I have two questions I would be interested in hearing replies on.
Firstly the management of carbon monoxide poisoning with hyperbaric oxygen. Ive recently performed an EBM review on the above and come to the conclusion that HBO is not of any value - mostly on the basis of a well designed australian study, the only one which is a true RTC. With the others reaching conflicting conslusions as to its value.
http://www.mja.com.au/public/issues/mar1/sheink/sheink.html
However despite what I perceive is a well done study, the standard of care is still very much for HBO, Id appreciate any thoughts on this. Are there problems with the study Ive missed ? Is there anyone involved in hyperbaric medicine on the list with a opinion ?
And secondly, the use of ace-inhibitors in severe pulmonary oedema. There is good evidence that they work, yet it it appears they are rarely being used in English or Australasian practice ( I may be wrong here ). Indeed, a recent ABC article in the BMJ, did not even mention them in the mangement of acute LVF. So why are we not using them ? Or if you are, what do think of them anecdotally ?
many thanks
Craig
Dr Craig Ellis
Emergency Medicine Registrar
Wellington Hospital
Wellington, New Zealand.
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