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An Australian feasibility study has confirmed that focused assessment by sonography in trauma (FAST) is possible in a helicopter. Why bother? Because a positive prehospital FAST scan might expedite the availability of staff and resources on arrival at hospital, yet FAST performed at scene could result in detrimental delays. Although this study describes how accurate images can be obtained in-flight by experienced retrieval physicians, there was no mention of patient outcomes. It now needs to be demonstrated that in-flight FAST does benefit patients (Injury 2008;39:512–18).


The Surviving Sepsis Campaign published its updated guidelines in January (Crit Care Med 2008;36:296–327). Unfortunately for those used to the previous ones (Crit Care Med 2004;30:536–55), no summary of changes has been provided. And although the article is nearly twice as long as the previous one with more than twice the references, the guidelines themselves are remarkably similar. There is more emphasis on doing simple things well: initial intravenous fluid boluses of at least a litre of crystalloid, and earlier administration of antibiotics. On the other hand, activated protein C is now recommended only for those with …

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