score, an ultrasound performed as part of care, or a time interval, and the single commonest failure is a study whose outcome depends on what happened after the patient left the department. Examiners press on who performed and interpreted a point-of-care scan, on whether time zero was defined before data collection began, and on how patients who left against advice or were referred elsewhere were handled.

Topic register · 44 entries · 7 designs^[6]

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ICMR 2017 · ethics

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Study design

Feasibility in a teaching unit

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Showing 44 of 44 topics

The sample figure on each plate is a planning range read off the design, not a calculated answer. Your own number comes from a calculation against your own assumptions — the difference you would call clinically meaningful, the variability in your setting, the power you want — and it belongs in the synopsis with those assumptions written beside it.

Topic 01 / 44
Link to this entry
Agreement between the Manchester Triage System and the Emergency Severity Index for category assignment in an emergency department
DesignCross-sectionalFeasibilityStraightforward
Primary outcome
Agreement between the two systems for triage category, reported as a weighted kappa, with the proportion assigned a different acuity level
Collection time
8 to 10 months
Sample, as a planning figure
roughly 400–600 presentations, subject to a calculation for the agreement you wish to estimate
What your unit must already have
- triage nurses or residents trained in both systems
- two independent assessors triaging the same patient without conferring
- a triage register recording the time of arrival and the category assigned
What derails it
Two assessors at the same desk will influence each other within minutes, so separate them physically, prevent them from seeing each other's forms, and collect in blocks rather than continuously if staffing makes true independence impossible.
Topic 02 / 44
Link to this entry
Concordance between triage category and eventual disposition in an emergency department: an audit
DesignRetrospectiveFeasibilityStraightforward
Primary outcome
Proportion of presentations with a triage category discordant with the eventual disposition by stated undertriage and overtriage definitions
Collection time
3 to 5 months of record review
Sample, as a planning figure
about 800–1200 presentations, which a busy department accumulates in a few weeks of records; fix the figure by a proportion calculation
What your unit must already have
- an electronic or legible paper triage register with disposition recorded
- written definitions of undertriage and overtriage agreed before extraction
- ethics committee waiver of consent for record review
What derails it
Disposition in a government hospital reflects bed availability as much as illness severity, so a patient sent home for want of a bed will read as overtriage; record the stated reason for disposition and report it separately.
Topic 03 / 44
Link to this entry
NEWS2 at triage and deterioration within twenty-four hours of admission from the emergency department
DesignProspective observationalFeasibilityModerate
Primary outcome
Proportion experiencing a pre-defined deterioration event within twenty-four hours, in relation to the triage NEWS2 score
Collection time
12 months
Sample, as a planning figure
roughly 300–450 admitted patients so that enough events accrue, subject to a formal calculation
What your unit must already have
- full vital signs including respiratory rate and oxygen saturation recorded at triage
- a written definition of the deterioration composite outcome
- a route to follow the patient into the ward for twenty-four hours
What derails it
Respiratory rate is the variable that carries the score and it is the one written as a round twenty without being counted, so require a timed sixty-second count at triage and audit a sample of records against direct observation.
Topic 04 / 44
Link to this entry
qSOFA and SIRS criteria at presentation as predictors of in-hospital mortality in suspected infection
DesignProspective observationalFeasibilityModerate
Primary outcome
Discrimination for in-hospital mortality expressed as area under the ROC curve for each criterion set
Collection time
12 to 15 months
Sample, as a planning figure
about 300–450 patients with suspected infection, driven by the number of deaths needed, subject to a formal calculation
What your unit must already have
- a written definition of suspected infection applied at presentation
- vital signs and mental status recorded before any resuscitation changes them
- a route to ascertain in-hospital outcome after the patient leaves the department
What derails it
Your outcome happens upstairs, and patients referred out or taken home against advice vanish from the denominator, so set up ward linkage and a telephone check before enrolment and report how many outcomes could not be ascertained.
Topic 05 / 44
Link to this entry
Serum lactate at presentation and in-hospital mortality in patients with undifferentiated shock
DesignProspective observationalFeasibilityModerate
Primary outcome
In-hospital mortality across strata of initial lactate, with the need for vasopressors as a secondary outcome
Collection time
12 to 15 months
Sample, as a planning figure
roughly 150–250 patients in shock, subject to a formal calculation
What your unit must already have
- point-of-care lactate or a laboratory turnaround measured in minutes
- a written definition of shock applied at presentation
- a record of fluids and vasopressors given before the sample
What derails it
A lactate drawn after two litres of fluid is a different measurement, so record the volume infused before the sample for every patient and fix a window from arrival within which the first sample must be taken.
Topic 06 / 44
Link to this entry
Extended focused assessment with sonography for trauma against contrast-enhanced CT in blunt abdominal trauma
DesignDiagnostic accuracyFeasibilityModerate
Primary outcome
Sensitivity and specificity of the ultrasound examination for free fluid against CT as the reference standard
Collection time
12 to 15 months
Sample, as a planning figure
about 150–250 patients, driven by the expected sensitivity and the proportion with free fluid
What your unit must already have
- an ultrasound machine in the resuscitation area and residents credentialled to perform the examination
- CT available for stable trauma patients as part of routine care
- a written record of the scan findings made before the CT is reported
What derails it
The scan findings must be recorded and sealed before the CT report is seen, and in practice the same resident does both and updates the form, so use a separate proforma kept by the investigator and timestamp it.
Topic 07 / 44
Link to this entry
Point-of-care ultrasound in undifferentiated hypotension and its agreement with the final diagnosis
DesignDiagnostic accuracyFeasibilityModerate
Primary outcome
Agreement between the shock category assigned by the ultrasound protocol and the final discharge diagnosis category
Collection time
15 months
Sample, as a planning figure
