title: The role of acupuncture in emergency department settings: a systematic review.
abstract: OBJECTIVE
  Patients with non-emergent and non-life threatening conditions often present to the emergency department (ED), which hinders the efficient utilisation of healthcare resources. Acupuncture has frequently been used for such common conditions, although not in the ED context. This study aimed to evaluate the current evidence for acupuncture treatment in the ED and to inform future randomised controlled trials (RCTs) for acupuncture in ED settings.
  
  
  METHODS
  Four English databases (MEDLINE, EMBASE, CENTRAL and AMED) were systematically searched to identify studies that tested the effects of acupuncture in ED settings using the search terms of "acupuncture" and "emergency". Data extraction and the risk of bias assessments were performed by two independent reviewers.
  
  
  RESULTS
  Of the 102 screened studies, two RCTs and two uncontrolled observational studies were deemed eligible. Sample sizes ranged from 42 to 100. The conditions treated included various musculoskeletal and non-musculoskeletal symptoms and showed substantial clinical heterogeneity. Acupuncture was delivered in conjunction with standard medical care with the goal of immediate pain alleviation; in one RCT, acupuncture resulted in a positive outcome, but it did not in the other. The risk of bias was generally high or unclear. Uncontrolled studies reported beneficial effects for acupuncture, although these studies were prone to bias. Two studies reported mild and transient adverse events associated with acupuncture.
  
  
  CONCLUSIONS
  The current evidence is insufficient to make any recommendations concerning the use of acupuncture in the ED. The effectiveness and safety as well as the feasibility of acupuncture should be tested in future RCTs.
authors: Department of Acupuncture & Moxibustion Medicine, Korean Medicine Hospital, Pusan National University, Yangsan, South Korea.
authors: Kun Hyung
authors: KH
authors: Kim
authors: Byung Ryul
authors: BR
authors: Lee
authors: Ji Ho
authors: JH
authors: Ryu
authors: Tae-Young
authors: TY
authors: Choi
authors: Gi Young
authors: GY
authors: Yang
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged