Abstract:
STUDY OBJECTIVE:Anecdotal concerns suggest that health management organization (HMO) membership instructions may deter members from calling 911 or going to an emergency department for a perceived emergency. This study examines such instructions, specifically in regard to their definition of an emergency condition and associated instructions. METHODS:Member instructions were requested from 28 HMOs in 3 large West Coast cities with HMO penetration exceeding 30%. Fifteen (54%) provided membership materials. Features examined included the definition of an emergency, instructions for calling 911, specific instructions regarding chest pain and stroke, and mention of costs associated with emergency care. RESULTS:Instructions and definitions varied widely. Six HMOs (40%) included chest pain in their definition of an emergency; 2 (13%) included symptoms of stroke. Ten (67%) made mention of calling 911 or going to the ED somewhere within their instructions; 4 (27%) provided no options for calling 911 or seeking ED care. Three (20%) cited higher costs associated with ED care. Eleven (73%) indicated that claims would be denied for visits determined on retrospective review to be nonemergencies. CONCLUSION:Instructions varied considerably. Most did not include chest pain or symptoms of stroke in their definition of an emergency. Most did include directions to call 911 or go to an ED. Other instructions may lead members to call the HMO first during an emergency.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Neely KW,Norton RLdoi
10.1016/s0196-0644(99)70267-2subject
Has Abstractpub_date
1999-07-01 00:00:00pages
19-24issue
1eissn
0196-0644issn
1097-6760pii
S0196064499002012journal_volume
34pub_type
杂志文章abstract::The medical antishock trouser (MAST) has been advocated as potentially beneficial in the resuscitation of patients in cardiac arrest. Currently available data indicate that the MAST will increase the blood pressure generated by external cardiopulmonary resuscitation. In addition, there may be an increased survival of ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80453-9
更新日期:1984-09-01 00:00:00
abstract:STUDY OBJECTIVE:Computed tomography (CT) is frequently used in evaluating children with blunt head trauma. Routine use of CT, however, has disadvantages. Therefore, we sought to derive a decision rule for identifying children at low risk for traumatic brain injuries. METHODS:We enrolled children with blunt head trauma...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/s0196-0644(03)00425-6
更新日期:2003-10-01 00:00:00
abstract::A seven-year-old boy ingested 3,000 mg (125 mg/kg) of isoniazid. Initial blood levels of isoniazid were 250 micrograms/mL approximately six hours after ingestion. Despite IV treatment in the emergency department with 3,000 mg pyridoxine and a repeat of the same antidote one hour later in the intensive care unit, the h...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80509-2
更新日期:1988-01-01 00:00:00
abstract::Managed care organizations (MCOs) have proliferated throughout the United States. Interaction by patients, physicians, and emergency medical services systems with MCOs is evolving. Although MCOs have had some notable successes in reducing health care expenditures, the way in which MCO enrollees gain access to emergenc...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70098-7
更新日期:1996-12-01 00:00:00
abstract:STUDY OBJECTIVE:Immobility predisposes to venous thromboembolism, but this risk may vary, depending on the underlying cause of immobility. METHODS:This was a prospective, longitudinal outcome study of self-presenting emergency department (ED) patients who were from 12 hospitals and had suspected venous thromboembolism...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2008.10.033
更新日期:2009-08-01 00:00:00
abstract:STUDY OBJECTIVES:To determine whether music significantly reduces the pain and anxiety associated with laceration repair in the emergency department. PARTICIPANTS AND SETTING:Adult patients presenting to the ED at an urban teaching hospital for laceration repair. Exclusion criteria included patients less than 18 years...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(05)81652-x
更新日期:1991-04-01 00:00:00
abstract::In May 1993, the appearance of critically ill patients with unexplained respiratory distress was noted in the Four Corners area formed by New Mexico, Arizona, and Colorado. This epidemic was ultimately linked to a hantavirus, an emerging pathogen. The impact on the emergency department of a new infectious disease with...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70179-2
更新日期:1994-09-01 00:00:00
