What does pooled patient-level evidence from PARAMEDIC3 and IVIO tell us about which vascular access route to try first? Simon Carley examines survival, neurological outcomes and the practical limits of the findings for out-of-hospital cardiac arrest.
JC: IV or IO first in cardiac arrest? St Emlyn’s Read More
Rick Body explains what the fifth universal definition changes for emergency clinicians. The article covers the revised MI classification, sex-specific troponin thresholds, the role of imaging and the distinction between myocardial injury and infarction.
Why can delays persist even when individual parts of an urgent and emergency care pathway work well? Stevan Bruijns examines the gaps between emergency care, acute care and discharge, and the often unrecognised work of bed and site managers who connect them.
Ghost jams and the seams between the Model UEC papers Read More
Routine sodium bicarbonate has largely disappeared from modern ALS algorithms, but it continues to be used in many cardiac arrests. We review the BIHCA trial and discuss what it means for emergency physicians and prehospital clinicians.
Does Sodium bicarbonate improve outcomes for in-hospital cardiac arrest? Read More
Evidence from academic studies, professional bodies, coroners, NHS trusts and patient-safety investigators increasingly links corridor care and prolonged emergency department boarding with avoidable harm. Stevan Bruijns asks whether the evidence now warrants a formal public inquiry.
Corridor care and boarding harm: how much evidence is enough? Read More
Struggling with vascular access in trauma? Practical tips on IO access, central lines, external jugular access and rapid alternatives for trauma resuscitation.
TTL Tip 15: Alternative vascular access Read More
Arterial injuries can be easy to miss. Learn how trauma team leaders recognise hard and soft signs of vascular injury, identify high-risk injury patterns and expedite limb-saving care.
TTL tips 14: Should I CTA this limb injury? Read More
Can prehospital emergency anaesthesia improve survival after major trauma? This review examines a UK study using machine learning and causal modelling, with attention to patient selection, residual confounding and why an observational estimate is not definitive proof of benefit.
Survival effect of prehospital emergency anaesthesia in major trauma Read More
