Rich Carden reviews a cohort study linking post-intubation hypotension with 30-day mortality in severe traumatic brain injury. The appraisal considers what the association means for prehospital anaesthesia and how far observational findings can guide practice.
Can salbutamol relieve pain in renal colic? We review a phase II randomised controlled trial exploring intravenous salbutamol as an adjunct analgesic in the emergency department.
Twenty-one years of London’s Air Ambulance data offer a closer look at prehospital resuscitative thoracotomy. This appraisal examines survival, timing and the distinction between tamponade and exsanguination, alongside the limits of applying an observational study from a mature urban service elsewhere.
The Sub30 study tested whether a London prehospital team could establish extracorporeal CPR within 30 minutes of cardiac arrest. This appraisal examines the logistical lessons, the small patient group and the distinction between demonstrating feasibility and showing a survival benefit.
Does starting with anterior-posterior rather than anterior-lateral pads improve cardiac arrest outcomes? This appraisal examines an observational study in out-of-hospital VF or pulseless VT, distinguishing return of spontaneous circulation from longer-term survival and considering the biases that prevent a firm change in practice.
Tom Roberts and Dan Horner discuss the SHED study of adults presenting with acute headache. The article and podcast examine CT timing, the Ottawa SAH rule and lumbar puncture, including why observational evidence and the distinction between aneurysmal and non-aneurysmal bleeding matter when considering changes to practice.
Practical perspectives on trauma care and team leadership.
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