Critical-care and emergency teams get a focused appraisal of fluid-prioritised and vasopressor-prioritised resuscitation after initial crystalloid in septic shock. ARISE-FLUIDS, CLOVERS and CLASSIC support individualised care with repeated reassessment, while VICTORY provides no support for routine high-dose intravenous vitamin C in severe burns and raises concern about possible harm.

Critical-care, emergency and nephrology clinicians get a trial-appraisal update on sodium bicarbonate in in-hospital cardiac arrest, metabolic acidosis, shock and kidney outcomes. Routine bicarbonate after in-hospital arrest shows no clear ROSC, survival or neurological benefit, while selected critically ill patients with acidosis and shock may have a renal-outcome signal.

Critical-care teams reviewing new conference results get a cautious appraisal frame across oseltamivir for severe influenza, balanced crystalloids in septic shock and volatile ICU sedation. It links trial design, baseline imbalance, biological plausibility, full publication and local capability to protocol decisions.

Critical care teams get a broad update on neutral trials, trauma haemorrhage resuscitation, post-ICU rehabilitation, severe respiratory infection and possible hantavirus exposure. The most practical point is how protocols set a baseline while local logistics and patient physiology still shape escalation.

Ventilated ICU patients do not all need wrist restraints by default. A lower-use approach depends on agitation scoring, delirium status, airway and line risk, light sedation practice and clear criteria for applying, loosening or removing restraints.

Agitated ICU delirium needs a target, not just more sedation. Use RASS and CAM-ICU together, define calm and rousable before dexmedetomidine, and remember the 4D signal was clearest for about one hour quicker agitation relief, with early stopping limiting certainty.

Sepsis care is safer when antimicrobial breadth, fluid choice and vasopressor targets are revisited after the first rush. This update is strongest on cultures before antibiotics when feasible, balanced crystalloids, norepinephrine-led shock care, and not letting positive fluid balance continue unchecked after initial resuscitation.

Acute pulmonary embolism management starts with severity-based classification, but prompt anticoagulation remains the key first move. Low-risk symptomatic PE may suit early discharge with a safe plan, whereas shock, RV strain, biomarkers or oxygen requirement should push escalation.

Albumin in septic shock still lacks definitive patient benefit. The bedside rule is to keep crystalloids as default and avoid treating a low serum albumin number itself: subgroup signals, early stopping and control-arm crossover can all make neutral trials look more persuasive than they are.