roughly 100–160 patients with undifferentiated hypotension, driven by the agreement you wish to estimate
What your unit must already have
- an ultrasound machine with cardiac and abdominal probes available at the bedside at all hours
- at least two operators trained in the protocol with a documented credentialling record
- a blinded adjudication of the final diagnosis by a clinician who did not perform the scan
What derails it
The person who scans usually also treats, which makes the final diagnosis partly a consequence of the scan, so the adjudicator must be independent and must not see the ultrasound record, which needs to be written into the protocol.
Topic 08 / 44
Link to this entry
Lung ultrasound compared with chest radiography in patients presenting with acute dyspnoea
DesignDiagnostic accuracyFeasibilityModerate
Primary outcome
Sensitivity and specificity of each modality for the stated pulmonary findings, against a composite reference standard
Collection time
12 to 15 months
Sample, as a planning figure
about 150–250 patients, driven by the expected sensitivity and the prevalence of each finding
What your unit must already have
- an ultrasound machine with a suitable probe in the resuscitation area
- chest radiography available without delay for every enrolled patient
- a written composite reference standard combining clinical course, imaging and response
What derails it
A portable chest film taken in a sitting, breathless patient is of poor quality and reading it generously flatters the ultrasound, so have the radiograph reported by a radiologist blinded to the ultrasound and record film quality.
Topic 09 / 44
Link to this entry
Inferior vena cava collapsibility on ultrasound and response to a fluid bolus in hypotensive patients
DesignProspective observationalFeasibilityModerate
Primary outcome
Proportion classified as fluid responsive by a stated haemodynamic criterion, in relation to the baseline collapsibility index
Collection time
15 months
Sample, as a planning figure
roughly 90–140 patients, subject to a calculation against the responsive proportion assumed
What your unit must already have
- ultrasound with a curvilinear probe and an operator trained to obtain a reproducible vena cava view
- a written fluid bolus protocol with a fixed volume and duration
- a stated and measurable definition of fluid responsiveness
What derails it
Collapsibility is useless in a spontaneously breathing patient making large respiratory efforts, and those are most of your hypotensive patients, so record respiratory effort and exclude or analyse separately the patients in whom the measurement is not valid.
Topic 10 / 44
Link to this entry
Optic nerve sheath diameter on ultrasound and computed tomography signs of raised intracranial pressure
DesignDiagnostic accuracyFeasibilityDemanding
Primary outcome
Sensitivity and specificity of the ultrasound measurement at a stated cut-off against pre-defined CT signs as the reference standard
Collection time
15 to 18 months
Sample, as a planning figure
about 100–160 patients, driven by the expected sensitivity and the proportion with CT signs
What your unit must already have
- a linear probe with an ocular preset and an operator trained in the measurement technique
- CT reported by a radiologist blinded to the ultrasound measurement
- a measurement protocol specifying depth, plane and the number of readings averaged
What derails it
The measurement varies by fractions of a millimetre between operators and planes, which is the entire size of the effect, so require three readings per eye averaged, train on a phantom or healthy volunteers first, and report your own repeatability.
Topic 11 / 44
Link to this entry
Ultrasound-guided compared with landmark peripheral intravenous cannulation in patients with difficult access
DesignRandomised controlledFeasibilityModerate
Primary outcome
First-attempt success rate, with the total time to successful cannulation as a secondary outcome
Collection time
12 to 15 months
Sample, as a planning figure
roughly 50–80 per arm, subject to a proper calculation against the success proportion assumed
What your unit must already have
- ultrasound with a linear probe available in the resuscitation area
- ethics approval and trial registration before the first enrolment
- a written definition of difficult access applied before randomisation
What derails it
Operator skill dominates the result, so a trial where the ultrasound arm is done by the one enthusiast and the landmark arm by interns measures the operator; specify operator experience, balance it across arms, and record who performed each attempt.
Topic 12 / 44
Link to this entry
Revised Trauma Score at arrival and twenty-four-hour mortality in road traffic accident victims
DesignProspective observationalFeasibilityStraightforward
Primary outcome
Twenty-four-hour in-hospital mortality in relation to the arrival Revised Trauma Score
Collection time
12 months
Sample, as a planning figure
around 300–450 trauma presentations so that enough deaths accrue, subject to a formal calculation
What your unit must already have
- Glasgow Coma Scale, systolic pressure and respiratory rate recorded at arrival
- a trauma register with time of arrival and outcome
- a route to ascertain outcome for patients transferred to another hospital
What derails it
Patients who die in the first minutes are often not scored at all because resuscitation takes precedence, and excluding them biases the score badly, so allow retrospective scoring from the resuscitation record and flag those cases in the analysis.
Topic 13 / 44
Link to this entry
Injury Severity Score and hospital length of stay in polytrauma patients
DesignRetrospectiveFeasibilityModerate
Primary outcome
Length of hospital stay in days in relation to the Injury Severity Score computed from the records
Collection time
4 to 6 months of record review
Sample, as a planning figure
about 150–250 records, depending on trauma volume and the completeness of imaging reports
What your unit must already have
- records with injury descriptions and imaging reports sufficient to assign abbreviated injury scale values
- a single person trained in scoring, or two with an agreement check
- ethics committee waiver of consent for record review
What derails it
Scoring needs anatomical detail the notes often lack, so a sizeable share of records cannot be scored at all; pull twenty files and attempt to score them before finalising the objective, and state how unscorable records were handled.
Topic 14 / 44
Link to this entry
Application of the Canadian CT Head Rule in adults with minor head injury
DesignDiagnostic accuracyFeasibilityModerate
Primary outcome
Sensitivity of the rule for clinically important intracranial injury on CT, with the proportion of scans the rule would have avoided
Collection time
12 to 15 months
Sample, as a planning figure
roughly 300–450 patients with minor head injury, since important injuries are uncommon; refine by calculation
What your unit must already have
- CT performed as routine care for minor head injury, so that every enrolled patient has a reference standard
- the rule's criteria recorded prospectively before the CT request
- a radiologist reporting scans without seeing the rule assessment
What derails it
