The TOP-ART trial of Artesunate in the treatment of bleeding trauma patients. This RCT shows no benefit and potential harm, but it may be more complex than that. Further work may be needed on immunomodulation in bleeding trauma patients.
TOP-ART study: Artesunate for bleeding trauma patients Read More
Iain and Simon review the St Emlyn’s blog from June 2023, with a focus on critically ill patients in emergency and prehospital care. The episode includes AMAX4, the PATCH trial and highlights from the Wessex and Intensive Care Society conferences.
Podcast – June 2023 Monthly Round Up Read More
Written during the 2023 ketamine shortage, this appraisal revisits etomidate for induction in critically ill adults. It examines a meta-analysis of randomised trials, the reported mortality signal and limitations in applying pooled results to emergency and prehospital practice.
Etomidate for RSI induction? St Emlyn’s Read More
A discussion of the 2023 joint Royal College statement on emergency contrast CT and renal function. It examines delays while awaiting creatinine results, decisions in life- or limb-threatening situations, and the caveat that a senior decision maker should be involved.
Contrast Induced Nephropathy – sense at last. Read More
Can remifentanil replace neuromuscular blockade for rapid sequence induction? Dan Horner appraises a randomised trial in operating-room patients at risk of aspiration, examining first-attempt intubation without major complications, the non-inferiority design and how the findings translate to emergency care.
Keep on blocking in the free world. Remi vs. NMB for RSI. St Emlyn’s Read More
Can patients have lasting problems after a mild traumatic brain injury despite a normal CT scan? This appraisal examines a prospective cohort study of functional recovery, persistent symptoms and the implications for follow-up, including how the selected population affects interpretation.
Can head-up positioning combined with mechanical CPR and an impedance threshold device improve cardiac arrest outcomes? This 2022 appraisal examines an observational comparison, explaining why differences between cohorts and exploratory analyses limit the conclusions it can support.
A 2022 overview of severe traumatic brain injury, centred on preventing secondary injury before and during specialist transfer. Dan Horner discusses tiered management and unresolved questions about osmotherapy, blood-pressure targets and brain tissue oxygen monitoring.
TBI: The Final Frontier… Read More
