Abstract：
STUDY OBJECTIVES:To determine the sensitivity and specificity of the urine ketone dip test as a screening test for ketonemia in hyperglycemic patients and to compare the performance of the urine ketone dip test with the anion gap and serum bicarbonate level. METHODS:This was a prospective study conducted in an urban, university-affiliated public hospital emergency department. Inclusion criteria consisted of (1) patients with known diabetes and hyperglycemia (glucose level>200 mg/dL) and any complaint of illness, or (2) patients with hyperglycemia and symptoms of undiagnosed diabetes mellitus. Urine ketone dip test, serum ketone, and electrolyte levels were determined on all subjects. Sensitivity, specificity, and predictive values along with 95% confidence intervals (CIs) were calculated. RESULTS:The study group comprised 697 patients, including 98 patients with diabetic ketoacidosis (DKA) and 88 with diabetic ketosis (DK). The sensitivity, specificity, positive, and negative predictive values of the urine ketone dip test for the detection of DKA were 99% (95% CI 97% to 100%), 69% (95% CI 66% to 73%), 35% (95% CI 29% to 41%), and 100% (95% CI 99% to 100%), respectively. For DKA and DK, the sensitivity, specificity, positive, and negative predictive values of the urine ketone dip test were 95% (95% CI 90% to 97%), 80% (95% CI 76% to 83%), 63% (95% CI 57% to 69%) and 98% (95% CI 96% to 99%). The anion gap and serum bicarbonate level were less sensitive but more specific than the urine ketone dip test for the detection of DKA and DK. CONCLUSION:The urine ketone dip test has high sensitivity for detecting DKA and a high negative predictive value for excluding DKA in hyperglycemic patients with diabetes with any symptoms of illness. The urine ketone dip test is a better screening test for DKA and DK than the anion gap or serum bicarbonate.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Schwab TM,Hendey GW,Soliz TCdoi
10.1016/s0196-0644(99)70128-9subject
Has Abstractpub_date
1999-09-01 00:00:00pages
342-6issue
3eissn
0196-0644issn
1097-6760pii
S0196064499002991journal_volume
34pub_type
杂志文章abstract：STUDY OBJECTIVE:In 2008, a pay-for-performance program was implemented in sequential waves in Ontario emergency departments (EDs), with the aim of reducing length of stay. We seek to evaluate its effects on ED length of stay and quality of care. METHODS:This was a retrospective observational study of ED visits in Onta...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2015.06.028
更新日期：2016-04-01 00:00:00
abstract：:Temporary ventricular pacing was successfully employed in two patients suffering refractory bradycardia following traumatic cardiac arrest. The hemodynamic response to pacing was dramatic and both patients eventually recovered fully from an apparent moribund state. Cardiac pacing may be an effective adjuvant in the ea...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80233-2
更新日期：1980-11-01 00:00:00
abstract：STUDY OBJECTIVE:Video capsule endoscopy has been used to diagnose gastrointestinal hemorrhage and other small bowel diseases but has not been tested in an emergency department (ED) setting. The objectives in this pilot study are to demonstrate the ability of emergency physicians to detect blood in the upper gastrointes...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/j.annemergmed.2012.11.008
更新日期：2013-04-01 00:00:00
abstract：STUDY OBJECTIVE:Buffered lidocaine was compared with plain lidocaine as a local anesthetic for simple lacerations. DESIGN:Randomized, double-blind, prospective clinical trial. SETTING:Urban emergency department. TYPE OF PARTICIPANTS:Ninety-one adult patients with simple linear lacerations were enrolled. Patients wit...
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)82603-4
更新日期：1990-12-01 00:00:00
abstract：:The 1982 US Festival, a three-day outdoor rock music festival, attracted close to 410,000 people. Through a private contractor, a group of physicians participated in the design, administration, and implementation of medical care for this event. Basic ambulatory care was provided by a multitiered approach, using emerge...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80986-6
更新日期：1986-05-01 00:00:00
abstract：STUDY OBJECTIVE:This study compares selected laboratory values of blood samples obtained by means of venipuncture and by means of a peripheral intravenous catheter after a normal saline solution bolus. METHODS:In this prospective experimental study, each participant served as his or her own control. Hospital employees...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1067/mem.2001.118015
更新日期：2001-11-01 00:00:00
abstract：STUDY OBJECTIVE:Tetanus antibody levels have been shown to be inadequate in 50% of patients older than 65 years. Although immunization recommendations have been made for this age group, the efficacy of this intervention has not been well documented. We sought to determine the difference in tetanus antibody levels after...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70005-2
更新日期：1997-10-01 00:00:00
abstract：:Varicella (Chicken pox) is a contagious disease common in childhood but uncommon in adulthood. Pneumonia, however, is a relatively common complication of the disease in adults. Recognition of the potential for this complication in adult patients with varicella is essential for the emergency physician. Three cases of v...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80679-5
更新日期：1986-08-01 00:00:00
abstract：:A patient with primary axillary vein thrombosis was treated successfully in the emergency department with a single IV bolus of anistrepalase followed by continuous IV heparin. The patient's symptoms resolved quickly, and a repeat venogram 16 hours later showed near-complete resolution of the venous obstruction. We dis...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81863-3
更新日期：1993-04-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate selective aortic arch perfusion (SAAP) with an oxygenated fluorocarbon emulsion, with and without aortic arch epinephrine during cardiac arrest. METHODS:This randomized, controlled study, undertaken at a university research laboratory, involved 15 mixed-breed dogs. After 10 minutes of ventr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70244-0
更新日期：1997-05-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the concordance of emergency physicians' and cardiologists' interpretations of abnormal ECGs. DESIGN:Retrospective cohort study. SETTING:An urban teaching hospital emergency department. TYPE OF PARTICIPANTS:Patients with an abnormal ED ECG that was interpreted by both an emergency physic...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82521-1
更新日期：1992-05-01 00:00:00
abstract：:There is general agreement that physical examination alone is inadequate for abdominal evaluation in the multiply injured blunt trauma patient; but controversy exists regarding the preferred method of detecting intraabdominal injuries requiring celiotomy. Both peritoneal lavage and the newer computed tomography imagin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80269-0
更新日期：1989-12-01 00:00:00
abstract：:Presented is the case of a 10-year-old child who presented in cardiopulmonary arrest from hypovolemic shock due to pathologic splenic rupture of undetermined etiology. Despite aggressive resuscitation efforts, the patient died. Although rare, pathologic rupture of an abnormal spleen must be considered in the patient w...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(82)80040-1
更新日期：1982-08-01 00:00:00
abstract：STUDY OBJECTIVE:Dabigatran is a reversible direct thrombin inhibitor recently approved for stroke prevention in patients with atrial fibrillation. An increasing number of patients receiving dabigatran present to the emergency department (ED) with bleeding complications. Unlike vitamin K antagonists, there are no accept...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.02.008
更新日期：2013-04-01 00:00:00
abstract：:Survival after out-of-hospital cardiac arrest is intimately related to the time from cardiovascular collapse to the initiation of CPR, or downtime. Furthermore, the reperfusion technique that optimizes coronary and cerebral blood flow after cardiac arrest may also be dependent on downtime. Peak blood lactate levels ha...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80408-0
更新日期：1987-12-01 00:00:00
abstract：STUDY OBJECTIVE:We identify factors that define frequent and highly frequent emergency department (ED) users. METHODS:Administrative health care records were used to define less frequent (1 to 6 visits), frequent (7 to 17 visits), and highly frequent (≥18 visits) ED users. Analyses were conducted to determine the most...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.11.036
更新日期：2012-07-01 00:00:00
abstract：STUDY OBJECTIVE:Methicillin-resistant Staphylococcus aureus (MRSA) transmission dynamics in the emergency department (ED) are not well defined; environmental surfaces may serve as reservoirs for transmission. This study investigates the effect of patients with a history of MRSA colonization or infection on subsequent M...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2018.12.014
更新日期：2019-07-01 00:00:00
abstract：:Autoerythrocyte sensitization syndrome is characterized by sudden and spontaneous painful bruising and swelling occurring in young female patients with psychiatric disorders. This syndrome may present with such severe swelling of involved areas that aspiration or excision may be needed to relieve pressure. The present...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80019-8
更新日期：1989-07-01 00:00:00
abstract：STUDY OBJECTIVE:The role of emergency department (ED) thoracotomy after blunt trauma is controversial. The objective of this review is to determine whether patients treated with an ED thoracotomy after blunt trauma survive and whether survivors have a good neurologic outcome. METHODS:A structured search was performed ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.annemergmed.2014.08.020
更新日期：2015-03-01 00:00:00
abstract：STUDY OBJECTIVE:We examine the availability of follow-up appointments for emergency department (ED) patients without established primary care by insurance and clinical condition. METHODS:We used "secret shopper" methodology, employing 2 black men to telephone all 53 primary care practices in greater New Haven, posing ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2017.08.045
更新日期：2018-04-01 00:00:00
abstract：STUDY OBJECTIVE:Women and students underrepresented in medicine are less likely to apply for residency in emergency medicine. The latter are from racial or ethnic populations that are underrepresented as physicians relative to the general population. The factors that result in lower application rates from women and gro...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.annemergmed.2019.04.008
更新日期：2019-12-01 00:00:00
abstract：:Organophosphate insecticides have become increasingly popular for agricultural, industrial, and home use and represent a significant potential health risk. We have reviewed the history, pathophysiology, clinical presentation, laboratory findings, differential diagnosis, therapy, and complications of toxic exposure to ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(87)80015-x
更新日期：1987-02-01 00:00:00
abstract：STUDY OBJECTIVES:Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database f...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.115214
更新日期：2001-06-01 00:00:00
abstract：STUDY OBJECTIVE:Pleuritic chest pain is a common presenting complaint in the emergency department (ED) and a symptom of pulmonary embolism. Patients with pleuritic chest pain would benefit from a simple and rapid way of screening for pulmonary embolism. The aim of this study is to assess the utility of Simplify D-dimer...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/j.annemergmed.2005.03.018
更新日期：2005-10-01 00:00:00
abstract：STUDY OBJECTIVE:We evaluate the effect of midazolam and haloperidol premedication for reducing ketamine-induced recovery agitation in adult patients undergoing procedural sedation. We also compare physician satisfaction and recovery time. METHODS:We randomized emergency department patients older than 18 years who need...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2018.11.016
更新日期：2019-05-01 00:00:00
abstract：:Gastrointestinal obstruction is a rare complication of multiple-dose administration of activated charcoal. Previous reports deal only with obstruction after ingestion of drugs that impair gastrointestinal motility. This patient developed a small-bowel obstruction associated with the administration of multiple doses of...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70170-9
更新日期：1994-07-01 00:00:00
abstract：STUDY OBJECTIVE:Stress is an emergent occupational problem in modern societies. Among workers, medical practitioners are particularly exposed. However, data objectifying stress levels during work time are scarce. The aim of this study was to establish diurnal salivary cortisol levels in a highly stressful work environm...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2003.109
更新日期：2003-04-01 00:00:00
abstract：:Thrombolytic therapy offers the promise of major therapeutic intervention in many areas as well as in the treatment of patients with acute myocardial infarction who present to the emergency department. Infusion of tissue-type plasminogen activator (tPA) during field transport has been proven safe, but optimal methods ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(89)80271-9
更新日期：1989-12-01 00:00:00
abstract：STUDY OBJECTIVE:We compare the efficacy of intranasal fentanyl versus intravenous morphine in a pediatric population presenting to an emergency department (ED) with acute long-bone fractures. METHODS:We conducted a prospective, randomized, double-blind, placebo-controlled, clinical trial in a tertiary pediatric ED bet...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2006.06.016
更新日期：2007-03-01 00:00:00
abstract：:Ultrasonography in the emergency department is being used for many purposes, including the evaluation of patients with cardiac arrest. Ultrasound testing has been shown to be useful in such patients in determining the presence of true electromechanical dissociation and pericardial effusions. We report a case of ventri...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(99)70372-0
更新日期：1999-03-01 00:00:00
