A September 2020 appraisal of REMAP-CAP's hydrocortisone results in critically ill patients with COVID-19. Dan Horner and Simon Carley explain adaptive trials, Bayesian analysis and organ support outcomes, weighing the findings against early stopping, treatment crossover and the wider corticosteroid evidence.
An emergency medicine overview of GBL intoxication in the context of chemsex. Gareth Roberts discusses recognition, respiratory depression, co-ingestion and the challenges of airway management, alongside the need to consider consent, safeguarding and sexual health support as patients recover.
Does combining vitamin C, hydrocortisone and thiamine improve outcomes in septic shock? This 2020 appraisal of ACTS examines its organ dysfunction endpoint, the lack of a demonstrated benefit and how patient selection and treatment in the control group affect interpretation.
A selection of COVID-19 papers reviewed for emergency clinicians in August 2020. The Leicester team examines aerosol transmission, CPAP, surgical and cardiac complications, thromboprophylaxis, staff mental health and frailty, distinguishing early signals and expert consensus from stronger evidence.
A personal reflection of one Clinical Director of an Emergency Department, discussing the lure of leadership and some of its potential perils
Journal ClubEvidence-Based Medicine
An August 2020 appraisal of hydroxychloroquine after household or occupational exposure to COVID-19. It examines a placebo-controlled trial's lack of a clear benefit, adverse effects and the uncertainty introduced by remote recruitment and outcomes based largely on self-reported symptoms.
Practical perspectives on trauma care and team leadership.
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