Emergency medicine journal : EMJ
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Randomized Controlled Trial Comparative Study
Impact of oral dexamethasone versus placebo after ED treatment of migraine with phenothiazines on the rate of recurrent headache: a randomised controlled trial.
Evidence suggests that the rate of recurrent headache after treatment of migraine in the emergency department (ED) is high. The mechanisms for this are unclear, but neurogenic inflammation may play a role. There is conflicting evidence about whether adjuvant dexamethasone reduces the rate of recurrent headache. The aim of this study was to compare the rate of recurrent headache in patients with migraine randomised to receive a single dose of oral dexamethasone or placebo at discharge after treatment in the ED with intravenous phenothiazine. ⋯ A single oral dose of dexamethasone following phenothiazine treatment for migraine in the ED did not reduce the rate of recurrent headache. There is weak evidence for a possible benefit in the subgroup who present within <24 h of symptom onset. A multicentre trial to confirm this finding is warranted.
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Randomized Controlled Trial Comparative Study
Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation.
Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation techniques is poorly understood. ⋯ One year after a single episode of ventilation training, lay persons tended to hyperventilate; however, the degree of hyperventilation and resulting stomach inflation were lower when a mouth-to-mask or a face shield device was employed. Regular training is therefore required to retain ventilation skills; retention of skills may be better with ventilation devices.