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The Cochrane PEC team wishes you all the best for 2019. Our field is involved in knowledge translation and diffusion to health professionals and public about emergency medicine, news and change in practice. All year round, meet us in conferences, training sessions and on our website!


Dr Nagi Souaiby

Nagi Souaiby

Emergency and Forensic Medicine
Faculty of Medicine, St Joseph University, Beirut – Lebanon
Chief editor – MJEM
Director – National School for Emergency Care
President – Lebanese Resuscitation Council
Head of the ED – ND Maritime hospital, Byblos – Lebanon



Dr Souaiby is an emergency physician based in Byblos, Lebanon. He’s involved in research and publication through its role as editor in chief of the Mediterranean Journal of Emergency Medicine (MJEM). 





We are pleased to work with him in disseminating Cochrane systematic reviews relevant to emergency medicine. Succinct summaries of these reviews are published in a Cochrane Corner in the MJEM.




The Cochrane PEC PEARLS consists of succinct summaries of Cochrane systematic reviews relevant to emergency medicine, developped in french by members of the Cochrane PEC .

 Find our Cochrane PEC PEARLS in the AFMU



Vitamin K antagonists (VKA) versus low-molecular-weight heparin (LMWH) for the long term treatment of symptomatic venous thromboembolism (VTE)

Alina Andras, Adriano Sala Tenna, Marlene Stewart

Moderate‐quality evidence shows no clear differences between LMWH and VKA in preventing symptomatic VTE and death after an episode of symptomatic Deep Vein Thrombosis. LMWH may represent an alternative for some patients, for example, those residing in geographically inaccessible areas, those who are unable or reluctant to visit the thrombosis service regularly, and those with contraindications to VKA.

Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation

Karsten MH Bruins Slot, Eivind Berge

Treatment with factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in people with atrial fibrillation. The absolute effect of factor Xa inhibitors compared with warfarin treatment was, however, rather small. Factor Xa inhibitors also reduced the number of intracranial haemorrhages, all‐cause deaths and major bleedings compared with warfarin.

Delayed antibiotic prescriptions for respiratory infections

Geoffrey KP Spurling, Chris B Del Mar, Liz Dooley, Ruth Foxlee, Rebecca Farley

For many clinical outcomes, there were no differences between prescribing strategies. Symptoms for acute otitis media and sore throat were modestly improved by immediate antibiotics compared with delayed antibiotics. There were no differences in complication rates. Delaying prescribing did not result in significantly different levels of patient satisfaction compared with immediate provision of antibiotics . However, delay was favoured over no antibiotics . Delayed antibiotics achieved lower rates of antibiotic use compared to immediate antibiotics (31% versus 93). Delayed antibiotics for people with acute respiratory infection reduced antibiotic use compared to immediate antibiotics, but was not shown to be different to no antibiotics in terms of symptom control and disease complications.

Plasma transfusions prior to lumbar punctures and epidural catheters for people with abnormal coagulation

Lise J Estcourt, Michael J Desborough, Carolyn Doree, Sally Hopewell, Simon J Stanworth

There is no evidence to determine whether plasma transfusions are required prior to insertion of a lumbar puncture needle or epidural catheter, and, if plasma transfusions are required, what is the degree of coagulopathy at which they should be given.

Direct oral anticoagulants (DOAC) versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation (AF) patients with chronic kidney disease (CKD)

Miho Kimachi, Toshi A Furukawa, Kimihiko Kimachi, Yoshihito Goto, Shingo Fukuma, Shunichi Fukuhara

DOAC are as likely as warfarin to prevent all strokes and systemic embolic events without increasing risk of major bleeding events among AF patients with kidney impairment. These findings should encourage physicians to prescribe DOAC in AF patients with CKD without fear of bleeding.

Inhaled magnesium sulfate in the treatment of acute asthma

Rachel Knightly, Stephen J Milan, Rodney Hughes, Jennifer A Knopp-Sihota, Brian H Rowe, Rebecca Normansell, Colin Powell

Treatment with nebulised MgSO₄ may result in modest additional benefits for lung function and hospital admission when added to inhaled β₂‐agonists and ipratropium bromide. Individual studies suggest that those with more severe attacks and attacks of shorter duration may experience a greater benefit but further research into subgroups is warranted.

Corticosteroids for pneumonia

Anat Stern, Keren Skalsky, Torner Avni, Elena Carrara, Leonard Leibovici, Mica Paul

Corticosteroid therapy reduced mortality and morbidity in adults with severe comminuty-aquired pneumonia (CAP). Corticosteroid therapy reduced morbidity, but nor mortality, for adults and children with non-severe CAP. Corticostéroid therapy was associated with more adverse events, especially hyperglycaemia, but the harms did not seem to outweigh the benefits.

Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children

Amy McTague, Timothy Martland, Richard Appleton

Intravenous lorazepam and diazepam appear to be associated with similar rates of seizure cessation and respiratory depression. Although intravenous lorazepam and intravenous diazepam lead to more rapid seizure cessation, the time taken to obtain intravenous access may undermine this effect. In the absence of intravenous access, buccal midazolam or rectal diazepam are therefore acceptable first‐line anticonvulsants for the treatment of an acute tonic‐clonic convulsion that has lasted at least five minutes. There is no evidence provided by this review to support the use of intranasal midazolam or lorazepam as alternatives to buccal midazolam or rectal diazepam.

