Should patients with restored circulation after cardiac arrest bypass their nearest hospital for a specialist centre? This appraisal of the ARREST trial examines patients without ST elevation, the lack of a survival benefit and the limits of applying London's results elsewhere.
A review of a paper from the European Heart Journal looking at the prehospital use of troponin in patients with low risk chest pain.
A Dutch randomised trial tests extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest. This appraisal examines survival with favourable neurological outcomes, patient selection and delays to treatment, asking how much the result reflects the system delivering ECPR.
What do we actually mean by 'downtime' after cardiac arrest? This discussion examines how a single number can obscure periods of CPR, low flow and restored circulation, and explores clearer ways to communicate the patient's course during handover.
A 2022 appraisal of a randomised trial comparing double sequential, vector-change and standard defibrillation for refractory ventricular fibrillation. It examines survival outcomes, the limitations of a trial stopped early and the practical challenges of introducing alternative defibrillation strategies.
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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