In a department that scans everyone, the rule can be assessed; in one that scans selectively, patients not scanned have no reference standard and the sensitivity is uninterpretable, so confirm the local scanning practice before choosing this.
Topic 15 / 44
Link to this entry
Glasgow Coma Scale at arrival and functional outcome at thirty days in traumatic brain injury
DesignCohortFeasibilityModerate
Primary outcome
Glasgow Outcome Scale category at thirty days, in relation to the arrival Glasgow Coma Scale score
Collection time
15 to 18 months
Sample, as a planning figure
about 150–250 patients after allowing for attrition, subject to a formal calculation
What your unit must already have
- Glasgow Coma Scale scored at arrival before sedation or intubation, with the time recorded
- neurosurgical cooperation for in-hospital course data
- a thirty-day follow-up route by visit or a structured telephone interview
What derails it
Scoring after intubation and sedation is not the same measurement, and in practice the airway is secured first, so record whether the score was pre-sedation, note the verbal component as untestable where it is, and state the rule you used.
Topic 16 / 44
Link to this entry
Shock index at presentation and the need for blood transfusion in trauma patients
DesignProspective observationalFeasibilityStraightforward
Primary outcome
Proportion receiving any blood transfusion within twenty-four hours, in relation to the arrival shock index
Collection time
12 months
Sample, as a planning figure
roughly 250–400 trauma patients, subject to a calculation against the transfusion proportion assumed
What your unit must already have
- pulse rate and systolic pressure recorded accurately at arrival
- blood bank records retrievable and linkable to the patient
- a written definition of the twenty-four-hour transfusion window
What derails it
Transfusion in many Indian hospitals depends on whether the family can arrange replacement donors, so the outcome partly measures blood availability; record the indication and any delay caused by donor arrangements as separate variables.
Topic 17 / 44
Link to this entry
Severity grading in organophosphate poisoning and the need for mechanical ventilation
DesignProspective observationalFeasibilityModerate
Primary outcome
Proportion requiring mechanical ventilation during admission, in relation to the severity grade assigned at presentation
Collection time
12 to 15 months
Sample, as a planning figure
about 100–160 patients, subject to a calculation against the ventilation proportion assumed
What your unit must already have
- a validated severity grading scale applied at a fixed time after arrival
- atropine and oxime availability with a written dosing protocol
- ventilators available so that need is not confounded by supply
What derails it
The compound is frequently unidentified because nobody brought the container, and different compounds behave differently, so record the compound where known, create an unidentified category, and report it rather than pooling everything as organophosphate.
Topic 18 / 44
Link to this entry
Clinical profile and in-hospital outcome of aluminium phosphide poisoning
DesignRetrospectiveFeasibilityStraightforward
Primary outcome
In-hospital mortality with the proportion developing shock, acidosis and arrhythmia as documented in the records
Collection time
3 to 5 months of record review over several years
Sample, as a planning figure
roughly 80–150 records, depending on the local pattern of agricultural poisoning
What your unit must already have
- emergency and ward records retrievable by diagnosis
- a classification of severity decided before extraction
- ethics committee waiver of consent, with attention to the medicolegal status of these cases
What derails it
These are medicolegal cases and the files may be with the police or the court, so confirm with the records officer how many are accessible before you build the study, and state how many files could not be retrieved.
Topic 19 / 44
Link to this entry
Twenty-minute whole blood clotting test and antivenom requirement in snake bite
DesignProspective observationalFeasibilityModerate
Primary outcome
Proportion with an abnormal clotting test at presentation and at six hours, in relation to the total antivenom administered
Collection time
15 to 18 months, weighted to the monsoon months
Sample, as a planning figure
about 100–160 patients with suspected envenomation, governed by the local season
What your unit must already have
- a written protocol for the clotting test, including tube type and the timing of readings
- antivenom supply with an administration protocol
- a unit receiving bites directly rather than after referral
What derails it
The test is invalidated by a glass tube that has been washed with detergent or by a sample collected through a cannula flushed with saline, so standardise the tube and the sampling method and train the night staff before enrolment.
Topic 20 / 44
Link to this entry
Emergency management and endoscopic referral in corrosive ingestion
DesignRetrospectiveFeasibilityModerate
Primary outcome
Proportion undergoing upper gastrointestinal endoscopy within the stated interval, with the distribution of injury grades recorded
Collection time
4 to 6 months of record review
Sample, as a planning figure
roughly 60–120 records, depending on the local pattern of ingestion
What your unit must already have
- emergency and gastroenterology records linkable for the same patient
- endoscopic grading documented in the reports
- ethics committee waiver of consent for record review
What derails it
Endoscopy in these patients is performed in another department and often on a later date, so the link between emergency and endoscopy records breaks easily; check that the two sets of records can be matched before building the objective.
Topic 21 / 44
Link to this entry
Profile of drug overdose in adolescents and young adults presenting to an emergency department
DesignRetrospectiveFeasibilityStraightforward
Primary outcome
Distribution of agents involved, with the proportion needing intensive care and the disposition
Collection time
3 to 5 months of record review over three years
Sample, as a planning figure
about 100–200 records, depending on the department's volume
What your unit must already have
- records retrievable by presenting complaint across the study years
- an agent classification fixed before extraction
- ethics committee approval with particular attention to confidentiality in self-harm cases
What derails it
Intent is recorded inconsistently and families pressure staff to write accidental, so do not build the analysis on intent; classify by agent and outcome, and describe the documentation of intent as a limitation.
Topic 22 / 44
Link to this entry
Pattern and outcome of acute poisoning presenting to an emergency department
DesignCross-sectionalFeasibilityStraightforward
Primary outcome
Distribution of poisoning agents with the proportion admitted, ventilated and discharged alive
Collection time
12 months to cover seasonal variation
Sample, as a planning figure
roughly 250–400 presentations, subject to a proportion calculation
What your unit must already have
- a poisoning register or a reliable way to identify these presentations prospectively
