Why does calcium matter in traumatic haemorrhage and major transfusion? Iain Beardsell reviews two papers on hypocalcaemia, discusses the proposed ‘lethal diamond’ and considers earlier calcium replacement, while acknowledging the limited direct evidence behind this 2021 argument for practice change.
Hypocalcaemia, Trauma and Major Transfusion. St Emlyn’s Read More
A September 2020 appraisal of the ISARIC 4C mortality score for hospitalised patients with COVID-19. It explains model development and internal validation, then examines methodological concerns, access to required tests and the limits of applying a UK inpatient score in other settings.
JC: ISARIC. Possibly The Best COVID-19 Risk Prediction Tool To Date Read More
Does prehospital tranexamic acid improve neurological recovery after moderate or severe head injury? This September 2020 trial appraisal examines the absence of a clear primary-outcome benefit, missing follow-up data, injury severity and how the findings compare with CRASH-3.
JC: TXA in severe head injury. St Emlyn’s Read More
A selection of COVID-19 papers reviewed for emergency clinicians in August 2020. The Leicester team examines aerosol transmission, CPAP, surgical and cardiac complications, thromboprophylaxis, staff mental health and frailty, distinguishing early signals and expert consensus from stronger evidence.
Covid-19 Journal Club: The Director’s Cut #6 Read More
An August 2020 appraisal of hydroxychloroquine after household or occupational exposure to COVID-19. It examines a placebo-controlled trial’s lack of a clear benefit, adverse effects and the uncertainty introduced by remote recruitment and outcomes based largely on self-reported symptoms.
JC: Does post exposure prophylaxis (with HCQ) work in Covid-19? Read More
A 2020 appraisal of intravenous haloperidol for acute benign headache. The review considers pain relief, adverse effects and patient selection, asking whether a placebo-controlled trial can tell us enough when the useful clinical comparison would be with usual headache treatment.
JC: Haloperidol for Headaches. St Emlyn’s Read More
A critical tour of trauma research from 2019–20, covering tranexamic acid in head injury, plasma and whole blood, hypocalcaemia and prehospital care. Simon Carley weighs trial findings against the limits of observational evidence, with an additional look at the Zero Point Survey.
Top trauma papers of 2019-2020. St Emlyn’s Read More
A June 2020 appraisal of the RECOVERY dexamethasone preprint in hospitalised patients with COVID-19. The review examines mortality findings in patients receiving oxygen or ventilation, recruitment and generalisability, and the difficulties of assessing important research first announced through a press release.
Dexamethasone, COVID-19 and the RECOVERY trial. St Emlyn’s Read More