Antifibrinolytic drugs for treating primary postpartum haemorrhage

Haleema Shakur, Danielle Beaumont, Sue Pavord, Angele Gayet-Ageron, Katharine Ker, Hatem A Mousa

Tranexamic Acid (TXA) when administered intravenously reduces mortality due to bleeding in women with primary post partum haemorrhage, irrespective of mode of birth, and without increasing the risk of thromboembolic events. Taken together with the reliable evidence of the effect of TXA in trauma patients, the evidence suggests that TXA is effective if given as early as possible.

Different durations of corticosteroid therapy for exacerbations of chronic obstructive pulmonary disease (COPD)

Julia AE Walters, Daniel J Tan, Clinton J White, Richard Wood-Baker

Five days of oral corticosteroids is likely to be sufficient for treatment of adults with acute exacerbations of COPD, and this review suggests that the likelihood is low that shorter courses of systemic corticosteroids (of around five days) lead to worse outcomes than are seen with longer (10 to 14 days) courses.

Mechanical versus manual chest compressions for cardiac arrest

Peter L Wang, Steven C Brooks

The evidence does not suggest that cardio pulmonary resuscitation (CPR) protocols involving mechanical chest compression devices are superior to conventional therapy involving manual chest compressions only. We conclude on the balance of evidence that mechanical chest compression devices used by trained individuals are a reasonable alternative to manual chest compressions in settings where consistent, high‐quality manual chest compressions are not possible or dangerous for the provider.

Interventions for necrotizing soft tissue infections (NSTI) in adults

Camille Hua, Romain Bosc, Emilie Sbidian, Nicolas De Prost, Carolyn Hughes, Patricia Jabre, Olivier Chosidow, Laurence Le Cleach

Authors found very little evidence on the effects of medical and surgical treatments for NSTI. We cannot draw conclusions regarding the relative effects of any of the interventions on 30‐day mortality or serious adverse events due to the very low quality of the evidence.

Airway physical examination tests for detection of difficult airway management in apparently normal adult patients

Dominik Roth, Nathal L Pace, Anna Lee, Karent Hovhannisyan, Alexandra-Maria Warenits, Jasmin Arrich, Harald Herkner

Bedside airway examination tests, for assessing the physical status of the airway in adults with no apparent anatomical airway abnormalities, are designed as screening tests. Screening tests are expected to have high sensitivities. We found that all investigated index tests had relatively low sensitivities with high variability. The upper lip bite test showed the most favourable diagnostic test accuracy properties.

Point-of-care ultrasonography (POCS) for diagnosing thoracoabdominal injuries in patients with blunt trauma

Dirk Stengel, Johannes Leisterer, Paula Ferrada, Axel Ekkernkamp, Sven Mutze, Alexander Hoenning

In patients with suspected blunt thoracoabdominal trauma, positive POCS findings are helpful for guiding treatment decisions. However, with regard to abdominal trauma, a negative POCS exam does not rule out injuries and must be verified by a reference test such as Computerized Tomography. This is of particular importance in paediatric trauma, where the sensitivity of POCS is poor. Based on a small number of studies in a mixed population, POCS may have a higher sensitivity in chest injuries.


In April 2018, The Cochrane PEC has launched his priority setting exercise, aiming to generate a list of some priority topics of interest to its stakeholders.

The Cochrane PEC decided to search for gaps based on topics presented at annual scientific meetings: Urgences 2018 of the French Society of Emergency Medicine, EUSEM 2018 of the European Society of Emergency Medicine and most probably the SAEM19 of the Society for Academic Emergency Medicine.

The Cochrane PEC works closely with the Cochrane Acute and Emergency Care network and other Cochrane networks on this project.


We've been there


Notre Dame Maritime Hospital

19-21 April 2018

Byblos, Lebanon



 urg 2018

13-15 June 2018

Paris, France



8-12 September 2018

Glasgow, Scotland.







13 September 2018

Quimper, France




16-18 September 2018

Edinburgh, Scotland


The Cochrane PEC will take an active part in the following events:urg 19


5-7 June 2019

Paris, France







1-5 April 2019

Krakow, Poland





14-17 May 2019

Las Vegas, Nevada, USA






12-16 October 2019

Prague, Czech Republic





22-25 October 2019

Santiago, Chile




In order to develop and build on existing work and to encourage sharing of good practice, Cochrane has developed a Knowledge Translation Framework which is at the core of delivering Cochrane’s Strategy to 2020. Implementing this Framework will help us work towards ensuring the right Reviews are produced, in the right format and for the right audiences.







All Cochrane learning resources are listed on training.cochrane



Appel à candidatures des nouveaux membres du Cochrane Pre-hospital and Emergency Care (Cochrane PEC)

Le Cochrane PEC, soutenu par la Société Française de Médecine d'Urgence, renouvelle certains de ses membres. Le Cochrane PEC, les idées fortes : Reformatter les revues Cochrane intéressant la M[...]

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Cochrane Pre-hospital and Emergency Care
Contact : Patricia Jabre, director
SAMU de Paris - Hôpital Necker Enfants Malades - APHP
Université Paris Descartes - Paris V
149 rue de Sèvres, 75015 Paris, France
Phone: +33 1 44 49 24 51


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