This 2014 journal club examines the PARAMEDIC trial of mechanical versus manual CPR in out-of-hospital cardiac arrest. Alongside the cluster-randomised design and survival findings, Simon Carley reflects on separating life support from treatment of the underlying cause and how resuscitation teams divide their attention.
JC: PARAMEDIC trial m-CPR at St.Emlyn’s Read More
What do clinicians mean when they talk about ‘gestalt’? Simon Carley introduces its origins in perception, uses visual examples to explain how patterns emerge from fragments, and considers how these ideas relate to bedside assessment, ECG interpretation, clinical judgement and information that is difficult to measure.
What is Gestalt? St.Emlyn’s Read More
Can experiencing physiological stress make blood gas results more meaningful to learners? This account describes an exercise-based teaching experiment using lactate measurements, then examines the value and limits of comparing healthy volunteers with critically ill patients. It also discusses consent, organisational approval and the absence of patient-outcome evidence.
How low can you go? Experiential learning at St.Emlyn’s Read More
Does cooling during cardiac arrest improve outcomes, or simply lower temperature? This 2014 appraisal examines a small randomised trial of intra-arrest hypothermia, questioning patient selection, statistical power and surrogate outcomes, while separating the cooling headlines around London’s ‘cool car’ from its broader package of advanced resuscitation care.
JC: Getting Chilly Quickly 3. Hypothermia at St.Emlyn’s Read More
Why does accurate emergency department coding matter beyond hospital income? This 2014 podcast introduction explains the English payment system used at the time and how incomplete records can distort accounts of the care patients receive, encouraging clinicians to record investigations, treatment and discharge information carefully.
Show Me The Money: Coding at St.Emlyn’s Read More
Rick Body examines NICE’s 2014 recommendations on high-sensitivity troponin testing for early exclusion of NSTEMI. The article and podcast explain the guidance’s limited assay-specific scope, the distinction between excluding infarction and deciding on discharge, and the practical challenge of fitting repeat testing into emergency department workflows.
New NICE high sensitivity troponin guidance: 3 hours and done? Read More
A critical response to NICE’s 2014 acute heart failure guidance, questioning whether varied presentations can be treated as one condition. The author examines the evidence behind diuretics, nitrates and non-invasive ventilation, and argues for clearer definitions and research that better reflects the sickest emergency department patients.
Should ultrasound or CT be the first investigation for suspected renal colic? This 2014 appraisal examines a trial comparing emergency physician ultrasound, radiologist ultrasound and CT, focusing on patient outcomes, missed diagnoses, cumulative radiation and the need for additional imaging after the initial test.
JC: Should USS be first investigation for renal colic? St.Emlyn’s Read More
