The 2018 PARAMEDIC-2 trial challenged assumptions about adrenaline in cardiac arrest. Simon Carley examines the distinction between improved survival and favourable neurological outcomes, the trial’s patient selection and the competing arguments about practice, stressing why the results need more than a simple yes-or-no interpretation.
JC: Does Epinephrine work in Cardiac Arrest. St Emlyn’s Read More
More oxygen is not necessarily better. This 2018 journal club examines a systematic review comparing liberal and conservative oxygen strategies in acutely ill adults. Simon Carley considers mortality findings, the size of the absolute effect and why even a meta-analysis needs careful critical appraisal.
JC: Oxygen in the Acutely Unwell Patient. St Emlyn’s Read More
What can early pupil responses tell us after cardiac arrest? This 2018 review examines a large French observational study, separating association with outcome from the ability to predict an individual patient’s recovery. It challenges decisions based on a single early finding and considers how prognosis is discussed.
JC: Do early pupil responses predict outcome in cardiac arrest? St Emlyn’s Read More
The September 2018 podcast roundup revisits airway management after out-of-hospital cardiac arrest, the Zero Point Survey and pulmonary embolism. Its linked reading also covers neonatal emergencies, equality in emergency medicine and reports from EMS Gathering, ResusTO and EuSEM, bringing together the month’s clinical and professional discussions.
Podcast – September 2018 Monthly Round Up Read More
Should patients without ST elevation undergo early coronary angiography after cardiac arrest? This 2017 review examines mortality and neurological outcomes, then challenges the impressive apparent benefit by considering selection bias, retrospective studies and the limited randomised evidence available at the time.
JC: Should non ST elevation ROSC patients go to cath lab? St.Emlyn’s Read More
A 2017 ResusFriday session uses simulation and shared learning to examine cardiac arrest care, including team roles, reversible causes and dual-axis defibrillation. The post explains why enthusiasm for the latter needed to be tempered by the limited evidence available then.
Dual Axis Defibrillation & #ResusFriday at St.Emlyn’s Read More
What happens beyond initial survival after cardiac arrest? This 2017 review of Danish registry data explores associations between bystander CPR or defibrillation and longer-term outcomes, emphasising that the analysis concerns 30-day survivors and cannot establish causation on its own.
JC: Bystanders make the difference in cardiac arrest. St.Emlyn’s Read More
Does intubation during in-hospital cardiac arrest improve survival? This 2017 appraisal examines a large US registry study that found an association with poorer outcomes, then considers confounding, missing procedural information and why observational data cannot settle the airway decision.
JC: Intubate or not intubate? That is the question… Read More
