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Tag: SLO4

Bayes belief and bias

Bayes and Belief: How pre-review belief influences critical appraisal. St Emlyn’s

I’ve been reflecting on why there is disagreement about how influential new evidence is to clinical practice in the last year or so. COVID-19 has shown that the thresholds for what we believe and when

cricothyroidotomy

JC: Real world cricothyroidotomy experience. St Emlyn’s

Cricothyroidotomy is a procedure that worried many emergency physicians. Partly because it’s a rare procedure, but also because we are likely to embarking on it at a time when things are ‘going wrong’. The most

NoPAC study

JC: The NoPAC trial. TXA does not work for epistaxis. St Emlyn’s

Over the years we have had more than a passing interest in tranexamic acid. In part because we have been involved in some of the research, recruiting to trials, or acting as principal investigators, but

JC: Canadian TIA risk score. St Emlyn’s

We see a lot of patients in the ED with a history of what sounds very much like a transient ischaemic event (TIA). By definition the patient will have had resolution of their symptoms/signs and

JC: Early plasma use in traumatic brain injury. St Emlyn’s

There seems to be a lot of really interesting papers on Traumatic Brain Injury (TBI) this year. A welcome relief from COVID 19 perhaps but also a reminder that other pathologies exist and that TBI

JC: TXA in severe head injury. St Emlyn’s

Our post on the CRASH-3 trial, an RCT examining the use of TXA in head injury, was arguably our most controversial of 2019 (1). Our view was that the evidence was not entirely definitive, but

Dexamethasone, COVID-19 and the RECOVERY trial. St Emlyn’s

We have previously covered the RECOVERY trial on St Emlyn’s noting that the first results out of this large pragmatic, adaptive design platform RCT showed no benefit to Hydroxychloroquine. A few weeks ago a press

JC: AVP in Haemorrhagic Shock. St Emlyn’s

Blood product transfusion can be lifesaving for patients who have suffered major trauma, but the associated side-effects and risks, mean that most people would agree that less is more. This paper by Sim et al

JC: Lower GI bleeding guidance. St Emlyn’s

The management of the patient with apparent lower GI (gastro-intestinal) bleeding is, in my experience at least, somewhat variable. Unlike upper GI bleeding where the standards and expectations are reasonably well known​1,2​, the lower GI

JC: Why do bleeding trauma patients die? St Emlyn’s

Just a quick JC blog post this week to point you to an editorial written by Karim Brohi and John Holcomb on why, and when, patients die of trauma. The editorial appears in Intensive Care