Abstract:
STUDY OBJECTIVE:We sought to determine whether working 5 serial night shifts in the emergency department results in a decline in physician performance as measured with an intelligence test. METHODS:This study compared the cognitive functioning of emergency physicians who worked the day shift (7 AM to 5 pm) with those who worked 5 consecutive night shifts (11 pm to 7 am). The Fluid Scale of the Kaufman Adolescent and Adult Intelligence Test (KAIT) was administered to 16 emergency medicine residents. Half of the residents (group A) were tested while working day shifts, and the other half (group B) were tested after working 5 consecutive night shifts. After a minimum interval of 2 months, the residents were retested in reverse order, with group A tested after working night shifts and group B tested while working day shifts. RESULTS:A total of 16 emergency medicine residents were tested. A paired t test was used to determine whether day-shift KAIT scores are different from night-shift KAIT scores. The mean day-shift KAIT score was 119.1 (SD=7.7), and the mean night-shift KAIT score was 107.2 (SD=10.2). This difference was significant (mean difference=11.9; 95% confidence interval 7.0 to 16.8; P <.001), with the day-shift scores being statistically higher than the night-shift scores. CONCLUSION:Working a series of 5 night shifts results in a substantial decline in cognitive performance in physicians working in the ED.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Dula DJ,Dula NL,Hamrick C,Wood GCdoi
10.1067/mem.2001.116024subject
Has Abstractpub_date
2001-08-01 00:00:00pages
152-5issue
2eissn
0196-0644issn
1097-6760pii
S0196-0644(01)64493-7journal_volume
38pub_type
杂志文章abstract::After Hurricane Katrina hit the Gulf Coast on August 29, 2005, thousands of ill and injured evacuees were transported to Houston, TX. Houston's regional disaster plan was quickly implemented, leading to the activation of the Regional Hospital Preparedness Council's Catastrophic Medical Operations Center and the rapid ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.10.014
更新日期:2009-04-01 00:00:00
abstract::A 43-year-old woman presented to the emergency department with acute agitation, confusion, and tonic seizures. She had a history of drug abuse, most notably beer, which constituted her major dietary intake. The patient's seizures were at first thought to be factitious in association with an acute psychosis; however, h...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80442-5
更新日期:1986-06-01 00:00:00
abstract::Verapamil is considered by many investigators to be the drug of choice for the acute management of uncomplicated PSVT. Several clinical investigators have demonstrated termination of PSVT in more than 90% of their patients within minutes following IV drug administration. The incidence of reported severe adverse reacti...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(81)80013-3
更新日期:1981-10-01 00:00:00
abstract::A survey completed by 265 emergency medical technicians (EMTs) who provide emergency prehospital care in a rural area included a stress inventory for health professionals and a job satisfaction scale. Logistic regression indicated that the 118 paid EMTs were more likely to be dissatisfied with the freedom they have on...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80070-7
更新日期:1987-06-01 00:00:00
abstract:STUDY OBJECTIVES:To develop a practical procedure for producing a nomogram describing the relationship between the osmolality gap and serum ethanol concentrations that is appropriate for the formulas and analytical methodologies in use at any laboratory. DESIGN:Retrospective review of serum sodium, glucose, urea nitro...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81899-2
更新日期:1992-11-01 00:00:00
abstract::Experimental data have suggested that pneumatic external counterpressure improves outcome in intra-abdominal hemorrhage by either a tamponade effect and/or elevation in central systemic blood pressure. As a result, the empiric use of the pneumatic antishock garment (PASG) has become a standard of care, even to the poi...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(87)80064-1
更新日期:1987-06-01 00:00:00
abstract:STUDY OBJECTIVES:This study measures the effect of meeting emergency department (ED) patients' expectations for diagnostic and therapeutic interventions on patient satisfaction. METHODS:This was a cross-sectional study of consecutive patients during block enrollment periods surveyed at the beginning and end of their E...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2009.01.024
更新日期:2009-09-01 00:00:00
abstract::One hundred forty-one medical schools were surveyed to determine the emergency medicine core content topics and skills being taught in the curricula. Responses were obtained from 96 schools through two mailings and a telephone followup. Most topics surveyed were offered in the vast majority of medical schools (greater...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80478-4
更新日期:1986-01-01 00:00:00
abstract::A retrospective review of all patients admitted to an urban teaching hospital emergency department with the complaint of overdose, poisoning, or ingestion during a 10-month period was conducted. Analysis of these 82 episodes involving 69 individuals revealed: 1) a preponderance of women in the 20- to 40-year old range...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80453-2
更新日期:1981-01-01 00:00:00
abstract:STUDY OBJECTIVE:To derive a highly sensitive decision rule for the selective use of radiography in acute knee injuries. DESIGN:Prospectively administered survey. SETTING:Emergency departments of two university hospitals. PARTICIPANTS:Convenience sample of 1,047 adults with acute knee injuries. RESULTS:Attending eme...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70106-0
更新日期:1995-10-01 00:00:00
abstract:STUDY OBJECTIVES:To assess the timing of key decisions and clinical events in the treatment of acute myocardial infarction with thrombolytic therapy. DESIGN:Prospective study of emergency department patients. SETTING:EDs in 11 urban and two rural hospitals. TYPES OF PARTICIPANTS:Patients with presumed acute myocardi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/s0196-0644(05)81749-4
更新日期:1992-10-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy of a 4-day "burst" course of prednisone added to standard treatment with H1 antihistamines for the management of acute urticaria in outpatients. DESIGN:Prospective, randomized, double-blinded, clinical trial. SETTING:Emergency department of an urban tertiary care teaching hosp...
