Does cooling during cardiac arrest improve outcomes, or simply lower temperature? This 2014 appraisal examines a small randomised trial of intra-arrest hypothermia, questioning patient selection, statistical power and surrogate outcomes, while separating the cooling headlines around London’s ‘cool car’ from its broader package of advanced resuscitation care.
JC: Getting Chilly Quickly 3. Hypothermia at St.Emlyn’s Read More
Should ultrasound or CT be the first investigation for suspected renal colic? This 2014 appraisal examines a trial comparing emergency physician ultrasound, radiologist ultrasound and CT, focusing on patient outcomes, missed diagnoses, cumulative radiation and the need for additional imaging after the initial test.
JC: Should USS be first investigation for renal colic? St.Emlyn’s Read More
Does a lack of evidence for benefit mean paramedic trauma training does not work? This 2014 critique of a Cochrane review examines its small, dated and methodologically limited evidence base, distinguishing uncertainty about educational interventions from a justification for withdrawing investment in training.
JC: Is there any point teaching paramedics? St.Emlyn’s Read More
Can CT measurements identify which older patients with acute subdural haematoma need neurosurgical referral? This 2014 journal club examines a proposed decision tool, questioning selection bias, measurement reliability and how a ‘surgical’ bleed was defined, and explaining why promising retrospective findings still need validation.
JC: When a subdural needs surgery in the elderly. St. Emlyn’s Read More
An introduction to planning sample size and understanding statistical power, linking effect size, precision and the risks of false positive and false negative results. Worked examples cover continuous outcomes, proportions and diagnostic accuracy studies, helping readers understand the assumptions behind calculations and ask better questions about research.
An introduction to sample size calculations. St.Emlyn’s Read More
Could bedside ultrasound improve the assessment of patients with acute breathlessness? This 2014 journal club examines a randomised trial, separating improved diagnostic accuracy from evidence of better patient outcomes and considering how patient selection and reliance on a single ultrasound operator limit the findings.
JC: POCUS for the breathless patient. St.Emlyn’s Read More
How should a department prepare for the rare child who needs massive transfusion after trauma? This 2014 journal club examines a small retrospective series, discussing coagulopathy, the limitations of sparse evidence and the importance of planning, shared protocols and simulation for infrequent but time-critical events.
JC: Paediatric massive transfusion. St.Emlyn’s Read More
What happens when later research overturns an established medical practice? This 2014 journal club examines a decade of medical reversals reported in one major journal, considering publication bias, the limits of that sample and the need to question both new treatments and familiar clinical beliefs.
JC: A decade of reversal: an analysis of 146 contradicted medical practices. Read More
