Could serum neurofilament light chain help predict neurological outcomes after out-of-hospital cardiac arrest? Dan Horner’s 2019 appraisal examines an analysis of TTM trial samples, considering promising test performance alongside validation gaps, false predictions and the risks of relying on a biomarker in isolation.
Should adults receive midazolam or haloperidol before ketamine sedation in the ED? This 2019 trial appraisal weighs reduced agitation against longer recovery, examines the study’s size and outcome measures, and asks whether observed behaviour captures what matters to patients.
JC: Should we premedicate for ketamine sedation? St Emlyn’s Read More
This January 2019 update examines the November 2018 changes to the UK Green Book’s tetanus guidance. Chris Gray discusses wound classification, vaccination and immunoglobulin recommendations, then considers the evidence and unanswered questions behind those changes. It is a historical guideline discussion.
New Year, New Tetanus Guideline. St Emlyn’s Read More
How should we interpret survival improvements after changes to UK trauma services? This appraisal examines TARN data from 2008–2017, considering regional trauma networks alongside changing patient populations, case identification and missing data. It also highlights the challenge of recognising serious injury in older people.
Trauma in the UK, who cares? Read More
Can some traumatic pneumothoraces and haemothoraces be managed without a chest drain? This 2018 appraisal examines a UK observational study, including patients receiving positive-pressure ventilation. It considers selection bias, the limits of a single-centre dataset and the importance of monitoring when conservative management is chosen.
JC: Conservative management of chest trauma. St Emlyn’s Read More
Salim Rezaie’s St Emlyn’s Live 2018 presentation explores cognitive offloading during cardiac arrest care. The accompanying notes discuss CPR, vascular access, airway management, medication and PEA assessment, explicitly bringing together published evidence and ideas for consideration. This is a historical presentation rather than an updated resuscitation guideline.
Beyond A(C)LS. Salim Rezaie at #stemlynsLIVE Read More
Why return to whole blood in major trauma? Zaf Qasim reviews the military experience, early civilian studies and practical challenges of introducing a whole-blood programme. This 2018 overview considers compatibility, storage and transfusion risks while acknowledging the limits of the evidence for civilian patients.
Whole Blood in Major Trauma – Everything old is new again Read More
Does early hypothermia improve outcomes after traumatic brain injury? This review of the 2018 POLAR trial examines its patient selection, cooling strategy and six-month neurological outcomes. It discusses the absence of demonstrated benefit in this population and why the findings cannot answer every question about rescue cooling.
JC: Hypothermia in brain injury: The POLAR trial. St Emlyn’s. Read More
