Emergency clinicians and departmental leaders get a human-factors reminder that access to food and fluids affects sustained attention, decision-making and communication. Senior staff can reduce risk by explicitly normalising and arranging brief supported breaks across the multidisciplinary team.

Emergency, trauma and prehospital clinicians get a concise framework for resuscitative thoracotomy in traumatic arrest. Mechanism, witnessed loss of pulses, CPR duration and signs of life guide selection, while aortic cross-clamping, direct haemorrhage control, open cardiac massage and staff sharps safety shape procedural preparation.

Emergency and toxicology teams get a focused comparison of intramuscular medicines for methamphetamine-associated agitation. In the study described, droperidol, olanzapine and midazolam achieved adequate sedation faster than lorazepam, which also required more rescue medication.

Emergency clinicians get a practical bite-and-sting review covering local reactions, anaphylaxis, bronchospasm, multiple-sting venom load, spider syndromes and bed bugs. The key distinction is allergy versus systemic toxicity: adrenaline treats sting-related anaphylaxis, while high sting burden should trigger assessment for rhabdomyolysis and organ dysfunction.

Emergency and critical-care teams get a compact airway-preparation update. First-pass success is treated as a patient-safety target, with video laryngoscopy, bougie use, preoxygenation, suction, positioning, medicines, rescue equipment and the SOAPME pause supporting the first attempt.

Prehospital, toxicology and emergency teams get a found-down case involving GHB toxicity, hypoxaemia, shock, vomiting and abrupt shifts between coma and agitation. It prioritises assisted ventilation, suction readiness, parallel diagnostic assessment, focused toxidrome examination and clear documentation of the pre-sedation neurological state.

An older woman with repeated urinary tract infections needs a prevention conversation, not only another acute prescription. Vaginal oestrogen is presented as a locally acting option with low systemic absorption and a practical three-times-weekly regimen.

Older adults with chronic low back pain may need function-centred care when sedating medicines or invasive procedures are unattractive. The point is to ask how pain affects walking, daily activity and sleep, and to discuss acupuncture as one possible option.

Caffeine is not just a lifestyle detail when sleep disruption, palpitations or SVT come up. Adenosine receptor blockade masks sleep pressure for hours, so timing, amount and last intake can explain crashes and may affect response to adenosine.

Cannabis presentations depend on product and route. Edibles can behave differently because oral THC becomes 11-hydroxy-THC, while chronic vomiting with hot-shower relief suggests cannabinoid hyperemesis. Synthetic cannabinoids need surveillance for seizures, respiratory effects, dehydration, rhabdomyolysis and acute kidney injury.