Resuscitation

The opening day of the Intensive Care Society’s 2018 meeting covered sepsis, moral injury and the response to the Salisbury Novichok incident. This report also follows discussions of delirium, extubation and frailty, including how patients’ goals can shape decisions about critical care.

Can some traumatic pneumothoraces and haemothoraces be managed without a chest drain? This 2018 appraisal examines a UK observational study, including patients receiving positive-pressure ventilation. It considers selection bias, the limits of a single-centre dataset and the importance of monitoring when conservative management is chosen.

Salim Rezaie’s St Emlyn’s Live 2018 presentation explores cognitive offloading during cardiac arrest care. The accompanying notes discuss CPR, vascular access, airway management, medication and PEA assessment, explicitly bringing together published evidence and ideas for consideration. This is a historical presentation rather than an updated resuscitation guideline.

The October 2018 podcast roundup revisits a month of learning and reflection at St Emlyn’s. Its written reading guide links discussions of cricoid pressure, resuscitation, teaching in pressured settings and the pursuit of excellence, alongside FemInEM conference reflections and a personal account of PTSD and therapy.

Why return to whole blood in major trauma? Zaf Qasim reviews the military experience, early civilian studies and practical challenges of introducing a whole-blood programme. This 2018 overview considers compatibility, storage and transfusion risks while acknowledging the limits of the evidence for civilian patients.

Does early hypothermia improve outcomes after traumatic brain injury? This review of the 2018 POLAR trial examines its patient selection, cooling strategy and six-month neurological outcomes. It discusses the absence of demonstrated benefit in this population and why the findings cannot answer every question about rescue cooling.