Could changing D-dimer thresholds reduce unnecessary CT pulmonary angiography? This 2012 journal club examines a retrospective study, questioning how patients were selected, how risk was assessed and whether small subgroups can support changes to investigation pathways.
Can case conferences help teams learn without becoming an exercise in blame? Rick Body uses a hypothetical asthma emergency to explore constructive reflection, fair feedback and the importance of recognising good care alongside opportunities to improve.
Who needs thromboprophylaxis after lower-limb immobilisation? This 2012 discussion introduces College of Emergency Medicine guidance, considers the evidence for ambulatory trauma patients and argues for individual VTE risk assessment rather than treating every plaster cast in the same way.
How should an emergency team respond when a patient refuses treatment after an overdose? This 2012 case discussion explores decision-making capacity, disagreement between clinicians, senior involvement and legal advice, illustrating the complexity of balancing autonomy with potentially life-saving treatment.
Does introducing a risk score genuinely reduce admissions and resource use? This 2012 follow-up appraisal of the Glasgow Blatchford Score examines selection bias, missing follow-up and the lack of a control group, explaining why a promising service evaluation can still leave important questions unanswered.
Could the Glasgow-Blatchford score help identify patients with upper gastrointestinal bleeding who can avoid admission? This 2012 introduction explains the score's purpose and reviews a study that moved from validation to implementation, examining what happened when selected low-risk patients were managed as outpatients.
Practical perspectives on trauma care and team leadership.
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