Journal Club

Should a displaced ankle fracture be X-rayed before reduction? This 2013 journal club challenges the conclusions of a retrospective study, exploring differences between patient groups, missing documentation and the limitations of repeat manipulation as an outcome before accepting a proposed change in practice.

Could surgical fixation help patients with flail chest who need ventilatory support? This 2013 journal club examines a small study using historical controls, exploring promising findings alongside selection bias, differences between groups and the need for stronger comparative evidence.

Can one CT scan reliably investigate coronary artery disease, pulmonary embolism and aortic dissection in patients with chest pain? This 2013 review of triple rule-out CT examines diagnostic accuracy, patient selection and reference standards, asking whether the evidence establishes a meaningful benefit for emergency patients.

How safe is propofol sedation when delivered by emergency physicians? This 2013 journal club reviews a single-centre audit of 1,008 cases, distinguishing transient adverse events from lasting harm and considering how training, supervision and patient selection affect the relevance of its findings elsewhere.

Does prehospital fluid resuscitation improve survival after trauma? This 2013 journal club challenges the interpretation of an observational study, examining the difference between its headline, unadjusted mortality figures and adjusted analysis, alongside selection bias and uncertainty from a small sample.

Could nebulised hypertonic saline prevent admission for infants with bronchiolitis? This 2013 journal club examines a Cochrane review, separating findings in hospitalised children from the smaller emergency and outpatient studies, and highlighting the uncertainty around admission avoidance.