#FOAMed

Could early prehospital plasma help trauma patients with brain injury? This 2020 review examines a secondary analysis of PAMPer, its apparent survival signal and why post-hoc findings, uncertain mechanisms and unanswered neurological-outcome questions require caution before changing practice.

Could carotid ultrasound make pulse checks more reliable? Natalie May examines a proof-of-concept study using recordings from patients undergoing cardiac surgery, and explains why interpreting those images is a different challenge from obtaining and using them during a real cardiac arrest.

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.

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.