A 2014 journal club examines falling severe-sepsis mortality across Australian and New Zealand intensive care units between 2000 and 2012. It asks what improving outcomes might tell us about the whole package of care, while distinguishing historical comparisons from evidence for any single treatment.
An initial response to the 2014 ProCESS trial of protocolised sepsis care. The post asks how changing background care, differences between patient populations and widespread adoption of resuscitation principles might affect the interpretation of a trial that challenged early goal-directed therapy.
How do experienced trauma team leaders know whether they are performing well? This reflection makes the case for peer observation and feedback, describes a practical process using a TEAM assessment sheet, and explores how colleagues can help each other develop beyond formal training.
Should families be offered the chance to be present during brain-death evaluation? This 2013 journal club examines a small randomised study of understanding and psychological wellbeing, while considering participation, loss to follow-up and questions about families’ and clinicians’ experiences that the trial could not resolve.
Does the precordial thump deliver the dramatic benefit its image suggests? This 2013 journal club examines Australian cardiac-arrest registry data, considering rhythm deterioration, the small number of treated patients and the limitations of using observational records to judge an intervention.
What did the original trial comparing temperature targets of 33°C and 36°C after out-of-hospital cardiac arrest establish? This 2013 appraisal explores sample size, uncertainty and the distinction between failing to detect a difference and demonstrating equivalence, placing the debate in its historical research context.
Practical perspectives on trauma care and team leadership.
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