abstract::We present the case of a 6-year-old boy with reactive airway disease who developed cervical lung herniation resulting in compression of the trachea and audible stridor. This association has never been reported in the pediatric age group, and a review of the literature revealed that lung herniation is a rare condition ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81574-4
更新日期:1990-08-01 00:00:00
abstract:STUDY OBJECTIVES:To survey faculty attrition in emergency medicine and compare it with faculty attrition in the specialties of orthopedic surgery and cardiology. DESIGN:Chairmen of the three departments were surveyed regarding faculty attrition, work hours, and motivation for leaving. Those emergency physicians having...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81110-2
更新日期:1991-01-01 00:00:00
abstract::Hemodynamically unstable patients will benefit from therapy to control their blood pressure only if this pressure can be determined with accuracy. We compared the accuracy of arterial blood pressure measurements taken aboard helicopters by palpation with a Doppler device and with an oscillometric device. Twenty critic...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80401-3
更新日期:1988-06-01 00:00:00
abstract::Lisfranc fracture-dislocations are rare, and their correct diagnosis is important. Misdiagnosis is common and can lead to grave, chronic disability. We present two cases of Lisfranc fracture-dislocation to highlight the mechanisms of injury, clinical presentation, diagnosis, and treatment. Accurate diagnosis by emerge...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70156-7
更新日期:1995-08-01 00:00:00
abstract::As the sciences of emergency medicine and acute care medicine develop, it becomes imperative for researchers in these fields to accurately and completely report the methodology of their investigations. It is only through complete reporting that other investigators can critically examine, replicate, or expand on the re...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80244-4
更新日期:1985-10-01 00:00:00
abstract:STUDY OBJECTIVE:The primary objective is to compare total sedation time when ketamine/propofol is used compared with ketamine alone for pediatric procedural sedation and analgesia. Secondary objectives include time to recovery, adverse events, efficacy, and satisfaction scores. METHODS:Children (aged 2 to 17 years) re...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2010.08.032
更新日期:2011-05-01 00:00:00
abstract:STUDY OBJECTIVE:To develop clinical rules for the safe and effective use of flumazenil in suspected benzodiazepine overdose. METHODS:We assembled a retrospective series of 35 consecutive comatose patients admitted between October 1992 and July 1993 to a toxicologic ICU with the presumptive diagnosis of drug overdose. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70191-9
更新日期:1996-06-01 00:00:00
abstract::Excitatory behavior, xerostomia, chest pain, severe dyspnea, tachycardia (150 beats/min), and mild hypertension (160/80 mm Hg) without ECG abnormalities were observed in a 20-year-old subject 6 hours after nasal insufflation (snorting) of a "legally" obtained white powdered substance sold as Synthacaine. A serum sampl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.01.007
更新日期:2014-12-01 00:00:00
abstract:STUDY OBJECTIVE:We characterize repeat pediatric emergency department visits and determine the cause for such visits as an indicator of potential need for quality improvement. We hypothesized that most repeat ED visits resulting in hospitalization do not represent medical errors. METHODS:The study was performed at a l...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.116595
更新日期:2002-02-01 00:00:00
abstract::Emergency clinicians often care for patients with terminal illness who are receiving hospice care and many more patients who may be in need of such care. Hospice care has been shown to successfully address the multidimensional aspects of the end-of-life concerns of terminally ill patients: dying with dignity, dying wi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2010.06.569
更新日期:2011-03-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the spectrum of electrical injuries and develop guidelines for management. DESIGN:Retrospective review of charts compiled during a 6-year period (1988 through 1993). SETTING:Pediatric emergency department. PARTICIPANTS:Seventy-eight patients seen for electrical injuries. RESULTS:Fifty-fou...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70012-9
更新日期:1995-11-01 00:00:00
abstract:STUDY OBJECTIVE:Influenza has been linked to emergency department (ED) crowding, yet few studies have examined this association. We describe the relationship between ED crowding and influenza outbreaks. METHODS:A retrospective time series analysis was conducted in Toronto from January 1996 to April 1999 (n=170 weeks)....
