Does early ambulatory ECG monitoring help after unexplained syncope? This review of ASPIRED weighs increased arrhythmia detection and treatment changes against the lack of improvement in recurrent syncope, and explores the practical questions for an emergency care pathway.
ASPIRED: Ambulatory ECG Monitoring After Unexplained Syncope Read More
Does a 2 g TXA bolus differ from a 1 g bolus followed by a 1 g infusion in traumatic brain injury? This appraisal examines a subgroup analysis of patients with CT-confirmed bleeding, separating its mortality and neurological findings from the limits of post hoc evidence.
2g or 1+1g Tranexamic Acid (TXA) in traumatic brain injury? Read More
Is persistent ventricular fibrillation the same as a rhythm that returns after a successful shock? This appraisal examines a secondary analysis of DOSE-VF, comparing outcomes in shock-refractory and recurrent VF and considering the implications for defibrillation strategy.
Does the outcome from refractory VF differ from recurrent VF in DOSE-VF patients? Read More
Can newer CT scanners reliably exclude subarachnoid haemorrhage beyond six hours? This 2021 appraisal examines a retrospective study, focusing on patient selection, uncertain symptom timings and why cumulative sensitivity figures may not answer the emergency clinician’s question.
Are CT scanners getting more sensitive at detecting Subarachnoid haemorrhage? Read More
A June 2021 review of early RECOVERY results for casirivimab and imdevimab in hospitalised COVID-19 patients. It explains the reported mortality benefit in patients without detectable antibodies, why that finding did not extend to the whole trial population, and the preliminary evidence available then.
REGN monoclonal antibodies work in selected hospitalised COVID-19 patients. St Emlyn’s Read More
A June 2021 look at the first RECOVERY results for aspirin in hospitalised COVID-19 patients. The review considers the absence of a demonstrated mortality benefit, the balance between bleeding and thrombotic events, and the limits of the early results.
JC: Aspirin is not effective for hospitalised COVID19 patients. St Emlyn’s Read More
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
Sam Fitzsimmons joins a two-part podcast on adults with congenital heart disease in the emergency department. The accompanying notes explore Fontan circulation, Eisenmenger syndrome, transposition of the great arteries and aortic coarctation, focusing on presentations and complications that non-specialists may encounter.
Podcast – Demystifying Adult Congenital Heart Disease in the ED Read More
