Could oral rivaroxaban replace fondaparinux injections for superficial vein thrombosis? This 2017 appraisal of SURPRISE examines its non-inferiority design, composite outcomes, bleeding and generalisability, asking how convenience should be weighed against uncertainty about benefits and harms.
The rise and SURPRISE of the DOACs. St.Emlyn’s Read More
Could vitamin C, thiamine and steroids transform sepsis care? This 2017 appraisal interrogates a striking before-and-after study, exploring confounding, retrospective data and the risks of adopting an unproven treatment before reliable evidence of benefit and harm is available.
JC: Vitamin SCepTiC? Read More
Does therapeutic hypothermia improve recovery after status epilepticus? This 2017 appraisal examines a randomised trial’s 90-day functional outcomes, questioning its sample-size assumptions, treatment variation and whether a non-significant result was enough to rule out a clinically important benefit.
Hypothermia in status epilepticus. St.Emlyn’s Read More
Does low-molecular-weight heparin prevent symptomatic clots after lower-limb casting? This 2016 review of POT-CAST examines a trial that found no statistically significant reduction, while discussing patient selection, low event numbers and the unresolved question of benefit in higher-risk groups.
JC: Clots in Pots gets Top Spot. Thromboprophylaxis at St.Emlyn’s Read More
How can clinicians support a bleeding trauma patient while definitive haemorrhage control is being arranged? This 2016 discussion explores resuscitation physiology, fluids, vasopressors and treatment endpoints, setting out the authors’ perspective while acknowledging limited evidence and the importance of the wider trauma system.
Can we buy time in bleeding trauma. St.Emlyn’s. Read More
The EUROTHERM trial tested therapeutic hypothermia for raised intracranial pressure after traumatic brain injury and stopped early after evidence of harm. This 2015 appraisal examines neurological outcomes, trial design and why the timing and position of cooling within an escalation strategy matter when interpreting the results.
JC: EuroTHERM or EuroBURNED. St.Emlyn’s Read More
Highlights from the 2015 neuroanaesthesia and critical care meeting in Manchester, with a focus on collaboration around traumatic brain injury. Dan Horner reflects on variation in practice, fatigue and situational awareness, specialist intensive care, tracheostomy safety and communication with patients who experience awareness during anaesthesia.
Neurocritical care in Manchester NASGBI and St.Emlyn’s Read More
Which patients with blunt chest trauma are most likely to develop complications? This 2015 journal club examines the derivation and validation of a prognostic score, considering outcome definitions, reliability of recorded risk factors and the further evidence needed before a model should guide admission or discharge.
JC: What’s the ‘best’ test for a broken chest? Read More
