#FOAMed

Should selected cardiac arrest patients bypass their nearest hospital for a specialist centre? This 2017 review examines a London pilot trial, explaining its narrow patient group and why demonstrating feasibility is different from establishing an improvement in survival.

How should emergency medicine education change when information is instantly available and learning crosses borders? This 2017 talk companion challenges fact-recall assessments, explores personal learning networks and argues that online engagement must be accompanied by critical appraisal skills.

A sceptical 2017 appraisal of a systematic review of intravenous thrombolysis for acute stroke. The post examines functional outcomes, bleeding and mortality, showing how interpretation of benefits and harms fuels disagreement; it presents the author’s historical critique rather than current treatment guidance.

Small interpersonal habits matter when teams work under pressure. In the second Sydney HEMS reflection, Natalie May explores introductions, shared plans, checklists, fatigue and learning from mistakes, showing how everyday communication can support colleagues during demanding retrieval work.

What does critical illness feel like to a child? Eimear and her mother Rachel share their experience in a smaccMINI conversation, with written takeaways about fear, clear explanations, the ICU environment and preparing patients and families for recovery and discharge.

Can emergency medicine remain a broad specialty as clinical practice becomes more specialised? Reflecting on his SMACCDub debate with Scott Weingart, Simon Carley examines generalism, critical-care skills and the risk that subspecialisation fragments the team’s ability to care for undifferentiated patients.