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
Does computer-aided clinical decision support improve the management of acute abdominal pain? A systematic review.
Acute abdominal pain is a common reason for emergency presentation to hospital. Despite recent medical advances in diagnostics, overall clinical decision-making in the assessment of patients with undifferentiated acute abdominal pain remains poor, with initial clinical diagnostic accuracy being 45-50%. Computer-aided decision support (CADS) systems were widely tested in this arena during the 1970s and 1980s with results that were generally favourable. ⋯ Included articles underwent meta-analysis with a random-effects model. Ten studies underwent meta-analysis that demonstrated an overall mean percentage improvement in clinical diagnostic accuracy of 17.25% with the use of CADS systems. There is a role for CADS in the initial evaluation of acute abdominal pain, which very often takes place in the emergency department setting.
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Review Meta Analysis
Can the Ottawa knee rule be applied to children? A systematic review and meta-analysis of observational studies.
The Ottawa knee rule (OKR), a clinical decision aid is used to reduce unnecessary radiography. It is not clear whether this rule can be applied to children. ⋯ The OKR has high sensitivity and adequate specificity for children over the age of 5 years. There are not enough good data to advocate application of the OKR in children less than 5 years.
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Review Meta Analysis
Intravenous and nebulised magnesium sulphate for acute asthma: systematic review and meta-analysis.
To estimate the effect of intravenous and nebulised magnesium sulphate upon hospital admissions and pulmonary function in adults and children with acute asthma. ⋯ Intravenous magnesium sulphate appears to be an effective treatment in children. Further trials are needed of intravenous and nebulised magnesium sulphate in adults and nebulised magnesium sulphate in children.
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Review Meta Analysis
Potential cervical spine injury and difficult airway management for emergency intubation of trauma adults in the emergency department--a systematic review.
Emergency airway management for trauma adults is practised by physicians from a range of training backgrounds and with differing levels of experience. The indications for intubation and technique employed are factors that vary within EDs and between hospitals. ⋯ Full literature search for relevant articles in Medline (1966-2003), EMBASE (1980-2003), and the Cochrane Central Register of Controlled Trials. Relevant articles relating to adults and written in English language were appraised. English language abstracts of foreign articles were included. Studies were critically appraised on a standardised data collection sheet to assess validity and quality of evidence. The level of evidence was allocated using the methods of the Australian National Health and Medical Research Council.