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2003.12.008
更新日期:2004-07-01 00:00:00
abstract::Systemic toxicity after significant dermal exposure to hydrofluoric acid includes rapid development of hypocalcemia and hyperkalemia, leading to ventricular fibrillation. Similar dysrhythmias have occurred in patients after ingestion of sodium fluoride-containing compounds. Ingestion of hydrofluoric acid could induce ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81910-9
更新日期:1992-11-01 00:00:00
abstract:STUDY PURPOSE:To evaluate the efficacy of adenosine in the treatment of emergency department patients with unstable paroxysmal supraventricular tachycardia (PSVT). DESIGN:A retrospective chart review conducted over two years. SETTING:A university-affiliated hospital ED. PARTICIPANTS:Patients with unstable PSVT (syst...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81853-0
更新日期:1993-04-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to develop and validate standardized clinical criteria to identify patients presenting to the emergency department whose care may be safely deferred to a later date in a nonemergency setting. METHODS:Using a modified Delphi process, a 17-member multidisciplinary physician panel developed expl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2000.107003
更新日期:2000-07-01 00:00:00
abstract::Because of discontinuation of base hospital participation, paramedics in a large urban zone of a California emergency medical services (EMS) system serving 1.1 million persons went on emergency standing orders for nearly all calls requiring advanced life support. Subsequently, the base hospital resumed medical control...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80944-8
更新日期:1989-10-01 00:00:00
abstract::Fentanyl is an attractive agent for analgesia in the emergency department. Its use in this setting has been limited to IV bolus administration. We report successful sedation, muscle relaxation, and analgesia of a multiple trauma patient with fentanyl IV bolus and continuous infusion in the ED. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81439-8
更新日期:1991-08-01 00:00:00
abstract::An important aspect in the effective management of an emergency medical services system is the ability to monitor system performance. To provide this information on a timely basis, a comprehensive data collection system is required. We describe the design, implementation, use, and effect of a comprehensive, computeriz...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80847-9
更新日期:1989-05-01 00:00:00
abstract::Emergency thoracotomy has become a mainstay in the resuscitation of patients with major thoracic injuries. It also is occasionally useful in several other life-threatening conditions. The specific indications for emergency thoracotomy are reviewed, and expeditious thoracotomy in the emergency department, when necessar...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80057-1
更新日期:1981-05-01 00:00:00
abstract::Paliperidone, or 9-hydroxy risperidone, is the newest atypical antipsychotic agent to be approved for use by the Food and Drug Administration. Despite being the primary active metabolite of risperidone, paliperidone differs in several ways from risperidone. The most notable difference is that paliperidone is formulate...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.10.015
更新日期:2011-07-01 00:00:00
abstract::Management of snake venom poisoning with antivenin has been the time-proven and medically accepted standard in virtually every country, including the United States. All antivenins are equine in source, and administration to patients exposes them to all the adverse effects of heterologous antisera. The purity and speci...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80737-0
更新日期:1987-09-01 00:00:00
abstract::We present the cases of three patients with skin blisters following carbon monoxide (CO) poisoning. Their blisters appeared to be related to the severity of the poisoning (HbCO levels of more than 40%). Two of the three patients died despite aggressive initial 100% surface oxygen followed by hyperbaric oxygen therapy....
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80792-7
更新日期:1985-06-01 00:00:00
abstract::Life-threatening hypothermia can be treated by active and passive rewarming techniques, the treatment of choice being partial cardiopulmonary bypass. The use of closed thoracic cavity lavage has been evaluated in animals, but no formal presentations in human beings have been reported. We report two cases in which rapi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81810-4
更新日期:1990-02-01 00:00:00