Why can delays persist even when individual parts of an urgent and emergency care pathway work well? Stevan Bruijns examines the gaps between emergency care, acute care and discharge, and the often unrecognised work of bed and site managers who connect them.
Routine sodium bicarbonate has largely disappeared from modern ALS algorithms, but it continues to be used in many cardiac arrests. We review the BIHCA trial and discuss what it means for emergency physicians and prehospital clinicians.
Does intravenous magnesium improve outcomes for patients with acute non-traumatic headache in the emergency department? This review of a randomised trial examines the size of the analgesic benefit, adverse effects and whether a statistically positive result is enough to change practice.
A retrospective review of 600 patients treated for suspected sepsis in US emergency departments raises questions about antibiotic overtreatment. We examine the study’s use of hindsight, possible treatment-related harms and how its findings translate to UK practice.
Tom Roberts and Dan Horner discuss the SHED study of adults presenting with acute headache. The article and podcast examine CT timing, the Ottawa SAH rule and lumbar puncture, including why observational evidence and the distinction between aneurysmal and non-aneurysmal bleeding matter when considering changes to practice.
A 2022 journal club comparing anterior-posterior and anterior-lateral pad positions for elective cardioversion of atrial fibrillation. It reviews a randomised trial and asks how far its findings can be applied to emergency cardioversion or defibrillation for cardiac arrest.
Practical perspectives on trauma care and team leadership.
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