Emergency medicine journal : EMJ
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Randomized Controlled Trial
Cardioversion of acute atrial fibrillation in the emergency department: a prospective randomised trial.
Strategies to restore sinus rhythm in patients with atrial fibrillation (AF) lasting less than 48 h with haemodynamic stability remain controversial. The aim of this study was to test the hypothesis that electrical cardioversion (EC) would be more effective and safer in converting acute AF to sinus rhythm, compared with intravenous propafenone treatment. ⋯ EC was more effective in patients with acute AF and resulted in a shorter length of stay in the ED than PC. Adverse events were small in number and transient in both groups of patients. Clinical trials registration number NCT00933634.
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Randomized Controlled Trial
Slow infusion metoclopramide does not affect the improvement rate of nausea while reducing akathisia and sedation incidence.
To compare the effects of metoclopramide infusion in emergency department (ED) patients complaining of nausea to determine the changes in its therapeutic effect and prevention of side effects such as akathisia and sedation. ⋯ Even though slowing the rate of infusion of metoclopramide does not affect the rate of improvement in nausea, it may be an effective strategy for reducing the incidence of akathisia and sedation in patients with nausea.
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Randomized Controlled Trial Comparative Study
A comparison of the suction laryngoscope and the Macintosh laryngoscope in emergency medical technicians: a manikin model of severe airway haemorrhage.
The use of a suction laryngoscope that enables simultaneous suction and laryngoscopy was evaluated. 34 emergency medical technicians intubated the trachea of a manikin with simulated upper airway haemorrhage using the suction laryngoscope and the Macintosh laryngoscope, in random order. When using the suction laryngoscope, the number of oesophageal intubations was lower (3/34 vs 11/34; p=0.021) and the time taken to intubation was shorter (mean (SD) 50 (15) vs 58 (27) s; p=0.041). In cases of airway haemorrhage, the use of the suction laryngoscope might be beneficial.
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Randomized Controlled Trial Comparative Study
Randomised comparison of intravenous paracetamol and intravenous morphine for acute traumatic limb pain in the emergency department.
To compare the clinical effectiveness of intravenous paracetamol with intravenous morphine in patients with moderate to severe traumatic limb pain. ⋯ Intravenous paracetamol appears to provide a level of analgesia comparable to intravenous morphine in isolated limb trauma. Further larger studies are required.
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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.