The Resus Room
Welcome to January’s Papers of the Month, which marks 10 years of the podcast! First up, we look at a large multicentre cohort study from the East of England examining the association between prehospital post-intubation hypotension and mortality in severe traumatic brain injury. Preventing secondary brain injury sits at the centre of what we're try to achieve in early TBI care, but this paper quantifies the impact of post-RSI hypotension in a dramatic way and the associated increase in 30-day mortality. Our second paper moves into the world of stable supraventricular tachycardia,...
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Welcome to this special edition of Roadside to Resus where we’re diving into some of the progressive and practice-defining developments in pre-hospital emergency care. This episode brings together a superb group of clinicians, educators and leaders who are shaping the future of PHEM across the UK, and we caught up with them at the recent Faculty of Pre-hospital Care Conference entitled ‘The Wider World of Pre-hospital Care’! We start with Pam Hardy, the Chair of the FPHC, who offers an introduction to the College and its ongoing work to elevate standards across pre-hospital care. ...
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December brings us to the final Papers of the Month for 2025 and we’re finishing the year with three studies that challenge assumptions across critical care and resuscitation! This time questioning the role of arterial lines in shock, looking at the true prognostic value of end-tidal CO₂ in cardiac arrest and finally to airway management in neonates. We start in the ICU with the EVERDAC trial, a large multicentre RCT exploring whether early arterial catheterisation in shock truly changes outcomes. This challenges some of the papers we've recently looked at recently which champion the...
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Whether you’re just stepping into your first cardiac arrest or you’ve been running them since the days of paddles, this one’s for you. The 2025 resuscitation guidelines have landed after further collaboration between ILCOR, the ERC and the Resuscitation Council UK and in this episode we break down exactly what’s new, what’s stayed the same, and how it all fits into day-to-day practice. Across the board the 2025 updates represent evolution, a steady refinement of evidence rather than wholesale change. Adult ALS remains rooted in early recognition, high-quality compressions and rapid...
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This month we’ve got four cracking UK-led studies that really speak to how pre-hospital and emergency medicine continue to evolve, not just in the kit and skills we use, but in how we think about the whole patient journey. We’ll start with a paper fromAnaesthesia with Pallavicini et al., exploring pre-hospital central venous access for patients in haemorrhagic shock. Drawing on London’s Air Ambulance experience, it shows that large-bore central catheters can be placed safely and effectively, delivering earlier transfusion and improved survival to ED arrival. It’s high-stakes medicine...
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How, when and why to make the call… The pre-alert is one of the most powerful and sometimes most painful parts of emergency care. It can feel like the Spanish Inquisition, trigger tension between pre-hospital and ED teams, or drop another challenge into an already overflowing department. But done well, a pre-alert isn’t an irritation; it’s an opportunity to line up critical care for the next patient and genuinely improve outcomes. In this episode, Simon, Rob and James break down The UK NHS Ambulance Services and Emergency Department Pre-Alert Guideline, jointly released in July 2025 by...
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This month we’ve got three really interesting papers that shine a light on aspects of cardiac arrest management that many of us will recognise from clinical practice. First up, we look at the feasibility of arterial line placement during ongoing cardiac arrest in the Emergency Department. In our SPEAR episode we talked about the balance between securing invasive monitoring versus the potential distraction from other essential parts of resuscitation. This paper takes a pragmatic look at whether arterial access is achievable in that critical period in the Emergency Department, the success rate...
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a focus on its acute presentations and the care we can deliver to improve outcomes for our patients. Sickle cell disease (SCD) is a lifelong inherited blood disorder that affects over 15,000 people in the UK, and millions worldwide. It’s caused by the production of abnormal haemoglobin molecules, which distort red blood cells into a crescent, or “sickle,” shape. These rigid cells can block small blood vessels, leading to painful vaso-occlusive crises and organ damage. While the condition has long been most prevalent in parts of Africa, the Middle East, the Mediterranean...
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Welcome back to September’s Papers of the Month. We’ve got three cracking studies for you this time, each tackling really core questions in pre-hospital and emergency care and each giving us plenty to chew over when it comes to the evidence base and what it means for our practice. First up, we’re heading down under to Sydney with the PRECARE pilot feasibility study on pre-hospital extracorporeal CPR for refractory cardiac arrest. Now, we all know survival from refractory OHCA is pretty dismal with conventional CPR alone, and that the big limiting factor with ECPR is time to flow. So...
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Welcome back! First up a paper to challenge the way we think about rhythm recognition in cardiac arrest to start with, looking at the rate of VF identified on echo but not on the defibrillator. We have a huge amount of strategies to rule out acute coronary syndrome in the UK, our next paper looks at the clinical effectiveness of these, whilst also giving us some hugely important information about the incidence of ACS in those presenting to Eds. Finally we look at a paper quantifying the effect of hypertonic saline in those patients with a TBI. Once again we’d love to hear any thoughts or...
info_outlineWelcome back to April's Papers of the Month!
First up this month we have a think about posterior circulatory strokes, which can mimic benign vertigo, and can be really tricky to differentiate between a completely benign issue or a stroke that is really important to pick up. Clearly imaging everyone is one option but completely impractical when you consider the gold standard of MRI. So having a bedside tests to rule in or out the diagnosis of stroke would be a huge help. Our first paper looks at the use of three bedside scoring systems; HINTS, TriAGe+ and ABCD2 scores in ED for patients presenting with possible posterior circulatory strokes. How accurate are they and can we reliably incorporate into our practice?
Next up is traumatic cardiac arrest. This has obviously got a very high mortality rate. One of the interventions that might improve mortality (for some mechanisms and patients) is a resuscitative thoracotomy, however this is a really significant intervention and we want to ensure we are targeting it at the patients that may benefit. A great paper has just been published from London Air Ambulance which might just help us to identify those patients who would benefit with more certainty, along with those where futility has already been reached.
Finally we take a look at acute kidney injury (AKI) and its association contrasted scans. Contrast induced nephropathy (CIN) has historically been a concern, particularly for patients with chronic kidney disease, with contrast causing direct injury and limited blood flow. But recent studies have questioned the actual risk of CIN & there’s been a more recent RCEM statement on the topic, but we thought this might be a nice opportunity to refresh and look at a recent paper on the topic.
Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!
Simon & Rob