The Buddy Study: Local reach, adoption and implementation following a randomised controlled trial of conservative management of fifth metacarpal neck fractures.

Objective: To understand the reach, adoption and implementation of the evidence that buddy strapping for uncomplicated fifth metacarpal neck fractures is non-inferior to plaster casting.

Methods: Mixed-method study using clinical audit of the years before and after the original randomised controlled study was published (2019) and staff questionnaires/semi-structured interviews.

Results: Sixty-nine percent of questionnaire respondents were aware of the original study findings (i.

Intubation for patients with overdose: Time to move on from the Glasgow Coma Scale.

Patients frequently present to the ED with drug overdose and reduced conscious level leading to coma. There is considerable practice variation around which patients require intubation. Indications include: (i) respiratory failure (including airway obstruction); (ii) to facilitate specific therapies or intubation as a therapy in itself; and (iii) for airway protection in the unprotected airway.

Safety of rapid sequence intubation in an emergency training network.

Objective: Rapid sequence intubation (RSI) is a core critical care skill. Emergency medicine trainees are exposed to relatively low numbers of RSIs. We aimed to improve patient outcomes by implementing an RSI checklist, electronic learning and audit, in line with current best evidence.