Journal ClubEvidence-Based Medicine
Could vitamin C, thiamine and steroids transform sepsis care? This 2017 appraisal interrogates a striking before-and-after study, exploring confounding, retrospective data and the risks of adopting an unproven treatment before reliable evidence of benefit and harm is available.
A selection of trauma papers from 2016–17 explores whole-body CT, traumatic brain injury, coagulopathy, cardiac arrest and airway care. This Trauma Care conference companion weighs findings against study limitations and asks which results might meaningfully change emergency practice.
Does intubation during in-hospital cardiac arrest improve survival? This 2017 appraisal examines a large US registry study that found an association with poorer outcomes, then considers confounding, missing procedural information and why observational data cannot settle the airway decision.
Emergency Department Management
Could consultants gain more control over their working hours while maintaining department cover? Craig Ferguson explains how annualised hours and self-rostering work together in a shared spreadsheet, describing the flexibility achieved, the safeguards needed and the practical problems encountered.
How well do SOFA, qSOFA and SIRS predict outcomes in patients with suspected infection? This 2017 review examines a large intensive-care database study, highlighting missing data, sensitivity and specificity, and the limits of applying ICU findings to the emergency department.
Does diazepam add anything to naproxen for acute low back pain? This 2017 trial appraisal examines the lack of additional benefit in a selected group without radicular symptoms, alongside questions about blinding, follow-up and how well the results fit everyday ED patients.
Practical perspectives on trauma care and team leadership.
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