Could propofol have a role in refractory migraine? This 2013 journal club critiques an eight-patient case series, examining unclear recruitment, pain measurement during sedation and why larger, better-designed studies would be needed before drawing conclusions for practice.
JC: Milk for refractory migraines? Read More
Simon Carley offers an early emergency department response to the Surviving Sepsis guidance discussed in 2013. He highlights its resuscitation targets, antibiotic priorities and three- and six-hour bundles, while questioning how closely the recommendations reflected evolving practice at the time.
New Surviving Sepsis Guidelines – What’s new? St.Emlyn’s Read More
Does seeing fewer patients mean a doctor is performing poorly? Simon Carley examines the limits of productivity figures and league tables, arguing for supervision that explores case mix, quality and individual difficulties without putting pressure on trainees to sacrifice safety for speed.
Can you get the doctors to work faster? Read More
This short January 2013 post introduces a conversation with Matthew Harris about PACE and graded assertiveness in pre-hospital care. It links to a discussion of paramedic practice, learning and the forthcoming SMACC and SimWars events.
PACE with @HarrisCPD Read More
Can a tight ring be removed without destroying it? Simon Carley introduces a video demonstration of the undertaker’s ring method and discusses its limits, including wounds, bony obstruction and pain, with ring cutters available when the approach is unsuitable or unsuccessful.
The undertaker’s ring method. St.Emlyn’s Read More
How should clopidogrel use influence assessment after a head injury? This 2012 journal club examines a prospective cohort study of intracranial bleeding, questioning comparisons with warfarin, patient selection and whether CT findings adequately capture the outcomes that matter to patients.
JC: Clopidogrel + head injury = CT? Read More
Does combining antibiotics improve survival in severe sepsis? This 2012 journal club scrutinises an observational analysis from EduSepsis, exploring differences between treatment groups, confounding and why a reported mortality association does not establish that combination therapy caused the benefit.
JC: Blunderbuss antibiotics in sepsis?? Read More
How impressive are relative reductions in bleeding when the absolute event rates are small? This 2012 appraisal of newer oral anticoagulants for venous thromboembolism examines a systematic review, the comparison with warfarin and concerns at the time about managing major bleeding.
The new oral anticoagulants – the good news – or is it? Read More
