Simon Carley offers an early emergency department response to the Surviving Sepsis guidance discussed in 2013. He highlights its resuscitation targets, antibiotic priorities and three- and six-hour bundles, while questioning how closely the recommendations reflected evolving practice at the time.
New Surviving Sepsis Guidelines – What’s new? St.Emlyn’s Read More
This response to the 2012 NICE headache guidance considers its relevance to young people and adults presenting to emergency care. The discussion covers diagnostic features, imaging for reassurance, medication-overuse headache and the practical challenges of explaining assessment and treatment choices to patients.
Does introducing a risk score genuinely reduce admissions and resource use? This 2012 follow-up appraisal of the Glasgow Blatchford Score examines selection bias, missing follow-up and the lack of a control group, explaining why a promising service evaluation can still leave important questions unanswered.
Glasgow Blatchford Score 2 – The case for an RCT! Read More
Could the Glasgow-Blatchford score help identify patients with upper gastrointestinal bleeding who can avoid admission? This 2012 introduction explains the score’s purpose and reviews a study that moved from validation to implementation, examining what happened when selected low-risk patients were managed as outpatients.
Glasgow Scores… Not just for coma any more! Read More
Prompted by NICE guidance published in 2012, this discussion asks how emergency departments can improve care for people with painful sickle cell crises. It explores stigma, trust in patients’ accounts of pain, individual care plans and collaboration across the emergency and haematology teams.
Sickle Cell Disease – New Guidance Read More
Should patients in below-knee plaster casts receive heparin to prevent venous thromboembolism? This 2012 reflection examines a published evidence review, contrasting the frequency of detected DVT with rarer serious outcomes and asking how treatment harms and individual risk should influence practice.
Should POPs be mixed with Heparin? Read More
How did NICE’s 2012 DVT guidance balance diagnostic certainty with the services available? Simon Carley discusses Wells scoring, D-dimer testing and ultrasound, focusing on the distinction between proximal and calf thrombosis and the uncertainty surrounding repeat scanning and anticoagulation.
Deep Vein Thrombosis – New NICE guidance Read More