- a structured proforma including the compound, time since ingestion and prior treatment
- a route to record outcome for patients admitted under other departments
What derails it
Time since ingestion is the variable that explains most of the course and it is recorded as a vague morning or last night, so ask for a clock time anchored to a household event and record it in the proforma at the bedside.
Topic 23 / 44
Link to this entry
Return of spontaneous circulation and survival to admission after cardiac arrest managed in an emergency department
DesignProspective observationalFeasibilityModerate
Primary outcome
Proportion achieving return of spontaneous circulation, with survival to hospital admission, recorded in a standard reporting format
Collection time
15 months
Sample, as a planning figure
about 120–200 arrests, governed by the department's volume
What your unit must already have
- a standard arrest data collection form completed at the event
- a defibrillator with a rhythm record and a clock synchronised with the department clock
- a resuscitation team willing to have the event documented by an observer
What derails it
Times recorded from memory after the event are worthless and are what you will get unless someone is assigned only to record, so nominate a scribe for every arrest and use one clock, because wristwatches and wall clocks differ by minutes.
Topic 24 / 44
Link to this entry
Pre-hospital factors in out-of-hospital cardiac arrest presenting to an emergency department
DesignCross-sectionalFeasibilityStraightforward
Primary outcome
Proportion who received any bystander cardiopulmonary resuscitation, with the mode of transport and the interval from collapse to arrival
Collection time
12 to 15 months
Sample, as a planning figure
roughly 120–200 arrests, subject to a proportion calculation
What your unit must already have
- a structured interview with whoever accompanied the patient, done at the time
- a definition of bystander resuscitation that a lay person can confirm
- the arrival time recorded against a single department clock
What derails it
The only person who knows what happened before arrival leaves within minutes to arrange paperwork or money, so the interview must happen at the door; assign it to a specific team member rather than planning to do it later.
Topic 25 / 44
Link to this entry
End-tidal carbon dioxide during cardiopulmonary resuscitation and return of spontaneous circulation
DesignProspective observationalFeasibilityDemanding
Primary outcome
Proportion achieving return of spontaneous circulation, in relation to end-tidal carbon dioxide values at stated points during resuscitation
Collection time
15 to 18 months
Sample, as a planning figure
about 80–140 arrests with an advanced airway in place, governed by volume and equipment
What your unit must already have
- capnography available and connected during resuscitation, not only for intubation confirmation
- an advanced airway placed in most arrests, since the measurement depends on it
- a scribe recording values at fixed intervals
What derails it
Capnography is frequently attached late or not at all during a chaotic arrest, so the measurement exists only where someone made it a priority; assign that role explicitly and report the proportion of arrests with usable data.
Topic 26 / 44
Link to this entry
Video laryngoscopy compared with direct laryngoscopy for first-attempt intubation success in the emergency department
DesignRandomised controlledFeasibilityDemanding
Primary outcome
First-attempt intubation success, with the number of attempts and peri-intubation complications as secondary outcomes
Collection time
15 to 18 months
Sample, as a planning figure
roughly 60–100 per arm, subject to a proper calculation against the success proportion assumed
What your unit must already have
- a video laryngoscope with working blades and charged batteries available at all hours
- ethics approval and trial registration, with a protocol for emergency consent
- an independent observer recording attempts rather than the intubating doctor
What derails it
Consent for an emergency procedure is the ethical crux and the committee will ask exactly how it is obtained when the patient is unconscious and no relative is present, so draft the deferred or representative consent procedure with them before submission.
Topic 27 / 44
Link to this entry
Peri-intubation hypoxia and hypotension during rapid sequence intubation in the emergency department
DesignProspective observationalFeasibilityModerate
Primary outcome
Proportion with a pre-defined peri-intubation adverse event within the stated interval after induction
Collection time
12 to 15 months
Sample, as a planning figure
about 120–200 intubations, subject to a calculation against the event proportion assumed
What your unit must already have
- continuous monitoring with saturation and non-invasive pressure recorded at fixed short intervals
- an observer present for the procedure who is not part of the intubating team
- a written record of pre-oxygenation method and induction agents
What derails it
Monitor alarms are silenced during intubation and the dip in saturation is never written down, so an observer with a fixed recording schedule is the only way to capture the outcome, and that person must have no clinical role in the procedure.
Topic 28 / 44
Link to this entry
Ketamine compared with propofol for procedural sedation during orthopaedic reduction in the emergency department
DesignRandomised controlledFeasibilityDemanding
Primary outcome
Proportion with a pre-defined sedation-related adverse event, with procedure completion and recovery time as secondary outcomes
Collection time
15 to 18 months
Sample, as a planning figure
roughly 45–75 per arm, subject to a proper calculation against the event proportion assumed
What your unit must already have
- monitoring with capnography and an airway trolley at the bedside
- ethics approval and trial registration, with an anaesthesia-endorsed sedation protocol
- a trained observer recording depth of sedation on a validated scale
What derails it
Procedural sedation by emergency physicians needs institutional sanction and anaesthesia agreement, which is the real obstacle rather than the trial design, so obtain that agreement in writing before the synopsis goes forward.
Topic 29 / 44
Link to this entry
Time to first analgesic and adequacy of pain relief in patients presenting with acute pain
DesignProspective observationalFeasibilityStraightforward
Primary outcome
Median time from arrival to the first analgesic dose, with the proportion achieving a stated reduction on a numeric rating scale at sixty minutes
Collection time
10 to 12 months
Sample, as a planning figure
about 250–400 patients, subject to a calculation against the proportion achieving relief
What your unit must already have
- a numeric or visual pain scale used consistently at triage and at follow-up points
- drug administration times recorded by nursing staff
- a follow-up assessment at a fixed interval by the study observer
What derails it
Pain scores are recorded at triage and then never again unless someone returns at sixty minutes with the scale in hand, so the sixty-minute assessment must be assigned to a person, not to the treating team, and missed assessments recorded.
