Emergency medicine journal : EMJ
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Review Meta Analysis
Oxygen therapy for acute myocardial infarction: a systematic review and meta-analysis.
Oxygen (O(2)) is widely recommended in international guidelines for treatment of acute myocardial infarction (AMI), but there is uncertainty about its safety and benefits. A systematic review and meta-analysis were performed to determine whether inhaled O(2) in AMI improves pain or the risk of death. Cochrane CENTRAL Register of Controlled Trials, MEDLINE, MEDLINE In-Process, EMBASE, CINAHL, LILACS and PASCAL were searched from start date to February 2010. ⋯ Evidence for O(2) in AMI is sparse, of poor quality and pre-dates advances in reperfusion and trial methods. Evidence is suggestive of harm but lacks power and excess deaths in the O(2) group could be due to chance. More research is required.
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Review Meta Analysis
Meta-analysis of controlled studies on immunotherapy in severe scorpion envenomation.
Despite conflicting evidence, specific serotherapy is recommended for scorpion envenomation. ⋯ SAV should not be administered in Old World scorpion envenomation until its efficacy is established by an appropriately designed RCT. In the Arizona scorpion sting, SAV hastens the recovery process.
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Randomized Controlled Trial
Comparison of the over-the-head, lateral and alternating positions during cardiopulmonary resuscitation performed by a single rescuer with a bag--valve--mask device.
The 2005 guidelines for cardiopulmonary resuscitation (CPR) do not include a statement on performance of basic life support by a single healthcare professional using a bag-valve-mask device. Three positions are possible: chest compressions and ventilations from over the head of the casualty (over-the-head CPR), from the side of the casualty (lateral CPR), and chest compressions from the side and ventilations from over the head of the casualty (alternating CPR). The aim of this study was to compare CPR quality of these three positions. ⋯ In the case of a single healthcare professional using a bag-valve-mask device, the quality of over-the-head CPR is at least equivalent to lateral, and superior to alternating CPR. Because of the potential difficulties in bag-valve-mask ventilation in the lateral position, the authors recommend over-the-head CPR.