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 environment, the medical dispatch center of an emergency care unit. METHODS:Eight emergency medical dispatchers agreed to be sampled every 2 hours from 9 AM to 7 PM during a usual day of work. Eight matched control subjects sampled during their leisure time were used as a control group. RESULTS:Whatever the time of the day, emergency medical dispatchers showed significantly increased cortisol levels during their work time compared with levels found in the control group. There was a significant difference in the amount of daytime cortisol secretion between control subjects and emergency medical dispatchers (0.345 nmol/L; 95% confidence interval [CI] 0.04 to 0.93 nmol/L), with a mean daytime augmentation of 22.8% in emergency medical dispatchers compared with that in control subjects. In addition, among emergency medical dispatchers, the subjective perception of emotional stress was positively correlated with total cortisol concentrations per day (r =0.78; 95% CI 0.39 to 1). CONCLUSION:Our data show that work tasks of emergency medical dispatchers led to a hypersecretion of cortisol. Because the damaging effects of persistent cortisol increases on health and cognitive functions are well recognized in human beings, it seems necessary to rapidly identify stressful work situations and targets for organizational improvements to minimize stress in these situations.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Weibel L,Gabrion I,Aussedat M,Kreutz Gdoi
10.1067/mem.2003.109subject
Has Abstractpub_date
2003-04-01 00:00:00pages
500-6issue
4eissn
0196-0644issn
1097-6760pii
S0196064403000052journal_volume
41pub_type
杂志文章abstract：:Twenty cases of shaken baby syndrome are reviewed to determine important signs, symptoms, physical findings, laboratory parameters, and prognosis. The signs and symptoms of this form of head trauma are nonspecific. The findings may mimic infection, intoxication, or metabolic abnormalities. Diagnosis depends on a high ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80571-5
更新日期：1984-02-01 00:00:00
abstract：:It is common practice to soak acute traumatic wounds in dilute povidone-iodine solution before definitive wound cleaning and debridement. The effectiveness of soaking wounds is unknown. Using quantitative wound bacterial counts as a measure of efficacy, we compared wounds soaked in 1% povidone-iodine solution or in no...
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)82486-2
更新日期：1990-06-01 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：STUDY OBJECTIVE:The potential of infectious disease spread in diseases such as tuberculosis, infectious disease epidemic such as avian flu and the threat of terrorism with agents capable of airborne transmission have focused attention on the need for increased surge capacity for patient isolation. Total negative pressu...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2007.04.017
更新日期：2008-04-01 00:00:00
abstract：:We report the cases of three patients with residual symptoms from diving decompression sickness, each of whom presented to a recompression chamber three to seven days following original exposure. All three had complete resolution of symptomatology despite the delayed treatment. The late resolution of symptoms is evide...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80450-9
更新日期：1985-03-01 00:00:00
abstract：STUDY OBJECTIVE:We assess the prevalences of bacterial meningitis and herpes simplex virus meningoencephalitis (HSV-ME) in children with a complex febrile seizure and determine these prevalences in the subgroup of children with a clinical examination result not suggestive of meningitis or encephalitis. METHODS:This mu...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.annemergmed.2016.11.024
更新日期：2017-07-01 00:00:00
abstract：:In December 2002, the federal government began a program to immunize approximately 500000 civilian public health and health care workers with smallpox (vaccinia) vaccine as a part of our pre-event defense against bioterrorism. First responders will likely follow, and the general US population might be offered vaccinat...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(03)00629-2
更新日期：2003-11-01 00:00:00
abstract：STUDY OBJECTIVE:We examine how dedicated methodology and statistical review affects the quality of manuscripts published in Annals of Emergency Medicine. DESIGN:The dedicated reviewers developed a manuscript scoring form based on previously used instruments. The form contained 84 unique elements. Eight items sought th...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.127328
更新日期：2002-09-01 00:00:00
abstract：:As administrators evaluate potential approaches to improve cost, quality, and throughput efficiencies in the emergency department (ED), "front-end" operations become an important area of focus. Interventions such as immediate bedding, bedside registration, advanced triage (triage-based care) protocols, physician/pract...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2009.05.021
更新日期：2010-02-01 00:00:00
abstract：STUDY OBJECTIVE:We compare utilization, price per visit, and the types of care delivered across freestanding emergency departments (EDs), hospital-based EDs, and urgent care centers in Texas. METHODS:We analyzed insurance claims processed by Blue Cross Blue Shield of Texas from 2012 to 2015 for patient visits to frees...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.12.006
更新日期：2017-12-01 00:00:00
abstract：:Inconsistency in contacting the families of acutely ill patients can negatively affect relatives and induce stress in emergency department staff. Role clarification and performance guidelines are discussed in the context of a telephone notification of relatives checklist, with staff advised in six specific interventio...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(82)80204-7
更新日期：1982-11-01 00:00:00
abstract：STUDY OBJECTIVE:The use of the International Classification of Diseases system to describe emergency department (ED) case mix has disadvantages. We therefore developed computer algorithms that recognize a combination of words, word fragments, and word patterns to link free-text complaint fields to 20 reason-for-visit c...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(03)00748-0
更新日期：2004-03-01 00:00:00
