“Sir William Osler (1849–1919) said, 
 In science credit goes to the man who convinces the world, not to the man to whom the idea first occurs”

The desire to provide the highest possible level of care to all our patients is one of the primary motivations of emergency physicians. The scope of our practice is such that we need to be aware of the developments in most other specialties. The Cochrane Database continues to provide the world with rigorous analysis of research and thus gives us the opportunity to use this information in the best interests of our patients.

In this synopsis Of Cochrane Reviews applicable to emergency services (SOCRATES), we will look at the reviews that we found in our assessment of the output of the Cochrane Heart Group.

METHODS

The method used to find and summarise the reviews is as described previously. We found eight reviews from the Cochrane Heart Group that we thought were of particular relevance.

ACTIVE CHEST COMPRESSION–DECOMPRESSION FOR CARDIOPULMONARY RESUSCITATION

Background

The objective of this review was to determine whether active compression–decompression cardiopulmonary resuscitation (CPR) using a handheld suction device improved outcome (mortality) compared with standard manual CPR in adult patients with cardiac arrest. The secondary outcome measure was complications of CPR—for example, rib fractures or pneumothorax.

Results

Eight out-of-hospital studies (n = 4162), one in-hospital study (n = 53) and one study with both in-hospital and out-of-hospital components (n = 773) were included. No difference was found in mortality, survival to discharge or complications between the active compression–decompression CPR group and the standard manual CPR group.

SOCRATES says

Active compression–decompression CPR does not improve the outcome of adult patients with cardiac arrest when compared with standard manual CPR.

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ANTICOAGULANTS OR ANTIPLATELET TREATMENT FOR NON-RHEUMATIC ATRIAL FIBRILLATION AND FLUTTER

Background

Patients with atrial fibrillation and atrial flutter are at an increased risk of stroke. This review aimed to identify randomised controlled trials of drugs used to prevent thromboembolism in …