What should we say before intubating someone who may never regain consciousness? Through a hypothetical major-burns case, Simon Carley explores honesty, reassurance and the opportunity for final conversations, asking whether comforting words serve the patient and family or the resuscitation team.
Little white lies in the resus room – St.Emlyn’s Read More
What does a positive or negative test result really tell us? Part two of the Risky Business series explores diagnostic thresholds, false positives and false negatives, and why the neat categories in a research table do not remove uncertainty for the clinician treating an individual patient.
Emergency Medicine, a risky business part 2. Read More
Could etomidate offer an alternative for short paediatric procedures? This 2012 appraisal examines a small prospective cohort, questioning patient selection, the absence of a comparison group and the variability in sedation depth and recovery time behind apparently high procedural success.
Etomidate for Paediatric Sedation Read More
Are we diagnosing disease, or deciding when a probability is high enough to act? The opening Risky Business article uses myocardial infarction and pulmonary embolism to explore uncertainty, treatment harms and why stopping investigation is different from proving that disease is absent.
Emergency Medicine, a risky business part 1. You are not a diagnostician. Read More
What changed when UK paracetamol-overdose guidance was revised in 2012? This historical review discusses the move to a single treatment line, changes to acetylcysteine administration and the implications for admissions, treatment complications and reducing errors in a familiar emergency presentation.
Paracetamol 2012: less means more Read More
Does patient-controlled analgesia improve pain relief in the emergency department? This 2012 appraisal examines a randomised trial in acute abdominal pain, considering blinding, exclusions, the comparison treatment and how pain was measured, with additional explanations of area under the curve and block randomisation.
JC: Patient Controlled Analgesia in the ED Read More
Persistent swelling after a shearing injury may be more than a simple haematoma. This 2012 overview introduces Morel-Lavallée lesions, their sometimes delayed presentation and the role of ultrasound, then discusses treatment options and the uncertainty surrounding how best to manage them.
Morel-Lavallee – Mushrooms in the valley Read More
How do you act on an ECG suggesting STEMI when the rest of the presentation does not fit? This hypothetical cardiology case from 2012 combines altered consciousness, abdominal findings and no chest pain to explore competing diagnoses, bleeding risk and the urgency of reperfusion.
