Major Trauma

Can CT measurements identify which older patients with acute subdural haematoma need neurosurgical referral? This 2014 journal club examines a proposed decision tool, questioning selection bias, measurement reliability and how a ‘surgical’ bleed was defined, and explaining why promising retrospective findings still need validation.

A 2014 podcast introduction on trauma team leadership and the challenge of moving patients from ED arrival to CT within 30 minutes. The post places that goal alongside UK trauma standards of the time and includes a trauma transfer checklist to support the discussion.

How common is pituitary dysfunction after serious head injury, and what should clinicians do about it? This 2014 journal club reviews a meta-analysis of patients requiring critical care, distinguishing evidence of endocrine abnormalities from unanswered questions about screening, treatment and outcomes.

PECARN, CHALICE or CATCH: how should we compare decision rules for children with head injuries? This 2014 journal club examines a prospective comparison, weighing sensitivity against specificity and exploring how sample size, confidence intervals and the handling of observation affect the apparent winner.

A contemporary review of NICE’s January 2014 head-injury guideline, CG176. The post explores what changed for emergency clinicians, including CT decisions in adults and children, anticoagulation, cervical spine imaging and discharge information, while discussing the evidence and uncertainties behind the recommendations.