How strong was the evidence behind major transfusion protocols in trauma? This 2013 journal club examines a systematic review and meta-analysis, exploring before-and-after study bias, variation between protocols and why a statistically inconclusive pooled result may leave an important clinical question unresolved.
Could surgical fixation help patients with flail chest who need ventilatory support? This 2013 journal club examines a small study using historical controls, exploring promising findings alongside selection bias, differences between groups and the need for stronger comparative evidence.
Journal ClubEvidence-Based Medicine
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.
A 2013 journal club examines a randomised trial comparing GlideScope video laryngoscopy with direct laryngoscopy in trauma patients. It considers survival, uncertainty around a small head-injury subgroup and whether results from a specialist trauma centre apply across emergency medicine.
Could cryoprecipitate and tranexamic acid work together to improve trauma outcomes? This 2013 journal club examines observational data from Camp Bastion, highlighting baseline differences, statistical adjustment and the difficulty of transferring findings from a military setting to civilian practice.
Do changes in vital signs predict trauma outcomes better than a single set of observations? This 2013 journal club examines retrospective TARN data, considering shock index and changes in blood pressure, respiratory rate and heart rate, alongside study exclusions and the small number of deaths.
Practical perspectives on trauma care and team leadership.
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