Journal Club

Should selected cardiac arrest patients bypass their nearest hospital for a specialist centre? This 2017 review examines a London pilot trial, explaining its narrow patient group and why demonstrating feasibility is different from establishing an improvement in survival.

A sceptical 2017 appraisal of a systematic review of intravenous thrombolysis for acute stroke. The post examines functional outcomes, bleeding and mortality, showing how interpretation of benefits and harms fuels disagreement; it presents the author’s historical critique rather than current treatment guidance.

Does therapeutic hypothermia improve recovery after status epilepticus? This 2017 appraisal examines a randomised trial’s 90-day functional outcomes, questioning its sample-size assumptions, treatment variation and whether a non-significant result was enough to rule out a clinically important benefit.

A 2017 Northern Emergency Medicine conference companion introduces eleven papers on resuscitation, trauma, paediatric asthma and clinician wellbeing. Short appraisals and links to fuller discussions encourage readers to look beyond headline results before deciding what the findings mean for their patients.

Could selected patients with uncomplicated appendicitis receive antibiotics without a hospital admission? This 2016 appraisal examines a small pilot trial, questioning its mixed treatment comparison, restrictive eligibility and what feasibility findings can establish before a larger, more definitive study.

Does low-molecular-weight heparin prevent symptomatic clots after lower-limb casting? This 2016 review of POT-CAST examines a trial that found no statistically significant reduction, while discussing patient selection, low event numbers and the unresolved question of benefit in higher-risk groups.