Critical Care

A selection of resuscitation papers discussed at the Big Sick Conference in Zermatt in 2024. These personal appraisals examine airway management, haemorrhage and cardiac arrest, considering the findings, their limitations and the questions still facing clinicians and researchers.

Does a low Glasgow Coma Scale score in acute poisoning always require intubation? This appraisal examines a randomised trial of a conservative airway strategy, focusing on patient selection, criteria for intervention and the importance of assessing the clinical trajectory.

Could selective aortic arch perfusion become a future resuscitation technique? This appraisal examines a feasibility study using perfused human cadavers, explaining the procedure and its limitations. It considers the research and practical questions that remain before clinical use.

How do experienced prehospital clinicians decide when to give blood? This appraisal explores a qualitative study of physicians at two UK air ambulance services, examining the role of experience and uncertainty, and what these decisions can teach us about training and reflection.

How should clinicians decide who needs CT imaging for possible acute aortic syndrome? This appraisal examines the DAShED study's assessment of clinical decision rules and clinician judgement in UK emergency departments, highlighting the uncertainty that remains in this difficult diagnosis.