A historical review of the 2016 RCEM guidance on acute behavioural disturbance in the emergency department. The post discusses de-escalation, the risks of restraint, sedation, assessment for underlying illness and early senior involvement when severe agitation accompanies physiological instability.
Managing Acute Behavioural Disturbance Read More
Does hypertonic saline offer better outcomes than mannitol after traumatic brain injury? This 2016 appraisal explores the limited comparative evidence, distinguishes changes in intracranial pressure from outcomes that matter to patients and considers the uncertainty surrounding temporary treatment before definitive care.
JC: Salt or Sugar? Hypertonic saline for head injury at St.Emlyn’s. Read More
When might withdrawal of life-sustaining treatment be considered in the emergency department? Using hypothetical cases and the 2008 UK code of practice, this 2016 discussion explores uncertain prognosis, reversible causes, patient wishes and the need for senior colleagues and families to be involved.
A fictional Robocop trauma case provides the framework for this tour of NICE’s 2016 major-trauma guidance. The post follows care from scene to hospital, discusses areas of controversy and highlights unanswered research questions, with links to the full guidance and an accompanying infographic.
Robocop gets the NICE 2016 major trauma treatment. St.Emlyn’s Read More
An introductory 2015 overview of chemical, biological, radiological and nuclear incidents for emergency clinicians. The post considers recognising unusual presentations, triage, broad patterns of exposure and sources of specialist help, encouraging further preparation rather than presenting itself as a complete incident-management guide.
CBRN: An Introduction. St Emlyn’s Read More
What counts as a normal respiratory or heart rate in a child? This 2015 appraisal examines emergency department centile data, compares published reference ranges and considers how rounded measurements and uneven age groups affect interpretation. It asks how confidently these observations can inform clinical assessment.
JC: Don’t Write off the Respiratory Rate – Part Two Read More
Persistent fast breathing in an otherwise well baby can be difficult to interpret. This 2015 review explores respiratory-rate measurement, clinical context and possible underlying causes, highlighting the importance of reassessment and follow-up when the initial examination or investigations do not explain the finding.
JC: Don’t Write off the Respiratory Rate – Part One Read More
An August 2015 overview of NICE’s draft major trauma guidance during its stakeholder consultation. The post summarises the proposed approach to airway care, bleeding, imaging, analgesia and communication, and explains how clinicians could comment; it records the consultation rather than the final or current guidance.
Major Trauma – Have your say on the NICE guidance for Major Trauma Read More
