Journal Club

Musings form the evidence based journal club at St Emlyns

JC: Balanced fluids vs Saline on the ICU. The SMART trial. St Emlyn’s

There has a been a little flutter of activity in the #FOAMed world this week about two trials published in the NEJM on the subject of balanced fluids in the care of critically ill patients, and also on admitted patients…
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JC: Devastating Brain Injury. Complex decisions in the resus room. St.Emlyn’s

DBI devaststing brain injury stemlyns

Social media can sometimes give the impression that all is rosy in the world of resuscitation. We hear of the amazing saves, the wonders of ECMO, helicopters and heroic acts with great outcomes, but the reality is of course very…
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JC : Paracetamol, NSAID’s or both in MSK trauma. St.Emlyn’s

 Pain… patients complain about it… A LOT. It’s the commonest reason for attending emergency departments across the globe so we should be (and need to be) pretty good at treating it. With that in mind I thought we could look at this…
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JC: Subarachnoid Haemorrhage, Decision Rules & Overtesting Headaches

Headache is a pretty common reason for presentation to the Emergency Department – so common, in fact, that it has two curriculum sections of its own (and we’ve already produced an induction post about headaches that you can find here). It…
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JC: Does earlier TXA save lives? St.Emlyn’s

Administration of tranexamic acid (TXA) is integral part of the management for major trauma patients in the UK. It is deemed such an important aspect that its administration is used as a quality indicator to benchmark major trauma centres across…
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Is cMyC the new troponin?

Anyone who reads the news is likely to have seen the recent paper in Circulation evaluating a new biomarker of acute coronary syndromes: cardiac myosin binding protein C (cMyC) . This paper has been covered by the BBC, the Telegraph…
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JC: Oxygen in ACS. A fuss about nothing? The DETO2X Trial at St.Emlyn’s

DETO2X-SWEDEHEART sounds like a new low-carb, high-alkali, So-Cal diet plan but it is actually a trial exploring the affect of oxygen on mortality in patients with a suspected acute coronary syndrome (ACS). There is a striking similarity tenuous link between…
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JC: The VTE and Major Trauma. St.Emlyn’s

All good EM/CC clinicians know that venous thrombo embolism (VTE) is a potential complication of traumatic injury. The immobilisation and haematological changes associated with signficant injury are reasonably well described. Additionally there are controversies over the use of drugs such…
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