PECARN, CHALICE or CATCH: how should we compare decision rules for children with head injuries? This 2014 journal club examines a prospective comparison, weighing sensitivity against specificity and exploring how sample size, confidence intervals and the handling of observation affect the apparent winner.
JC: Duel of the Rules: Which decision rule for head injury in children? Read More
How well do prehospital triage tools identify major trauma in children? This 2014 journal club examines a PERUKI study, exploring over-triage, the uncertainty created by very few seriously injured patients, and the problem of testing ambulance tools in children who arrived without an ambulance.
JC: Paediatric Major Trauma Triage Read More
Could ROTEM help identify coagulation problems beyond trauma patients in the resuscitation room? This 2014 journal club reviews a small study in hypovolaemic shock, examining recruitment difficulties, the distinction between correlation and agreement, and the limits of an early proof-of-concept study.
JC. ROTEM for ED coagulopathy detection. St.Emlyn’s Read More
A short reading guide to two reviews of resuscitation research from 2013. The linked papers cover topics ranging from cardiac arrest prevention, basic life support and education to advanced life support, post-resuscitation care, prognostication and cardiac arrest centres.
JC: Rapid update on the resus pearls of 2013. St.Emlyn’s Read More
A 2014 journal club examines falling severe-sepsis mortality across Australian and New Zealand intensive care units between 2000 and 2012. It asks what improving outcomes might tell us about the whole package of care, while distinguishing historical comparisons from evidence for any single treatment.
JC: What has an awesome NNT of 5.8 for severe sepsis? St.Emlyn’s Read More
An initial response to the 2014 ProCESS trial of protocolised sepsis care. The post asks how changing background care, differences between patient populations and widespread adoption of resuscitation principles might affect the interpretation of a trial that challenged early goal-directed therapy.
JC: Is Early Goal Directed Therapy dead? St.Emlyn’s Read More
Could a shorter acetylcysteine infusion make treatment for paracetamol poisoning easier to tolerate? This 2014 journal club examines a randomised trial of an accelerated regimen, separating findings about nausea and infusion reactions from the larger question of effectiveness in preventing serious liver injury.
JC: Should we halve the time of acetylcysteine infusions for Paracetamol OD? St.Emlyn’s Read More
A contemporary review of NICE’s January 2014 head-injury guideline, CG176. The post explores what changed for emergency clinicians, including CT decisions in adults and children, anticoagulation, cervical spine imaging and discharge information, while discussing the evidence and uncertainties behind the recommendations.
JC: Updated NICE Head Injury Guidelines – Worth a Scan? Read More