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(95)70002-1
更新日期:1995-11-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the ability of emergency medical technician-paramedic (EMT-P) units to become and remain proficient in the performance of the intraosseous infusion procedure. DESIGN AND SETTING:Descriptive nonrandomized trial open to all patients meeting protocol criteria over a five-year period; prehospit...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80975-8
更新日期:1993-07-01 00:00:00
abstract::Irukandji syndrome is a constellation of delayed severe local and systemic symptoms occurring after a Carukia barnesi box jellyfish sting involving any exposed skin. These cases are limited to Australia, the habitat of that animal. Numerous other cases of an Irukandji-like syndrome after other small Carybdeid genus en...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(03)00513-4
更新日期:2003-12-01 00:00:00
abstract:STUDY OBJECTIVE:We describe the characteristics and outcomes of enrollee-health plan disputes over insurance coverage for emergency department (ED) services at 2 large health maintenance organizations (HMOs) that apply the prudent layperson standard. METHODS:We abstracted information from a stratified random sample of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(03)00637-1
更新日期:2004-02-01 00:00:00
abstract::The situational crisis is a period of acute disorganization of affective cognitive and behavioral function precipitated by a traumatic life experience. We review the clinical features of a situational crisis and the four phases of the crisis sequence. Special emphasis is placed on the practical principles of treatment...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80513-7
更新日期:1983-05-01 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::Randomized clinical trials, which aim to determine the efficacy and safety of drugs and medical devices, are a complex enterprise with myriad challenges, stakeholders, and traditions. Although the primary goal is scientific discovery, clinical trials must also fulfill regulatory, clinical, and ethical requirements. In...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2012.01.020
更新日期:2012-10-01 00:00:00
abstract::[Salomon B: Emergency department fugue. Ann Emerg Med March 1998;31:412-413]. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/S0196-0644(98)70358-0
更新日期:1998-03-01 00:00:00
abstract:STUDY OBJECTIVE:Emergency department records are an important source of injury surveillance data. However, documentation regarding intentional assault has not been studied and may be suboptimal. The purpose of this study was to analyze physician documentation of assailant, site, and object used in intentional assault. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70096-x
更新日期:1999-12-01 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 OBJECTIVES:To determine the sensitivity, specificity, and predictive values of a new rapid creatine kinase-MB (R-CK-MB) assay compared with a standard CK-MB (S-CK-MB) assay and to determine its potential use in the evaluation of emergency department patients with possible myocardial infarction. DESIGN:Retrospect...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82971-3
更新日期:1991-09-01 00:00:00
abstract:STUDY OBJECTIVE:The objective was to quantify the analgesic effect of a dose of intravenous morphine, 0.1 mg/kg, to emergency department (ED) patients presenting in acute, severe pain. METHODS:This was a prospective convenience cohort of patients aged 21 to 65 years and presenting to an academic urban ED with acute, s...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.03.010
更新日期:2005-10-01 00:00:00
abstract:STUDY OBJECTIVE:Emergency departments (EDs) frequently refer patients for needed outpatient specialty care, but little is known about the dynamics of these referrals when patients are publicly insured. Hence, we explored factors, including the role of ED referrals, associated with specialists' willingness to accept pat...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2012.10.030
更新日期:2013-04-01 00:00:00
abstract::During the evaluation of a victim of a motor vehicle accident, routine radiographs of the patient's cervical spine, chest, and pelvis revealed multiple radiopaque foreign bodies along his posterior neck, chest, abdomen, and pelvis. Repeat examination of the patient disclosed no evidence of foreign bodies. Further ques...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82986-5
更新日期:1991-09-01 00:00:00
abstract:STUDY OBJECTIVES:To determine if the use of verapamil in patients with contraindications is associated with adverse sequelae, thereby assessing whether process measures of the quality of care are correlated with patient outcomes. DESIGN:Retrospective chart review comparing the incidence of adverse outcomes and drug fa...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81382-4
更新日期:1991-10-01 00:00:00
abstract::The prevalence of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in 232 sexual assault victims who presented for examinations between August 1, 1987, and July 31, 1988, was determined. Results are reported for cervical, rectal, and oropharyngeal NG cultures and for cervical and rectal CT smears. Results fro...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82197-3
更新日期:1990-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether a set of published triage guidelines identifies patients who can safely be refused emergency department care. DESIGN:Historical cohort study. SETTING:A public hospital ED. TYPE OF PARTICIPANTS:All patients triaged during a one-week period who were not in the most acute triage cat...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70042-7
更新日期:1994-02-01 00:00:00
abstract::Few tools exist that are sufficiently robust to allow manipulation of key input variables to produce casualty estimates resulting from high-consequence events reflecting local or specific regions of concern. This article describes the design and utility of a computerized modeling simulation tool, Electronic Mass Casua...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.09.014
更新日期:2009-02-01 00:00:00
abstract::Pulmonary embolism, although uncommon in children, occurs in as many as 104 per 100,000 pediatric patients. Undiagnosed and untreated pulmonary embolism has a high mortality rate; thus, a high index of clinical suspicion and reliable diagnostic modalities are necessary to ensure prompt and accurate diagnosis. We repor...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81131-x
更新日期:1991-01-01 00:00:00