The American journal of emergency medicine
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Review Meta Analysis
A meta-analysis for Kuanxiong Aerosol on the treatment of angina pectoris.
Kuanxiong Aerosol (KA) has been used in patients with angina pectoris (AP) attacks for many years, this systematic review and meta-analysis aims to evaluate the clinical efficacy and safety of KA versus nitrates in the treatment of AP. ⋯ The clinical use of KA is effective and safe on the treatment of AP, which appears to be better than nitrates in terms of efficiency, adverse reactions, endothelial function and inflammatory response. Nevertheless, due to some limitations in the sample size and quality of the included studies, more high-quality RCTs were still needed for further verification.
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Randomized Controlled Trial Multicenter Study
A multicenter randomized controlled trial of a modified Valsalva maneuver for cardioversion of supraventricular tachycardias.
Valsalva maneuver is a recognized treatment for supraventricular tachycardia, but in clinical setting it has a low chance to achieve successful cardioversion. Studies suggested that the postural modification of valsalva maneuver may improve the rate of cardioversion. We further modified the maneuver and conduct a multicenter randomized controlled trial to test its efficacy. ⋯ To verify the efficacy of the modified Valsalva maneuver in SVT in Chinese population and simplify the operation process further.
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Multicenter Study
Variations in access to specialty care for children with severe burns.
Pediatric burns account for 120,000 emergency department visits and 10,000 hospitalizations annually. The American Burn Association has guidelines regarding referrals to burn centers; however there is variation in burn center distribution. We hypothesized that disparity in access would be related to burn center access. ⋯ The majority of children who met criteria were treated at burn centers. There was no significant difference between geographical regions. Of those who were treated at burn centers, more severe injury patterns were noted, but there was no significant mortality difference. Further study of optimal referral of pediatric burn patients is needed.
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Coagulation panels are ordered for a variety of conditions in the emergency department (ED). ⋯ Little utility for coagulation assessment is present for the evaluation of chest pain, routine perioperative assessment, initiation of anticoagulation, and screening for admitted patients. However, coagulation panel assessment should be considered in patients with hemorrhage, patients on anticoagulation, and personal history or family history of bleeding.
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Hands-on defibrillation (HOD) is a technique that has great potential to positively impact outcomes from cardiopulmonary resuscitation (CPR) with the removal of an interruption in chest compressions. The safety and efficacy of HOD, however, have yet to be proven. This review aims to examine the safety of HOD, and secondarily, its efficacy. ⋯ HOD generally appears safe, though significant uncertainty still remains for each protective barrier type. HOD appears to be efficacious in improving CPR with no strong evidence to suggest otherwise.