#FOAMed

What does pooled patient-level evidence from PARAMEDIC3 and IVIO tell us about which vascular access route to try first? Simon Carley examines survival, neurological outcomes and the practical limits of the findings for out-of-hospital cardiac arrest.

Which patients with chest pain actually need a troponin? Rick Body looks at how much we can trust the history, cardiovascular risk factors and our own clinical judgement before deciding to test.

What can teams optimise in shockable cardiac arrest before considering ECPR? This report from The Big Sick explores defibrillation, interruptions to compressions and physiology-guided resuscitation, including the evidence gaps and debate around emerging approaches.

How can the trauma team leader help specialists agree a timely plan for a patient with a significant pelvic fracture? This guide focuses on coordinating resuscitation and bleeding control, resolving competing priorities and planning for deterioration or delay.

Finding one spinal fracture raises the question of injury elsewhere in the spine. This trauma team leader tip discusses the rationale for whole-spine imaging, the roles of CT and MRI, and circumstances that may call for a different approach.

Does early ambulatory ECG monitoring help after unexplained syncope? This review of ASPIRED weighs increased arrhythmia detection and treatment changes against the lack of improvement in recurrent syncope, and explores the practical questions for an emergency care pathway.