Topic 30 / 44
Link to this entry
Intravenous paracetamol compared with intramuscular diclofenac for pain relief in acute renal colic
DesignRandomised controlledFeasibilityModerate
Primary outcome
Mean reduction in pain score at thirty minutes on a validated pain scale, with the need for rescue analgesia
Collection time
12 to 15 months
Sample, as a planning figure
roughly 40–70 per arm, subject to a proper calculation using the standard deviation of pain score change
What your unit must already have
- ethics approval and trial registration before the first enrolment
- ultrasound or clinical criteria to confirm the working diagnosis before randomisation
- an assessor recording pain scores who does not know the allocation
What derails it
Rescue analgesia given by the treating doctor at twenty minutes destroys the thirty-minute comparison, so fix the earliest permitted rescue time in the protocol, brief the duty staff, and record every rescue dose with its time.
Topic 31 / 44
Link to this entry
HEART score in undifferentiated chest pain and major adverse cardiac events at thirty days
DesignCohortFeasibilityModerate
Primary outcome
Proportion with a pre-defined major adverse cardiac event within thirty days, by HEART score risk category
Collection time
15 to 18 months
Sample, as a planning figure
about 250–400 patients, since events are uncommon in low-risk patients; refine by formal calculation
What your unit must already have
- troponin available with a stated assay and turnaround in the department
- a thirty-day follow-up route by telephone with a structured event questionnaire
- electrocardiograms reported to a consistent standard
What derails it
The score includes a subjective history component, and a resident who already suspects a cardiac cause scores it higher, so define the history categories with examples in the proforma and have the score assigned before the troponin result is known.
Topic 32 / 44
Link to this entry
Door-to-needle and door-to-balloon intervals for ST-elevation myocardial infarction: a retrospective audit
DesignRetrospectiveFeasibilityStraightforward
Primary outcome
Median door-to-needle or door-to-balloon interval in minutes, with the proportion meeting the stated target
Collection time
3 to 5 months of record review
Sample, as a planning figure
roughly 120–250 cases, depending on the department's volume and the period reviewed
What your unit must already have
- arrival, electrocardiogram and treatment times recorded in the emergency and cardiology records
- a clear rule for time zero, since arrival and registration times differ
- ethics committee waiver of consent for record review
What derails it
Registration time and actual arrival time can differ by half an hour when the family goes to the counter first, so decide which timestamp is time zero, state it, and check how often the two are both available.
Topic 33 / 44
Link to this entry
Door-to-computed-tomography and door-to-treatment intervals in acute stroke presenting to an emergency department
DesignRetrospectiveFeasibilityModerate
Primary outcome
Median interval from arrival to CT and from arrival to thrombolysis where given, with the proportion arriving within the treatment window
Collection time
4 to 6 months of record review
Sample, as a planning figure
about 150–300 records, depending on stroke volume
What your unit must already have
- CT request and report times retrievable from the radiology system
- a stroke register or a reliable way to identify these presentations retrospectively
- ethics committee waiver of consent for record review
What derails it
The interval from symptom onset is the figure that decides eligibility and it is the one most often missing or recorded as since morning, so count how many records carry a usable onset time before making it part of the primary outcome.
Topic 34 / 44
Link to this entry
Wells score with D-dimer for suspected pulmonary embolism in the emergency department
DesignDiagnostic accuracyFeasibilityDemanding
Primary outcome
Sensitivity and negative predictive value of the combined strategy against CT pulmonary angiography as the reference standard
Collection time
15 to 18 months
Sample, as a planning figure
roughly 150–250 patients with suspected embolism, driven by the expected sensitivity and the proportion confirmed
What your unit must already have
- D-dimer with a stated assay and cut-off available at all hours
- CT pulmonary angiography accessible for every enrolled patient, including at night
- the Wells criteria recorded before the D-dimer result is known
What derails it
CT pulmonary angiography is the bottleneck, because patients who cannot afford it or who are unstable never get the reference standard, so count how many scans are actually done per month before choosing this and state how unverified patients are handled.
Topic 35 / 44
Link to this entry
Point-of-care ultrasound compared with clinical assessment for suspected ureteric colic in the emergency department
DesignDiagnostic accuracyFeasibilityModerate
Primary outcome
Sensitivity and specificity of bedside ultrasound findings for urinary tract calculus against the departmental reference imaging
Collection time
12 to 15 months
Sample, as a planning figure
about 150–250 patients, driven by the expected sensitivity and the proportion with calculus
What your unit must already have
- an ultrasound machine with a curvilinear probe and credentialled operators
- a reference imaging pathway, whether formal ultrasound or CT, applied to every enrolled patient
- a record of the bedside findings made before the reference imaging
What derails it
If the reference standard is a formal ultrasound done by the radiologist, you are comparing two operators rather than two tests, so state the reference explicitly and consider restricting to patients who receive CT, acknowledging the cost implication.
Topic 36 / 44
Link to this entry
Non-invasive ventilation in acute cardiogenic pulmonary oedema in the emergency department
DesignProspective observationalFeasibilityModerate
Primary outcome
Proportion avoiding intubation during the emergency department stay, with the change in respiratory rate and saturation at one hour
Collection time
12 to 15 months
Sample, as a planning figure
roughly 80–130 patients, subject to a calculation against the intubation proportion assumed
What your unit must already have
- non-invasive ventilators with working masks in the resuscitation area
- a written initiation and escalation protocol with objective failure criteria
- monitoring and blood gas available at fixed time points
What derails it
Patients are frequently moved to the ward or the intensive care unit within the hour, so the department-based outcome is truncated for exactly the sickest patients; define the observation window and record where the patient was at each time point.
Topic 37 / 44
Link to this entry
Triage and disposition of febrile children presenting to an emergency department
DesignCross-sectionalFeasibilityStraightforward
Primary outcome
Proportion admitted, by triage category and by the presence of stated danger signs
Collection time
10 to 12 months
Sample, as a planning figure
about 400–600 febrile children, subject to a proportion calculation
What your unit must already have
