Emergency Medicine

What does STAAMP add to the evidence for prehospital tranexamic acid after trauma? This 2020 appraisal examines the lack of a clear overall mortality benefit, recruitment and power limitations, safety findings and the caution needed when interpreting encouraging timing, shock and dosing subgroups.

Can TEG or ROTEM improve outcomes when added to major haemorrhage care? Natalie May reviews the iTACTIC trial's comparison with conventional coagulation testing, separating faster treatment decisions from demonstrated patient benefit and examining the limits of its size and subgroup findings.

Iain and Simon review September 2020 on the blog, including REMAP-CAP, tranexamic acid in head injury and the ISARIC COVID-19 risk tool. They also reflect on the situation in northern England, the virtual RCEM conference and resources for teaching Bayesian thinking.

Dan Horner revisits the evidence on venous thromboembolism in COVID-19 as it stood in October 2020. The review examines how screening and case selection affect reported clot rates, the distinction between different thrombotic findings, and uncertainty around risk prediction and higher-dose anticoagulation.

An October 2020 appraisal of RECOVERY's hydroxychloroquine results in hospitalised patients with COVID-19. It reviews the lack of demonstrated benefit, concerns about harm and the arguments about timing and dosage, alongside an explanation of how the platform trial was organised.

Can antibiotics offer an alternative to surgery for selected adults with appendicitis? This 2020 trial appraisal weighs short-term health status against subsequent operations, recurrence and the limits of follow-up, explaining why the choice needs a more nuanced conversation than a simple yes or no.