Defibrillating the Data

Prospective ED validation found the HACOR score at 60 minutes discriminated HFNO failure substantially better than the admission score, without detected miscalibration. The established >5 threshold remained useful, while a proposed ≥8 threshold is exploratory.

ACEP’s new clinical policy evaluates whether agent-specific antidotes improve outcomes versus usual care, including prothrombin complex concentrate, for adults with major symptomatic bleeding while taking a direct oral anticoagulant.

A contemporary practical guide updates indications, survival windows, procedural steps, troubleshooting, team factors, and safety considerations for emergency thoracotomy.

Part 2 of a multidisciplinary Delphi consensus translates unscheduled procedural sedation principles into clinical practice guidance. The feed excerpt contains boilerplate rather than recommendations, so the full paper is required for detail.

This evidence review discusses prehospital type O whole blood versus component therapy for traumatic haemorrhage, anchored to the cited Sperry trial. The feed excerpt does not provide enough results for a firm efficacy conclusion.

In an ED randomised trial of older adults with hip fracture, ultrasound-guided PENG block produced better early pain relief than intravenous morphine, with rescue analgesia and adverse events assessed as secondary outcomes.

Part 1 of the multidisciplinary Delphi consensus addresses principles, oversight, and quality monitoring for unscheduled procedural sedation. The available excerpt is publication boilerplate, not the recommendations themselves.

EMJ’s monthly evidence roundup leads with ORIENTAL-MeVO, an open-label, blinded-outcome multicentre RCT of thrombectomy for medium-vessel occlusion stroke, alongside four other selected studies.

A Faculty of Pre-Hospital Care consensus statement offers structured, practical UK guidance for early crush injury and crush syndrome management after evidence review and expert consensus.

A short-cut review identified eight directly relevant papers comparing intranasal with intramuscular epinephrine for rapid symptom control in anaphylaxis. The feed excerpt does not establish equivalence or superiority.

A safety letter warns of potential complications from the 9.5 cm, 10-gauge SPEAR catheter marketed for blind prehospital needle decompression and questions aspects of its insertion instructions.

PECARN’s phase 3 STArT trial of intravenous arginine for paediatric sickle-cell acute pain was stopped early for futility. The commentary highlights striking between-hospital variation in time to crisis resolution and challenges in defining the enrolled syndrome.

In an observational sepsis cohort, longer time to norepinephrine was associated with higher 28-day mortality; initiation within 60 minutes of hypotension was associated with lower risk. Residual confounding limits causal inference.

A review of the AUGMENT-VA randomised trial asks whether manual pressure augmentation during defibrillation converts a favourable physiological effect—lower transthoracic impedance—into better patient outcomes.

A case-based airway discussion covers severe obstruction, high-risk hypoxaemia, CHOP assessment, induction in cardiogenic shock, and extreme metabolic acidosis. It is expert education rather than comparative evidence.

The issue overview highlights a randomised comparison of PENG block with intravenous morphine for hip fracture and points readers to other clinically relevant work in the same EMJ issue.

A practical review argues that common femoral artery access is increasingly relevant for central pressure monitoring and endovascular resuscitation, and outlines Seldinger-guided sheath insertion and training needs.

In response to correspondence, the authors reiterate findings from more than 5.3 million encounters: over one-third of the sickest patients were undertriaged, and undertriage was associated with a median eight-minute delay versus correct high-acuity triage.

A report on PECARN’s PRoMPT BOLUS trial says normal saline and balanced crystalloids were both safe and effective in suspected paediatric septic shock. Detailed outcomes are not present in the feed excerpt.

EMJ curates abstracts selected by partner emergency-medicine journals, including a randomised trial of intranasal versus subcutaneous ketamine for acute traumatic pain. It is a discovery collection, not a single synthesis.