- a paediatric triage tool applied by trained staff
- paediatric vital sign reference ranges available at the triage desk
- a disposition record that distinguishes admission from referral elsewhere
What derails it
Respiratory rate and heart rate in a crying child are unusable, and a busy triage desk records them anyway, so require a settled measurement with the state of the child noted, and treat readings taken while crying as a recorded category.
Topic 38 / 44
Link to this entry
Supervised oral rehydration in the emergency department for children with acute gastroenteritis
DesignProspective observationalFeasibilityStraightforward
Primary outcome
Proportion completing a supervised trial of oral rehydration without intravenous fluids, with unscheduled return to the department within seventy-two hours
Collection time
12 months
Sample, as a planning figure
roughly 200–300 children, subject to a calculation against the expected proportion completing the trial
What your unit must already have
- a written oral rehydration protocol stating volumes, the review interval and what counts as failure
- weighing facilities at triage, since volumes are calculated per kilogram
- a supervised area where a trial of oral fluids can be given and observed
What derails it
Without a rehydration corner and a nurse assigned to it, a vomiting child goes straight onto a drip whatever the protocol says, so record whether a supervised trial was offered at all, who supervised it, and treat the department's facility as part of the setting you describe.
Topic 39 / 44
Link to this entry
Length of stay and boarding time in an emergency department
DesignCross-sectionalFeasibilityStraightforward
Primary outcome
Median total length of stay in the department, with boarding time for admitted patients and the proportion exceeding stated thresholds
Collection time
8 to 10 months of structured sampling across shifts
Sample, as a planning figure
about 600–900 presentations sampled across all shifts and days, refined once the precision is fixed
What your unit must already have
- arrival, decision and departure times recorded against one clock
- a sampling plan covering nights, weekends and weekdays equally
- a definition of boarding time fixed before data collection
What derails it
Data collected only on weekday mornings, which is when a resident is free, gives a flattering answer, so fix a sampling plan across all shifts in advance and record the shift for every observation.
Topic 40 / 44
Link to this entry
Factors associated with unscheduled return to the emergency department within seventy-two hours: a case-control study
DesignCase-controlFeasibilityModerate
Primary outcome
Odds of stated index-visit factors in patients returning within seventy-two hours compared with matched patients who did not return
Collection time
6 to 9 months of record review and interviews
Sample, as a planning figure
roughly 100–150 cases with one or two controls each, subject to a formal calculation
What your unit must already have
- a register that can identify a repeat visit by the same patient
- index visit records retrievable for both cases and controls
- a method to confirm that controls did not attend elsewhere
What derails it
Patients who return to a different hospital are invisible and become misclassified controls, so confirm non-return by telephone for the control group and report how many could not be contacted.
Topic 41 / 44
Link to this entry
Profile and outcome of heat-related illness presenting during the summer months
DesignProspective observationalFeasibilityModerate
Primary outcome
Proportion with each severity category by a stated definition, with in-hospital mortality and cooling methods used
Collection time
two consecutive summer seasons within an 18-month window
Sample, as a planning figure
about 60–120 patients, dictated entirely by the season and the local climate
What your unit must already have
- a reliable core temperature measurement method specified in advance, not axillary readings
- a written cooling protocol so management is comparable
- ambient temperature records for the study period from a stated source
What derails it
Axillary temperature is what gets recorded and it is useless for this diagnosis, so specify rectal or another core measurement in the protocol, arrange the thermometers, and exclude patients for whom only an axillary reading exists.
Topic 42 / 44
Link to this entry
Accuracy of simple triage and rapid treatment categorisation by emergency staff in a simulated mass casualty exercise
DesignCross-sectionalFeasibilityModerate
Primary outcome
Proportion of simulated casualties correctly categorised against the pre-determined expert categorisation
Collection time
6 to 9 months including exercise preparation
Sample, as a planning figure
roughly 60–100 staff participants each triaging a fixed set of scenarios, refined by a proportion calculation
What your unit must already have
- a set of written or moulaged scenarios with expert-assigned categories fixed in advance
- institutional permission and protected time for staff to participate
- a scoring sheet and an independent scorer
What derails it
Staff discuss the scenarios between turns, so a participant who takes part late in the day may already have been told the answers, which is why participants must be run one at a time, the order of scenarios randomised, and the order recorded so any learning effect is visible in the analysis.
Topic 43 / 44
Link to this entry
Agreement between point-of-care blood gas potassium and laboratory serum potassium in emergency patients
DesignCross-sectionalFeasibilityModerate
Primary outcome
Bias and limits of agreement between the two measurements, with the proportion of patients in whom the treatment category would differ
Collection time
9 to 12 months
Sample, as a planning figure
about 150–250 paired samples, driven by the limits of agreement you wish to estimate
What your unit must already have
- a point-of-care blood gas analyser with documented quality control in the department
- laboratory samples drawn at the same time and transported promptly
- a record of sampling site and any delay before analysis
What derails it
The laboratory sample sits in a tray waiting for transport while the gas result is instant, and potassium rises with delay, so record the time from draw to analysis for every pair and exclude samples exceeding a pre-stated limit.
Topic 44 / 44
Link to this entry
Compliance with the first-hour sepsis bundle in an emergency department
DesignProspective observationalFeasibilityStraightforward
Primary outcome
Proportion of patients in whom each bundle element was completed within the stated time from recognition
Collection time
10 to 12 months
Sample, as a planning figure
roughly 150–250 patients with suspected sepsis, subject to a proportion calculation
What your unit must already have
- a written local sepsis bundle to audit against
- a recognition timestamp recorded prospectively at the bedside
- blood culture bottles, lactate and antibiotics physically available in the department
What derails it
Time zero is the moment of recognition, and in a retrospective reading it is assumed to be arrival, which flatters compliance, so record recognition time at the bedside prospectively and state exactly how it was defined.

