Evidence-Based Medicine

A rapid review of selected paediatric emergency medicine papers from 2015, presented at the Irish Association of Emergency Medicine conference. Natalie May examines research on trauma assessment, serious infection, cardiac arrest, bronchiolitis and procedural anxiety, highlighting limitations as well as possible implications for practice.

Does apnoeic oxygenation reduce desaturation during intubation of critically ill adults? This 2015 appraisal of the FELLOW trial examines its ICU population, oxygen-saturation outcomes and methodological limitations, asking how far the findings can be applied to emergency department airway practice.

What are the thromboembolic risks when prothrombin complex concentrate is used to reverse warfarin-associated intracranial bleeding? This 2015 appraisal examines a retrospective study, the importance of previous venous thromboembolism and the limitations of drawing conclusions from a different reversal regimen and clinical setting.

How can emergency clinicians keep up with the literature without being overwhelmed? Natalie May compares journal clubs, alerts, RSS feeds, online appraisals and social media in this 2015 overview, weighing the effort, access and critical appraisal involved in building a personal approach.

Does helping someone out of a car reduce cervical spine movement compared with self-extrication? This 2015 appraisal examines a small biomechanical study of six techniques, while emphasising that uninjured volunteers cannot establish which approach is safest for patients with pain or spinal injury.

The 2015 REVERT trial compared a modified Valsalva manoeuvre with the standard technique in adults with stable supraventricular tachycardia. This appraisal examines conversion to sinus rhythm, the need for further treatment and practical questions about applying the findings in the emergency department.