Rising demand and limited capacity in primary care are often cited as reasons for the increasing pressure on emergency departments (EDs). The COVID-19 pandemic further strained but also reshaped healthcare services and their accessibility. However, an equally critical yet often overlooked factor is the increasing complexity of cases. This study assessed ED attendance trends for the Northwest London (NWL) population between February 2017 and September 2023, before, during and after the pandemic lockdown measures (March 2020-March 2021) in the UK as a whole and across sociodemographic and multimorbidity profiles.

Management of out-of-hospital cardiac arrest (OHCA) in a pregnant patient is challenging, both logistically and emotionally. This review explores the adaptations to resuscitation in pregnancy; the indications and preparation for prehospital resuscitative hysterotomy (RH); the surgical procedure; and the post-procedure care. Prehospital clinicians should train for RH in their teams to maximise the chances of maternal and fetal survival. Further research is needed to understand the incidence of maternal OHCA, how we can improve the chain of survival and the duration of maternal cardiac arrest before RH becomes futile to inform future guidelines.

In rural settings, women with ST-elevation myocardial infarction (STEMI) are less likely to receive timely reperfusion than men. We explore factors that may impact time to reperfusion by sex for patients with STEMI.

Global health partnerships involve collaboration between institutions and individuals working in different contexts, typically between high-resource and low-resource settings. They are based on principles of mutual learning, play an important role in emergency care systems strengthening and are increasingly being delivered online. The objective of this study was to determine the effectiveness of online learning in an emergency care partnership between Uganda and the UK through assessment of virtual grand rounds (VGRs).

The establishment of an emergency medical services (EMS) pathway into a virtual emergency service-the Victorian Virtual Emergency Department (VVED)-introduced a video-enabled telehealth consultation service for patients assessed and treated by paramedics. This study examined the utilisation of the VVED by EMS in Victoria, Australia, including its impact on rates of non-transport to hospital and EMS reattendance.

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defines sepsis as a life-threatening organ dysfunction due to a dysregulated host response to infection. Measuring a dysregulated host response is difficult in practice, so patients with organ dysfunction due to other causes, such as an underlying comorbidity or the direct effects of infection, may be diagnosed with sepsis. We aimed to characterise patients diagnosed with sepsis and meeting the Sepsis-3 criteria according to whether organ dysfunction was potentially due to a dysregulated immune response or an alternative cause.

Regional data and trends in survival from out-of-hospital cardiac arrest (OHCA) are vital to improve favourable outcomes. Since the last cardiopulmonary resuscitation (CPR) guideline update, comprehensive OHCA data of the metropolitan area of Vienna, Austria, have been scarce.

Interstitial lung diseases (ILDs) represent a heterogenous group of disorders affecting the lung parenchyma. Patients with ILD are frequently admitted to hospital secondary to respiratory decompensation which can result in acute respiratory failure (ARF). High flow nasal oxygen (HFNO) has increasingly been used in other causes of ARF following the recommendations of the European Respiratory Society. A review was undertaken to evaluate the question: in adults with ILD and ARF without hypercapnia, is HFNO better than conventional oxygen therapy (COT) at reducing symptoms and all-cause mortality outcomes? Medline via PubMed, EMBASE via OVID and the Cochrane Library were searched between 1975 and 20 June 2025. 2362 papers were identified with 17 undergoing full-text review. Two systematic reviews met inclusion criteria and directly answered the three-part question. Study information, participant demographics, key results and study weaknesses were established for each paper. Neither systematic review found HFNO improved mortality outcomes, when compared with COT, to a statistically significant threshold for patients with ILD with ARF. Reported median survival with HFNO use was 21.0 days (95% CI 13.0 to 61.0) and COT use 133 days (95% CI 26.0 to 374.0, p=0.1323). Inpatient mortality with HFNO use ranged between 26.5% and 59.1%. Symptomatically, one review reported a numerical improvement in the Quality of Death and Dying Score for the HFNO group versus the COT group (4.58 ± 0.67 vs 4.09 ± 0.96). There is limited evidence to suggest that HFNO improves mortality outcomes for patients with ILD in ARF. However, it may be beneficial for symptom management. Mortality remains high despite HFNO use, thus careful discussions with patients and their relatives are required should a trial be used in the setting of ARF.