The designs

What each design commits you to

The designs in this Emergency Medicine register

The design is not a label on the title; it decides your ethics route, your timetable and the test that answers your primary question. Only the designs that appear above are explained here.

Cross-sectional
7 topics
One contact per participant. Usually the quickest to complete, and the design most often chosen when time is short.
Prospective observational
16 topics
Participants are followed after enrolment without allocating an intervention. Ethics approval must precede the first enrolment.
Retrospective
7 topics
Existing records only. Faster, but limited by what was recorded, and a waiver of consent is normally sought from the ethics committee.
Randomised controlled
4 topics
Allocation is randomised. Prospective interventional studies are registered with the Clinical Trials Registry of India before the first participant is enrolled.
Diagnostic accuracy
7 topics
An index test measured against a reference standard. The sample size depends on the expected sensitivity or specificity and the prevalence in your setting.
Case-control
1 topic
Cases and controls compared for prior exposure. Control selection is where these are most often criticised.
Cohort
2 topics
A defined group followed over time. Attrition is the usual threat, so plan for it in the sample size.

What the feasibility mark means

A judgement about a typical teaching unit, not about yours. Confirm the volume, the equipment and the co-operation a topic needs before your synopsis goes in, because after that the timetable stops being negotiable^[2].

Straightforward
14 topics
Achievable in most teaching units with routine caseload and no equipment beyond what is already in use.
Moderate
25 topics
Achievable, but needs either a specific piece of equipment, a collaborating department, or a caseload you should confirm before committing.
Demanding
5 topics
Only take this on if your unit already has the volume, the equipment and the co-operation it needs. Confirm all three before your synopsis goes in.

Next steps

Before you commit to one

What to do with a topic you like

Three steps, in this order. None of them is us: the first is arithmetic, the second is your guide, the third is a search only you can run.

Do the arithmetic
The figure on each plate is a planning range, not an answer. Put your own assumptions — the difference you would call clinically meaningful, the variability you expect, the power you want — into the free sample size calculator, then divide the result by the eligible patients your unit sees in a month and see whether the months you have left permit it.
Take it to your guide
Nothing on this page is approved by anybody. Your guide and your department decide what is feasible in your unit, and your ethics committee decides whether it may start — before the first participant, not before the analysis^[5]. Where your university ordinance is stricter than anything here, the ordinance wins^[1].
Run the search yourself
We make no claim that any question here is novel, under-studied or a gap, because that depends on a literature search run today in your own field. Read what the search returns before you write the introduction, and be ready to say why the question is worth asking in your setting.

What a thesis in this field has to satisfy — the obligations, the statistics and the questions residents ask first — is set out on the Emergency Medicine page. Other specialties are in the topic bank index, and the method is worked through in the guides.

Undertakings

Mechanisms, not promises

What protects your draft, and who owns the work

Each line below is a mechanism this platform implements or a published instrument it is built around. None of them is a guarantee, and we are affiliated with no regulator or university.

Protection of your work

Row-level security
Every table enforces row-level access. You read your own record, and nothing else.
View-only streaming
Drafts are streamed to you through an authenticated route, not handed over as a file.
Watermarked to you
Every page you read carries your own name and email across it.
Download gated
The final file unlocks when the fee is settled in full, and not before.
Mumbai region · DPDP 2023
Your record and your documents are held in the Mumbai region, so India's Digital Personal Data Protection Act 2023 applies to them.
Anonymised data only
We accept no patient identifiers. An NDA is available on request.

How this works

Instruments we work to

NMC PGMER-2023
The thesis obligations set out in the postgraduate medical education regulations.
NBEMS
DNB and DrNB protocol and thesis timelines, and the page limit, as published.
UGC 2018 · <10%
The academic integrity convention we work to on every draft.
ICMJE · Vancouver
Authorship criteria and reference style, applied as published.
No affiliation
We work to these published instruments. We are affiliated to none of the bodies that issue them.

