Can procalcitonin reliably guide antibiotic decisions in the emergency department? This 2017 review traces the biomarker’s evidence across adults, children and intensive care, explaining why different populations, study questions and uncertain effects on outcomes complicate apparently promising results.
Synthetic cannabinoids can produce unpredictable and severe presentations in the emergency department. This 2017 overview explains their pharmacology, varied effects and uncertain composition, then discusses the difficulties of recognition and management and the role of specialist poisons advice.
Does intubation during in-hospital cardiac arrest improve survival? This 2017 appraisal examines a large US registry study that found an association with poorer outcomes, then considers confounding, missing procedural information and why observational data cannot settle the airway decision.
How well do SOFA, qSOFA and SIRS predict outcomes in patients with suspected infection? This 2017 review examines a large intensive-care database study, highlighting missing data, sensitivity and specificity, and the limits of applying ICU findings to the emergency department.
Anand Swaminathan revisits his SMACCDub argument for considering thrombolysis in selected patients with submassive pulmonary embolism. This 2017 opinion piece weighs possible functional benefits against major bleeding, emphasising patient selection, shared decisions and the uncertainty in the evidence available then.
Moving a critically ill patient from the ED can be a high-risk part of their care. Natalie May and Simon Carley’s podcast notes explore patient preparation, equipment, team selection and handover, with contingency plans for delays, deterioration and airway problems.