This 2016 companion to the upper gastrointestinal bleeding podcast covers recognition, resuscitation, transfusion, risk assessment and referral for endoscopy. It also discusses variceal bleeding and rescue measures, reflecting the guidance and unresolved research questions available at the time.
Upper Gastro Intestinal Bleeding at St.Emlyn’s. Read More
Does adding ketamine to propofol make emergency procedural sedation safer? This 2016 appraisal of the POKER trial examines respiratory complications, recovery and patient experience, finding no convincing overall advantage while discussing blinding, event rates and the limits of the evidence.
JC: Is Ketofol worth the hassle? St.Emlyn’s Read More
Could platelet transfusion worsen outcomes after spontaneous intracerebral haemorrhage in patients taking antiplatelet drugs? This 2016 appraisal examines the PATCH trial’s unexpected findings, functional outcomes and limitations, asking why a biologically plausible treatment might fail to help the patients it was intended to benefit.
JC: Platelets for Intracranial Haemorrhage. St.Emlyn’s Read More
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
How can clinicians support a bleeding trauma patient while definitive haemorrhage control is being arranged? This 2016 discussion explores resuscitation physiology, fluids, vasopressors and treatment endpoints, setting out the authors’ perspective while acknowledging limited evidence and the importance of the wider trauma system.
Can we buy time in bleeding trauma. St.Emlyn’s. 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
Two 2016 studies examine difficult questions in out-of-hospital cardiac arrest: whether amiodarone or lidocaine improves outcomes, and how resuscitation duration relates to neurological recovery. Natalie May considers study design, statistical uncertainty and why translating findings into bedside decisions needs care.
JC: Arrested Developments. St.Emlyn’s Read More
Does combining ketamine and propofol improve procedural sedation compared with propofol alone? This 2016 appraisal examines a systematic review’s complication findings, questioning how differences in patients, procedures and drug regimens—and limited information on sedation success—affect its relevance to emergency departments.
Is Ketofol the milk of human kindness for procedural sedation. St.Emlyn’s Read More
