Resuscitation

Chris Gray’s report from the prehospital day of the 2015 London Trauma Conference brings together air ambulance practice, transport safety and emerging resuscitation techniques. Topics include prehospital ECMO, sepsis, REBOA and the challenge of translating specialist expertise into reliable systems of care.

Natalie May and Iain Beardsell review the opening day of the 2015 London Trauma Conference in this report and podcast. Highlights include older trauma patients, human factors, brain and spinal injury, mass-casualty care and why effective systems matter more than any single intervention.

The EUROTHERM trial tested therapeutic hypothermia for raised intracranial pressure after traumatic brain injury and stopped early after evidence of harm. This 2015 appraisal examines neurological outcomes, trial design and why the timing and position of cooling within an escalation strategy matter when interpreting the results.

What happens to circulation when we give intravenous fluid, and how can we tell whether it has helped? This 2015 physiology review connects Frank–Starling and Guyton models with fluid responsiveness, examining the limitations of routine observations and the role of cardiac output assessment.

Does apnoeic oxygenation reduce desaturation during intubation of critically ill adults? This 2015 appraisal of the FELLOW trial examines its ICU population, oxygen-saturation outcomes and methodological limitations, asking how far the findings can be applied to emergency department airway practice.

The 2015 SPLIT trial compared saline with Plasma-Lyte in intensive care patients. This appraisal explains its crossover design and kidney-injury outcomes, then considers statistical power, fluid given before ICU admission and the limits of applying the results to emergency department patients or other balanced solutions.