Simon Carley, Associate Editor of EMJ, talks through his highlights of the April 2021 edition of the Emergency Medicine Journal. Read the primary survey here: https://emj.bmj.com/content/38/4/249 Environmentally sustainable emergency medicine: https://emj.bmj.com/content/38/4/315 When dispatcher assistance is not saving lives: assessment of process compliance, barriers and outcomes in out-of-hospital cardiac arrest in a metropolitan city in China: https://emj.bmj.com/content/38/4/252 S100B protein level for the detection of clinically significant intracranial haemorrhage in patients with mild traumatic brain injury: a subanalysis of a prospective cohort study: https://emj.bmj.com/content/38/4/285 Effect of tranexamic acid on intracranial haemorrhage and infarction in patients with traumatic brain injury: a pre-planned substudy in a sample of CRASH-3 trial patients: https://emj.bmj.com/content/38/4/270 Synergistic effects of emergency physician empathy and burnout on patient satisfaction: a prospective observational study: https://emj.bmj.com/content/38/4/290 Handheld electronic device use in patient care: the emergency department patient perspective—a cross-sectional survey: https://emj.bmj.com/content/38/4/258 Read the full Aprilissue here: https://emj.bmj.com/content/38/4