Major Trauma

Does a 2 g TXA bolus differ from a 1 g bolus followed by a 1 g infusion in traumatic brain injury? This appraisal examines a subgroup analysis of patients with CT-confirmed bleeding, separating its mortality and neurological findings from the limits of post hoc evidence.

This PREMIER 2024 podcast follows the prehospital care of a child with traumatic brain injury, from the initial ambulance response to arrival at a major trauma centre. The case explores neuroprotection, coordination between teams and the practical decisions behind transport by road or air.

How feasible is a definitive trial of lidocaine patches for older patients with rib fractures? This appraisal examines recruitment, treatment crossover and follow-up in a randomised feasibility study, explaining why its clinical findings cannot establish whether patches improve pain or recovery.

A London Air Ambulance cohort study explores partial REBOA for trauma patients with life-threatening bleeding and recent or imminent cardiac arrest. This appraisal considers feasibility, survival and patient selection, alongside the limits of a small observational study and the training and systems needed to deliver the technique.

Review of an RCT of serratus anterior plane blocks in the emergency department for chest/rib injury. Is this now a standard of care?

Could selective aortic arch perfusion become a future resuscitation technique? This appraisal examines a feasibility study using perfused human cadavers, explaining the procedure and its limitations. It considers the research and practical questions that remain before clinical use.