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I’ve seen a few paediatric femoral shaft fractures in the last couple of years, and while they always make my spidey-sense tingle for non-accidental injury, most (even the spiral fractures) have been explained away by plausible mechanisms of injury; they are usually late toddling age, have got their feet stuck, twisted and fallen over.

Thanks for a great post, Gareth. If you've landed here without reading that post, hit the link - this is a follow on, a 'deep dive' in the words of Smart EM - to be taken in the context of Gareth's main post.

NICE have recently published new guidance on Upper GI bleeding.