This January 2019 update examines the November 2018 changes to the UK Green Book’s tetanus guidance. Chris Gray discusses wound classification, vaccination and immunoglobulin recommendations, then considers the evidence and unanswered questions behind those changes. It is a historical guideline discussion.
Must a new year begin with a plan to reinvent yourself? Liz Crowe reflects on resolutions, motivation and wellbeing, exploring small achievable changes, self-compassion and gratitude. Her account challenges all-or-nothing thinking and asks whether our goals reflect what we actually value.
The St Emlyn’s team looks back on 2018 through changes in clinical practice, memorable research, books, blogs and podcasts. Alongside personal highlights and experiences, contributors share what they learned and the people and ideas they were watching as 2019 began.
Journal ClubEvidence-Based Medicine
How should we interpret survival improvements after changes to UK trauma services? This appraisal examines TARN data from 2008–2017, considering regional trauma networks alongside changing patient populations, case identification and missing data. It also highlights the challenge of recognising serious injury in older people.
Catch up with St Emlyn’s in the December 2018 podcast roundup. The accompanying reading links cover teamwork across specialty boundaries, clinical handover, chest trauma and HIV, alongside reports from the Intensive Care Society meeting and the FemInEM Ideas Exchange.
Why did mortality remain so high among hypotensive patients needing emergency trauma laparotomy? Rich Carden’s 2018 discussion examines earlier studies, delays to surgery and damage control care, then explains the need for more detailed data and the planned TELA audit.
Practical perspectives on trauma care and team leadership.
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