Research

Rick Body discusses a 2014 study of emergency physicians’ judgement in suspected acute coronary syndromes. He explores the limitations of clinical judgement alone, the potential contribution of ECG and troponin results, and why promising findings still required validation before being used as a discharge strategy.

Louise Cullen introduces her SMACC Gold talk on how research is produced, analysed and reported. Reflecting on changes in her own approach to new evidence, she discusses the traps in interpreting published findings and the importance of critical appraisal before changing clinical practice.

Does improving an acid–base measurement demonstrate that a resuscitation fluid is better for patients? This 2014 journal club examines a small trial comparing Plasma-Lyte with saline in major trauma, exploring surrogate outcomes, fluid volumes and why the findings could not establish a benefit in patient-centred outcomes.

A short reading guide to two reviews of resuscitation research from 2013. The linked papers cover topics ranging from cardiac arrest prevention, basic life support and education to advanced life support, post-resuscitation care, prognostication and cardiac arrest centres.

Does giving prasugrel before angiography help patients with non-ST-elevation acute coronary syndromes? This 2014 appraisal of ACCOAST examines the balance between ischaemic outcomes and major bleeding, alongside patient selection, the composite endpoint and the limits of applying the findings more widely.

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.