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This trauma team leader guide discusses ketamine for analgesia, procedural sedation and delayed sequence induction. It covers monitoring, dose adjustment and the importance of matching its use to the patient and the team's airway expertise.

Does adding REBOA to advanced life support improve outcomes in non-traumatic out-of-hospital cardiac arrest? This appraisal of REBOARREST examines the neutral trial results, delays to aortic occlusion and incomplete delivery of the intervention, and asks what remains uncertain.

A case series from southern Gaza describes pericardiocentesis, drainage and intrapericardial tranexamic acid in 25 patients with penetrating cardiac tamponade. We examine the findings and their relevance to settings where emergency thoracotomy is unavailable, recognising the limits of this small study.

Does prehospital whole blood improve outcomes compared with blood components in traumatic haemorrhage? We critically appraise the SWiFT randomised trial, including its findings on death or massive transfusion within 24 hours and the limits of testing a prehospital-only intervention.

Harriet Tucker discusses damage control prehospital care at Trauma 2030: recognising patients who need surgical haemorrhage control, limiting delays on scene and moving selected interventions into the ambulance. The conversation also covers the governance and teamwork needed to support this approach.

Advice on planning for trauma in Trauma Units. How does it differ to MTCs? James, Rory and John take us through some tips and ideas.

Rich Carden reviews a cohort study linking post-intubation hypotension with 30-day mortality in severe traumatic brain injury. The appraisal considers what the association means for prehospital anaesthesia and how far observational findings can guide practice.

The FiiRST-2 randomised trial compared fibrinogen and prothrombin complex concentrate with plasma in trauma patients needing massive transfusion. No significant benefit was found.

How should we assess children with one or two positive PECARN abdominal trauma criteria? This appraisal examines a secondary analysis of the prediction rule, the different risks associated with individual findings and the continuing role of clinical judgement and repeated assessment.

A collection of trauma and resuscitation papers discussed at ICEM 2025 in Montreal, with summaries and critical appraisal. Topics include transfusion, oxygen strategies, paediatric cervical spine assessment, regional analgesia and emergency airway management.