Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether low-dose ketamine is better than morphine at safely and effectively reducing pain scores in ED patients with acute pain who do not respond to conventional therapies. One hundred and thirty-two papers were found using the reported searches, of these three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that the evidence is limited, but that ketamine can be an effective alternative or adjunct to intravenous opioid pain medications and in some instances may provide more effective pain relief when compared with opioids.
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Compression-only cardiopulmonary resuscitation (CPR) has been advocated as a preferable approach for bystanders in an out-of-hospital cardiac arrest (OHCA) event as it has been associated with an increased chance of survival. The elimination of mouth-to-mouth ventilation also addresses some of the barriers to performing CPR. The aim of this study is to undertake a literature review investigating the effectiveness of compression-only CPR in improving rescuers' CPR performance when compared with standard CPR. ⋯ More studies are needed to determine whether compression-only CPR can indeed help improve rescuers' CPR performance. Future research efforts, together with resuscitation policy and practice implications, are needed to further improve rescuers' CPR performance with the ultimate goal to enhance OHCA survival rates.
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In the year 1966, important advances in mobile coronary care and trauma care in the UK and USA influenced globally the development of modern prehospital emergency services and paramedic education. In that year, to meet the evolving role of prehospital care in the UK, the 'Millar Report' specified a new syllabus for ambulance personnel in England. As the 50th anniversary of this report approaches, this paper reviews key national UK reports to describe the development of paramedic education in England over this period. ⋯ Political reform agendas and initiatives and advances in clinical medicine largely shaped paramedic roles and education in England. The degree to which the paramedic profession initiated education development is difficult to determine from the literature. Overall, a nationally coherent standard for paramedic education in England needed five decades to develop and mature.
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A short cut review was carried out to establish whether incision and drainage followed by treatment with oral trimethoprim-sulfamethoxazole is better than incision and drainage alone at treating patients with uncomplicated skin abscesses. One hundred and ninety-seven papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that trimethoprim-sulfamethoxazole may help with abscess cure, and will decrease abscess formation at new sites.