A 2014 discussion of NICE guidance on intravenous fluids in adults, viewed from the emergency department. It explores assessment, prescribing, reassessment and staff training, while questioning how broad hospital guidance translates to the more individual decisions required during resuscitation.
What changes when a clinician joins an online discussion anonymously? Damian Roland reflects on creating a provocative Twitter account for a 2013 conference debate, exploring first impressions, trust, the temptation to speak differently and the unexpected discomfort of maintaining another identity.
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.
Emergency Department Management
A December 2013 update on efforts to address emergency medicine recruitment in the UK. The post points readers to a Health Education England document, an EMJ commentary and a podcast with Cliff Mann, then president of the College of Emergency Medicine.
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.
Do intravenous fluids shorten an emergency department stay for uncomplicated alcohol intoxication? This 2013 journal club reviews a randomised trial, examining its selected patient population, length-of-stay findings and uncertainty, and asks whether an impulse to intervene is supported by evidence.
Practical perspectives on trauma care and team leadership.
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