How this works

Authorship and the uniqueness check

Sole author
Mentoring, editing, statistics and compliance. You remain the sole author of your thesis.
Not ghostwriting
We will not write your thesis for you, and we will not be named in it.
MDSoftune
Word-level uniqueness checking, built with REDENN Informatics Inc., Canada.
Every version
Each draft is checked word by word before your university sees it.

How this works

MDThesis is an independent academic mentorship practice. It is not affiliated with, endorsed by, or acting for the NMC, NBEMS, UGC or any university.

Free feasibility call

Tell us where your thesis stands. A senior doctor will tell you what to do next.

A senior doctor replies within one working day. No obligation. MD, MS, DNB, DrNB, DM, MCh, MDS and international programmes.

Request for a feasibility call

No obligation

Reply within one working day · No obligation · Your details are not shared

Prefer to write to us first? Contact the practice. We mentor and edit; you remain the sole author of your thesis.

References

[1]
Post Graduate Medical Education Regulations, 2023, National Medical Commission. In force 1 January 2024. Thesis requirements at Regulation 5.2. nmc.org.in
[2]
DNB and DrNB thesis guidelines, National Board of Examinations in Medical Sciences. Protocol within 180 days of joining for three-year courses and 90 days for the two-year post-diploma DNB; research study complete by 24 months; thesis by 26 months; 80-page limit inclusive of certificates and annexures. natboard.edu.in
[5]
National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2017, Indian Council of Medical Research. Ethics approval precedes data collection. icmr.gov.in
[6]
Counts of specialties, tracked stages, supported currencies and supported countries are structural facts of this platform, read from its own configuration rather than from a claim.

Document: Topic bank — Emergency Medicine · Revision 1 · Last reviewed 10 SEPT 2026

Issued by MDThesis, a brand of REDENN Informatics Private Limited

Emergency Medicine thesis topics, with the design and feasibility for eachEmergency Medicine thesis topics, with the design and feasibility for each

Agreement between the Manchester Triage System and the Emergency Severity Index for category assignment in an emergency department

Concordance between triage category and eventual disposition in an emergency department: an audit

NEWS2 at triage and deterioration within twenty-four hours of admission from the emergency department

qSOFA and SIRS criteria at presentation as predictors of in-hospital mortality in suspected infection

Serum lactate at presentation and in-hospital mortality in patients with undifferentiated shock

Extended focused assessment with sonography for trauma against contrast-enhanced CT in blunt abdominal trauma

Point-of-care ultrasound in undifferentiated hypotension and its agreement with the final diagnosis

Lung ultrasound compared with chest radiography in patients presenting with acute dyspnoea

Inferior vena cava collapsibility on ultrasound and response to a fluid bolus in hypotensive patients

Optic nerve sheath diameter on ultrasound and computed tomography signs of raised intracranial pressure

Ultrasound-guided compared with landmark peripheral intravenous cannulation in patients with difficult access

Revised Trauma Score at arrival and twenty-four-hour mortality in road traffic accident victims

Injury Severity Score and hospital length of stay in polytrauma patients

Application of the Canadian CT Head Rule in adults with minor head injury

Glasgow Coma Scale at arrival and functional outcome at thirty days in traumatic brain injury

Shock index at presentation and the need for blood transfusion in trauma patients

Severity grading in organophosphate poisoning and the need for mechanical ventilation

Clinical profile and in-hospital outcome of aluminium phosphide poisoning

Twenty-minute whole blood clotting test and antivenom requirement in snake bite

Emergency management and endoscopic referral in corrosive ingestion

Profile of drug overdose in adolescents and young adults presenting to an emergency department

Pattern and outcome of acute poisoning presenting to an emergency department

Return of spontaneous circulation and survival to admission after cardiac arrest managed in an emergency department

Pre-hospital factors in out-of-hospital cardiac arrest presenting to an emergency department

End-tidal carbon dioxide during cardiopulmonary resuscitation and return of spontaneous circulation

Video laryngoscopy compared with direct laryngoscopy for first-attempt intubation success in the emergency department

Peri-intubation hypoxia and hypotension during rapid sequence intubation in the emergency department

Ketamine compared with propofol for procedural sedation during orthopaedic reduction in the emergency department

Time to first analgesic and adequacy of pain relief in patients presenting with acute pain

Intravenous paracetamol compared with intramuscular diclofenac for pain relief in acute renal colic

HEART score in undifferentiated chest pain and major adverse cardiac events at thirty days

Door-to-needle and door-to-balloon intervals for ST-elevation myocardial infarction: a retrospective audit

Door-to-computed-tomography and door-to-treatment intervals in acute stroke presenting to an emergency department

Wells score with D-dimer for suspected pulmonary embolism in the emergency department

Point-of-care ultrasound compared with clinical assessment for suspected ureteric colic in the emergency department

Non-invasive ventilation in acute cardiogenic pulmonary oedema in the emergency department

Triage and disposition of febrile children presenting to an emergency department

Supervised oral rehydration in the emergency department for children with acute gastroenteritis

Length of stay and boarding time in an emergency department

Factors associated with unscheduled return to the emergency department within seventy-two hours: a case-control study

Profile and outcome of heat-related illness presenting during the summer months

Accuracy of simple triage and rapid treatment categorisation by emergency staff in a simulated mass casualty exercise

Agreement between point-of-care blood gas potassium and laboratory serum potassium in emergency patients

Compliance with the first-hour sepsis bundle in an emergency department

What the feasibility mark means

Tell us where your thesis stands. A senior doctor will tell you what to do next.

Emergency Medicine thesis topics, with the design and feasibility for each