Musings form the evidence based journal club at St Emlyns
Category: Journal Club
JC: Convalescent plasma in COVID 19 patients.
This month the BMJ has published a trial on the use of convalescent plasma in the treatment of admitted patients with COVID-19 (the PLACID trial). Convalescent plasma therapy basically takes plasma, together with antibodies from …
JC: Spot the Difference, what can we do about petechiae? St Emlyn’s
Back in 2013, I wrote a post here on petechiae in well kids; it received a phenomenal number of views for reasons I don’t quite understand (I think it ended up as a link somewhere …
JC: Early plasma use in traumatic brain injury. St Emlyn’s
There seems to be a lot of really interesting papers on Traumatic Brain Injury (TBI) this year. A welcome relief from COVID 19 perhaps but also a reminder that other pathologies exist and that TBI …
JC: Finger on the Pulse?
If you’re an avid follower of FOAM, you’ll have seen many assertions that manual pulse checks by healthcare providers during cardiac arrest are pretty unreliable at best. The most commonly advocated alternatives are EtCO2 increase …
JC: Should we rubber STAAMP prehospital TXA?
This post is co-published with our friends at REBEL EM. Background: It almost seems that when it comes to the use of the antifibrinolytic agent tranexamic acid (TXA) in trauma, one argument has just been …
JC: Hydroxychloroquine in the the treatment of hospitalised COVID19 patients.
We previously covered the RECOVERY trial press release on the use of HCQ for hospitalised patients with COVID19. This is a UK based platform trial (more on this later) looking at patients admitted to hospital …
JC: Antibiotics or Surgery for appendicitis.
Appendicitis is a common problem in the emergency department, and for many years the standard of care has been to perform surgery to resolve it. When I trained in surgery (before transferring to EM) this …
JC: Can we give tranexamic acid (TXA) via the IM route? St Emlyn’s
Tranexamic Acid (TXA) is a mainstay of trauma management. CRASH 2 (2) demonstrated its effectiveness in bleeding patients and CRASH 3 (1,5) (in my opinion) showed that we should also be using it in mild/moderate …
JC: ISARIC. Possibly The Best COVID-19 Risk Prediction Tool To Date
Has your department been relying on clinical gestalt to risk stratify patients, perhaps using something you heard or read about in a short paper (perhaps Twitter), maybe something like post-exertional oxygenation has caught your eye, …
JC: TXA in severe head injury. St Emlyn’s
Our post on the CRASH-3 trial, an RCT examining the use of TXA in head injury, was arguably our most controversial of 2019 (1). Our view was that the evidence was not entirely definitive, but …