How should an emergency team respond when a patient refuses treatment after an overdose? This 2012 case discussion explores decision-making capacity, disagreement between clinicians, senior involvement and legal advice, illustrating the complexity of balancing autonomy with potentially life-saving treatment.
When was the last time fundoscopy changed your management? Prompted by missed retinal findings in severe hypertension, Simon Carley reflects on declining confidence with direct ophthalmoscopy, alternative ways of examining the fundus and the value of practising and teaching basic clinical skills.
What matters more in a fluid trial: haemodynamic targets or outcomes that matter to patients? This 2012 appraisal of CRYSTMAS examines hydroxyethyl starch versus saline in severe sepsis, questioning the analysis population, clinical relevance of the primary outcome and interpretation of mortality findings.
This archived 2012 invitation from the African Journal of Emergency Medicine sought experienced peer reviewers to support the journal's development. Simon Carley also encouraged established writers and researchers to help colleagues develop their academic work and contribute to emergency medicine scholarship in Africa.
How reassuring are a mild presentation and an initially normal scan after head injury in someone taking warfarin? This 2012 review examines the limitations of decision rules, evidence on delayed bleeding and the uncertainty then surrounding observation and repeat imaging.
What did the 2012 NICE quality standard for childhood meningitis and meningococcal septicaemia mean for emergency departments? This review connects safety-netting, monitoring, timely treatment, senior assessment and transfer arrangements with the practical task of auditing and improving local care.
Practical perspectives on trauma care and team leadership.
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