Category: Journal Club

Musings form the evidence based journal club at St Emlyns

The MACS Rule: Immediate ‘rule in’ and ‘rule out’ for suspected cardiac chest pain

This post is about a paper we published today in Heart – the result of more than 9 years of work – phew! Here’s a link to the paper (open access), which reports how we

JC: Duel of the Rules: Which decision rule for head injury in children?

Ladies and Gentlemen! The assessment and investigation of paediatric head injury is a case study in clinical risk management. Similar to chest pain in grown up medicine, it’s a frequent presentation, with a rare but

JC. ROTEM for ED coagulopathy detection. St.Emlyn’s

Coagulopathy is well known to be a significant issue in the ED. There is increasing awareness that the early awareness, detection and management of coagulation problems is important for ED management, but it’s tricky. Laboratory

JC: Rapid update on the resus pearls of 2013. St.Emlyn’s

Two papers on the prepublication list at the Resuscitation Journal. The first is open access (#FOAMed), and both are worth a read. There are some great resus pearls in here. Paper 1 covers highlights in

JC: What has an awesome NNT of 5.8 for severe sepsis? St.Emlyn’s

Last week we saw the publication of the ProCESS study suggesting that protocolised treatment of sepsis makes little difference to outcome. A little earlier we heard that cooling to 33C vs 36C may not make

JC: Should we halve the time of acetylcysteine infusions for Paracetamol OD? St.Emlyn’s

The week’s Lancet has a great paper on the management of paracetamol overdose. A subject close to our heart at St.Emlyn’s following the recent changes to UK guidelines that have led far more people in

JC: Updated NICE Head Injury Guidelines – Worth a Scan?

In the last few days Twitter has been buzzing (does twitter buzz? Or does it chirp? Tweet?) with EM practitioners getting to grips with the latest iteration of the NICE Head Injury Clinical Guideline, updated

JC. ACS: Antiplatelets ACCOAST-ed?

Most people I talk to who work in Emergency or Acute Medicine hate chest pain.  Personally I think they’re crazy but I can see where they’re coming from.  Chest pain is the most common reason

SMACCGold EBM workshop with St.Emlyns and Critical Care Reviews

With just 9 weeks to go there is still time to register for the Evidence Based Medicine workshop on the Gold Coast. Rob Sweeney, Rick Body and myself will be taking a half day to

JC: BestBets checklists for critical appraisal. St.Emlyn’s

Critical appraisal is a core skill for all emergency physicians. You must stay up to date with the literature…, but there is just SO much of it. What should you believe and what should you


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