abstract：:The ingestion of the mushroom Amanita phalloides is associated with hepatic necrosis appearing clinically two to three days after ingestion. The mechanism of this toxicity is unknown, and no reliable antidote is available. Because of the similarity of Amanita poisoning to other toxins affecting cytochrome P450, we inv...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80472-9
更新日期：1987-10-01 00:00:00
abstract：STUDY OBJECTIVE:We seek to examine the effectiveness of the graduated driver licensing system in Utah by determining whether crash rates of 16-year-old drivers decreased after graduated driver licensing implementation. METHODS:We studied 16-year-old-driver crashes using statewide motor vehicle crash data probabilistic...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2004.10.007
更新日期：2005-02-01 00:00:00
abstract：STUDY OBJECTIVE:Previous studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2018.02.022
更新日期：2018-07-01 00:00:00
abstract：STUDY OBJECTIVES:To test the feasibility of using handheld, battery-operated chemical analyzers by EMS personnel in a wilderness environment to aid in the diagnosis and management of heat illness. METHODS:During the summer of 1996, 3 portable clinical analyzers (i-STAT Corp, Princeton, NJ) were kept at different locat...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(99)70306-9
更新日期：1999-04-01 00:00:00
abstract：:We present the cases of three patients with preexisting bundle-branch block in whom wide-complex tachycardias were considered to be of supraventricular origin because QRS morphologies were essentially unchanged from those during normal sinus rhythm. The patients experienced adverse effects from medications for suprave...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(95)70245-8
更新日期：1995-07-01 00:00:00
abstract：STUDY OBJECTIVE:We determine the validity of self-reported prescription filling among emergency department (ED) patients. METHODS:We analyzed a subgroup of 1,026 patients enrolled in a randomized controlled trial who were prescribed at least 1 medication at ED discharge, were covered by Medicaid insurance, and complet...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2013.01.026
更新日期：2013-09-01 00:00:00
abstract：:Five cases of right-sided rupture of the diaphragm are reviewed. Orthopedic injury, head injury, and shock were the most common associated findings. Apparent elevation of the right hemidiaphragm was seen initially in all cases, but two were misdiagnosed. An algorithm that includes modified peritoneal lavage, CT scan w...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80464-8
更新日期：1983-06-01 00:00:00
abstract：:A mathematical model for tissue thermodilution was developed to study cerebral cortical perfusion before and after controlled perfusion arrest. Cerebral cortical perfusion rates are readily determined by this method. A thermistor was introduced into the subdural space and secured in direct contact with the frontal cor...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80123-1
更新日期：1983-01-01 00:00:00
abstract：:This review synthesizes the existing literature to provide evidence-based predictions for the future of emergency care in the United States as a result of the Patient Protection and Affordable Care Act, with a focus on emergency department (ED) visit volume, acuity, and reimbursement. Patient behavior will likely be q...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2015.04.007
更新日期：2015-11-01 00:00:00
abstract：:To simulate the effect of sublingual injections on pediatric patients, open-chested kid goats were injected sublingually or peripherally with Cardio-Green while being supported by internal cardiac massage. Our study demonstrates that there is statistically a ten-fold lower central blood level after sublingual injectio...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80005-0
更新日期：1984-06-01 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:In patients presenting to the emergency department (ED) with an initial diagnostic impression of noncardiac chest pain, we determine the 30-day incidence of adverse cardiac events and characteristics associated with those events. METHODS:The multicenter, prospectively collected Internet Tracking Regist...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2004.03.021
更新日期：2004-12-01 00:00:00
abstract：:The case of a patient with apparent cocaine toxicity and drug-mediated hypertension and tachycardia is presented. IV propranolol was used as the initial treatment for his hyperadrenergic state, resulting in a decrease in heart rate but a paroxsymal increase in blood pressure. The patient required nitroprusside for con...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80934-3
更新日期：1985-11-01 00:00:00
abstract：:We followed serial plasma baclofen concentrations in a woman who ingested more than 2 g of baclofen in a suicide attempt, the largest ingestion of baclofen reported to date. The plasma clearance of baclofen was characterized by first-order elimination kinetics with a half-life of 8.6 hours. The persistent central nerv...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80388-2
更新日期：1986-07-01 00:00:00
abstract：STUDY OBJECTIVE:We compare the efficacy and safety of intravenous lidocaine with that of hydromorphone for the treatment of acute abdominal pain in the emergency department (ED). METHODS:This was a randomized, double-blind, clinical trial conducted in 2 EDs in the Bronx, NY. Adults weighing 60 to 120 kg were randomize...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2019.01.021
更新日期：2019-08-01 00:00:00
abstract：STUDY OBJECTIVE:We compare the association between barriers to timely primary care and emergency department (ED) utilization among adults with Medicaid versus private insurance. METHODS:We analyzed 230,258 adult participants of the 1999 to 2009 National Health Interview Survey. We evaluated the association between 5 s...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2012.01.035
更新日期：2012-07-01 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：:Venomous bites and stings are numerous but severe local tissue damage is uncommon. Venoms may be simple substances or complex mixtures of many poorly characterized components whose interactions are still not fully understood. The best studied example of a dermonecrotic venom is that produced by the brown recluse spide...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(88)80360-3
更新日期：1988-12-01 00:00:00
