A first look at the 65 trial as presented at Critical Care Reviews 2020. The review examines lower blood-pressure targets in older intensive care patients with vasodilatory hypotension, reduced vasopressor exposure and uncertainty around mortality, with a discussion of interpretation beyond statistical significance.
JC: The 65 trial. Targeting MAP in sepsis. St Emlyn's at #CCR20 Read More
How do intranasal ketamine and fentanyl compare for children with painful limb injuries? This appraisal examines a small randomised trial reporting similar pain relief but more minor adverse events with ketamine, alongside concerns about sample size, trial design and applicability across different clinical settings.
JC: IN Fentanyl vs Ketamine for analgesia in PED. St Emlyn’s Read More
Should severely injured patients receive an early vena cava filter when anticoagulant thromboprophylaxis is initially unsuitable? Dan Horner examines a 2019 randomised trial, weighing its main outcome, subgroup findings and potential harms before considering what it means for trauma care.
Clot’s the Problem? Vena Cava filters in trauma patients. St Emlyn’s Read More
Appraisal and reflections on the recently published ConSEPT and EcLiPSE trials – what do they mean for the treatment of paediatric status epilepticus?
JC: Enter Sandman – Which Agent as Second Line in Paediatric Status Epilepticus? Read More
Can capillary refill time guide resuscitation as effectively as lactate measurements in septic shock? Dan Horner appraises the 2019 ANDROMEDA-SHOCK trial, examining its mortality results, sample size and potential bias, alongside the value of repeated clinical assessment.
JC: The beauty of simplicity. ANDROMEDA-SHOCK St Emlyn’s Read More
Does a trauma registry study justify abandoning REBOA? Zaf Qasim examines a 2019 comparison with standard care, considering reported mortality and complications, patient selection, missing procedural details and delays to definitive treatment before drawing conclusions about the technique.
JC: Time to put the REBOA balloon away? Maybe, maybe not… Read More
Why do some bleeding trauma patients die after surviving the initial resuscitation? This 2019 discussion of an editorial by Karim Brohi and John Holcomb examines changing patterns of mortality, possible mechanisms of later deaths and the need to consider the whole trauma system.
JC: Why do bleeding trauma patients die? St Emlyn’s Read More
Can helicopter emergency medical services improve survival after traumatic cardiac arrest? This 2019 appraisal examines a retrospective UK cohort, distinguishing procedures and return of circulation from survival to hospital discharge, and questioning what a small, uncontrolled dataset can tell us about benefit.
JC: Can HEMS improve patient outcome in Traumatic Cardiac Arrest? St Emlyn’s Read More
