Speedy sodium, and aortic balloon occlusion: Primary Survey October 2026

The hazards of rapid sodium correction in hyponatraemia are well known, and current guidelines recommend a "slow and steady" approach. But a new systematic review suggests that faster rather than slower may be in truth be safer.

The second paper of this episode returns to the topic of emergency care inequalities. A study from Scotland finds that the level of socio-economic deprivation in the catchment area of an emergency department not only affects presentation rates but also the length of stay of patients, which calls into question the wider strategy of demand management and diversion. 

Third, an expert practice review on endovascular resuscitation looks closely at this exciting and potentially revolutionary practice. Three percutaneous interventions are compared: Resuscitative endovascular balloon occlusion of the aorta (REBOA), Selective aortic arch perfusion (SAAP) and Extracorporeal cardiopulmonary resuscitation (ECPR).

The final paper this time is on patient centred care - how well does it translate? A Dutch study takes an Australian system for patient experience reporting and attempts to validate it in their own healthcare system. The study is an excellent example of how to do that.

Read the highlights: Primary survey

• On the optimal sodium correction rate in hyponatraemia and clinical outcome: a meta-analysis
• Association between catchment-area demographics and emergency department presentation rates and delays: a national cross-sectional study
• Endovascular resuscitation: an expert practice review
• Person-centred emergency care: translation and cross-cultural validation of the Australian Emergency Department Patient-Reported Experience Measure (ED PREM) in the Netherlands

The EMJ podcast is hosted by:

Prof. Richard Body, EMJ Editor-in-Chief, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Senior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards)

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