Should patients with restored circulation after cardiac arrest bypass their nearest hospital for a specialist centre? This appraisal of the ARREST trial examines patients without ST elevation, the lack of a survival benefit and the limits of applying London’s results elsewhere.
The ARREST trial. Does bypass to cardiac arrest centres save lives? Read More
How accurately can prehospital clinicians recognise life-threatening injuries from clinical examination? This appraisal examines a retrospective trauma study, the limits of its diagnostic accuracy findings and why uncertainty should inform decisions without abandoning examination altogether.
Can clinical examination identify life-threatening injuries? Read More
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
Zaf Qasim examines the UK-REBOA trial results presented at the 2023 Critical Care Reviews meeting. This early commentary considers the signal of harm, differences between patient groups, delays to bleeding control and the role of experience and systems of care.
The UK-REBOA trial – Has the balloon popped? Read More
A critical appraisal of the DEVICE trial comparing video and direct laryngoscopy in critically ill adults. It examines the improvement in first-attempt intubation success, the absence of a clear difference in severe complications, and how operator experience and patient selection affect interpretation.
Video Laryngoscopy vs Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults Read More
What does the PATCH trial tell us about tranexamic acid in major trauma? This appraisal examines the distinction between survival and favourable functional recovery at six months, and why the choice of outcome matters when interpreting the trial.
The PATCH trial. TXA in major trauma 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
