Becky Maxwell and Chris Connolly, both emergency physicians, delve into the new NICE head injury guidelines, clarifying assessment protocols for high-energy injuries, especially in children. They highlight the vital role of tranexamic acid for severe head injuries. Dave McCreary and Joseph Mathew explore high acuity, low occurrence procedures, emphasizing the importance of training and practice in emergency settings. The discussion shines a light on preparing for rare yet critical interventions and effective communication among emergency teams to enhance patient care.