Could etomidate offer an alternative for short paediatric procedures? This 2012 appraisal examines a small prospective cohort, questioning patient selection, the absence of a comparison group and the variability in sedation depth and recovery time behind apparently high procedural success.
What did the 2012 NICE quality standard for childhood meningitis and meningococcal septicaemia mean for emergency departments? This review connects safety-netting, monitoring, timely treatment, senior assessment and transfer arrangements with the practical task of auditing and improving local care.
Journal ClubEvidence-Based Medicine
How quickly does oral dexamethasone improve mild to moderate croup? This 2012 journal club examines a small randomised trial, questioning the clinical importance of early score changes, patient selection and statistical methods, with further teaching on blinding and intention-to-treat analysis.
A prescription only helps if the child can take the medicine. This 2012 discussion considers antibiotic taste, trying a first dose before discharge and a pilot study of mini-tablets, asking how formulation and acceptability influence adherence in paediatric practice.
What is the difference between levobupivacaine and bupivacaine, and does it matter for a child's nerve block? This 2012 discussion explains stereoisomers, examines the evidence behind claims of reduced cardiac toxicity and questions how well adult and animal findings apply to small paediatric doses.
When a child vomits after a head injury, how should that influence the decision to scan or observe? This 2012 discussion compares CHALICE, PECARN and CATCH, focusing on isolated vomiting, differences between study populations and the gap between identifying low risk and managing everyone else.
Practical perspectives on trauma care and team leadership.
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