Emergency Evidence Updates – October 2025

Randomised Controlled Trials

Adjunctive Atorvastatin for Sepsis in the Acute Medical Unit: A Randomized Controlled Trial  Acute Medicine

Intranasal Versus Subcutaneous Ketamine for the Treatment of Acute Traumatic Pain in the Emergency Department: A Randomized Clinical Trial  Annals of Emergency Medicine

Treatment of acute trauma-related pain in children and adolescents with methoxyflurane (Penthrox®) compared to placebo (MAGPIE): a randomised clinical trial  Injury

 

NICE

Head injury QS74

VA ECMO for extracorporeal cardiopulmonary resuscitation (ECPR) in adults with refractory cardiac arrest IPG808

 

Other Guidance/Reports

Developing a clinical decision tool to support paramedics when assessing and managing children with minor head injury  BMC Emergency Medicine

European Resuscitation Council Guidelines 2025 Ethics in Resuscitation  Resuscitation

European Resuscitation Council Guidelines 2025 First Aid  Resuscitation

European Resuscitation Council Guidelines 2025 System Saving Lives  Resuscitation

European Resuscitation Council Guidelines 2025 Adult Basic Life Support  Resuscitation

European Resuscitation Council Guidelines 2025 Executive Summary  Resuscitation

European Resuscitation Council Guidelines 2025 Paediatric Life Support  Resuscitation

Primary Research

Prehospital

Development and evaluation of a novel prehospital antidote service providing methylthioninium chloride (methylene blue) for sodium nitrite poisoning  Emergency Medicine Journal

Impact of on-scene time interval on survival in traumatic out-of-hospital cardiac arrest  Injury

Prehospital transfusion: an 8-year descriptive retrospective monocenter study  BMC Emergency Medicine

Successful prehospital extracorporeal cardiopulmonary resuscitation in pediatric cardiac arrest – a case report  Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

 

General

Beneath the Personal Protective Equipment: Perspectives on Infection Prevention and Control From Emergency Department Health Care Personnel  Journal of Emergency Nursing

Evaluating the impact of AI assistance on decision-making in emergency doctors interpreting chest X-rays: a multi-reader multi-case study  Emergency Medicine Journal

Exploring the physiotherapists’ role in the management of blunt mechanism chest wall injury – A qualitative focus group study  Injury

Factors contributing to missed injuries in patients with trauma: Polytrauma and night-time presentation at the trauma resuscitation unit  Injury

High ratio of plasma to red cells in contemporary resuscitation of haemorrhagic shock after trauma: a secondary analysis of the PATCH-trauma trial  Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

How is same day emergency care (SDEC) being implemented across England?  Emergency Medicine Journal

Low Clinical Value Pathology Tests in the Emergency Department: Audit of Urine Microbiology and Culture Use at a Large Regional Centre  Emergency Medicine Australasia

Therapeutic target of high fresh frozen plasma to red blood cell ratio in severe blunt trauma  Critical Care

 

Paediatrics

A Case of POUNCE Syndrome Requiring Suboccipital Craniectomy with a Favorable Neurological Outcome  The Journal of Emergency Medicine

Application of Step-by-Step and Paediatric Emergency Care Applied Research Network (PECARN) Clinical Decision Aids in the management of young febrile infants in a UK cohort  Emergency Medicine Journal

Association Between Hyperuricemia and Dehydration in Children With Acute Gastroenteritis  Pediatric Emergency Care

Balanoposthitis in children: does treatment matter?  The Journal of Emergency Medicine

Corrected QT Intervals in the Pediatric Emergency Department – Don’t Be Misled  Pediatric Emergency Care

Decreased Lumbar Puncture Utilization Following Implementation of Febrile Infant Guidelines in a Pediatric ED  Pediatric Emergency Care

Development and Implementation of the Modified Pediatric Emergency Department Overcrowding Scale in Two Large Academic Pediatric Centers  Journal of Emergency Nursing

Diagnosis of late-presenting congenital diaphragmatic hernia by point-of-care ultrasound  The Journal of Emergency Medicine

Distribution of Nonstandard Inflammatory and Cardiac Biomarker Levels in Children With Fever and Viral or Nonspecific Illness  Pediatric Emergency Care

Optimizing Pediatric Trauma Team Performance Through Interdisciplinary Trauma Simulation and Feedback From Trauma Code Video Analysis  Pediatric Emergency Care

Pediatric cardiac arrest outcome prediction using data-driven machine learning of early quantitative electroencephalogram (qEEG) features  Resuscitation

Sketching Silence – Exploring the Use of Children’s Drawings as an Early Bullying Detection Tool  Pediatric Emergency Care

Standardization of Discharge Instructions by Age for Children Presenting to the ED With Mild Traumatic Brain Injury – A Quality Improvement Project  Pediatric Emergency Care

Utility of Shock Index and Pediatric Age-Adjusted Shock Index in Predicting Severe Sepsis and Septic Shock  Pediatric Emergency Care

 

Adult

Associations Between Sex, Race/Ethnicity, and HEART Score Guideline Implementation for Cardiac Testing in the Emergency Department  The Journal of Emergency Medicine

Balancing Cure and Care for Geriatric Patients With Frailty in Emergency Care: A Qualitative Study  Journal of Emergency Nursing

Development and psychometric validation of a first aid health literacy assessment questionnaire for older adults  BMC Emergency Medicine

Early lactate dynamics for short-term mortality in emergency department sepsis  BMC Emergency Medicine

Efficacy of Adding Intravenous Saline Solution to Nonsteroidal Anti-Inflammatory Drug-Based Treatment of Acute Migraine in the Emergency Department  Annals of Emergency Medicine

Impact of atypical presenting symptoms on door-to-balloon time and mortality outcomes in ST-segment elevation myocardial infarction  BMC Emergency Medicine

Impact of strategies to improve flow and lower hospital admissions for low back pain in the emergency department: an interrupted time-series analysis  Emergency Medicine Journal

“Is my face swollen?” – Utilizing POCUS to Diagnose Odontogenic infections  The Journal of Emergency Medicine

pH-Corrected Ionised Calcium Predicts Coagulopathy After Major Trauma: A Retrospective Cohort Study  Emergency Medicine Australasia

Phantom Scanning in Point-of-Care Ultrasound after Out-of-Hospital Cardiac Arrest: Impact of Clinical Presentation in a Single-Center Analysis  The Journal of Emergency Medicine

Physiological scoring systems for early identification of critically ill older adults in the emergency department: a prospective observational cohort study  BMC Emergency Medicine

Prognostic value of lactate-to-hemoglobin ratio in nontraumatic critically ill patients presenting to the emergency department: a retrospective cohort study  BMC Emergency Medicine

Reducing time from presentation to diagnosis of scaphoid fractures with cone beam CT: a before-and-after study  Emergency Medicine Journal

The association of blood transfusion and sustained return of spontaneous circulation in blunt traumatic out-of-hospital cardiac arrest  Emergency Medicine Journal

The Prognostic Value of the Clinical Frailty Scale in Critically Ill Older Adult Patients in the Emergency Department  The Journal of Emergency Medicine

Use of in-hospital mild traumatic brain injury symptom checklist within 24 hours of injury to predict 3-month symptom outcome  The Journal of Emergency Medicine

Weather and Hip Fractures: A Nine-Year Study across England and Wales  Injury

Metadata

Summary author: Rebecca Howes @ClinicalLibsPHU
Summary date:
Picture by: Ehimetalor Akhere Unuabona on Unsplash

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