Abstract：
:Mechanical interventions in acute ischemic stroke promise to provide emergency physicians with tools to treat patients in whom conventional thrombolysis might be ineffective or contraindicated, including most patients with stroke who arrive at the emergency department beyond the 3-hour time window for intravenous tissue plasminogen activator. A systematic MEDLINE literature review was performed. Endovascular interventions currently in early human clinical trials include the use of lasers, ultrasonography, angioplasty, microsnares, and a variety of clot-retrieval devices. Potential advantages of these approaches include more rapid recanalization of occluded vessels, reduced or no exposure to fibrinolytic agents, and a longer treatment window. Early safety trials are promising, with serial improvements in device design to minimize trauma to cerebrovascular endothelium and accelerate vessel recanalization. The purpose of this review is to provide the emergency medicine community with an understanding of these promising and emerging approaches to acute stroke therapy.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Leary MC,Saver JL,Gobin YP,Jahan R,Duckwiler GR,Vinuela F,Kidwell CS,Frazee J,Starkman Sdoi
10.1067/mem.2003.194subject
Has Abstractpub_date
2003-06-01 00:00:00pages
838-46issue
6eissn
0196-0644issn
1097-6760pii
S019606440300266Xjournal_volume
41pub_type
杂志文章,评审abstract：:From October 1985 to April 1988, 297 patients with presumed unstable angina, acute myocardial infarction, or permanent pacemaker failure were transferred by helicopter from community hospitals to our medical center for tertiary care. Fifty-six patients (19%) experienced treatable bradycardia (heart rate of less than 5...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80006-x
更新日期：1989-07-01 00:00:00
abstract：:This clinical policy focuses on critical issues concerning the management of patients presenting to the emergency department (ED) with acetaminophen overdose. The subcommittee reviewed the medical literature relevant to the questions posed. The critical questions are: 1. What are the indications for N-acetylcysteine (...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,实务指引
doi：10.1016/j.annemergmed.2007.06.014
更新日期：2007-09-01 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：:A 19-year-old pedestrian who was the victim of a motor vehicle accident had a left pneumothorax with a large air leak. Despite a well-placed chest tube, a chest radiograph showed that the left lung had fallen down and away from the mediastinum and that no hilar structures were visible. This "fallen lung with an absent...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：
更新日期：1991-03-01 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：STUDY OBJECTIVE:We determine the incidence of serious bacterial infection in infants presenting to the emergency department (ED) with an apparent life-threatening event. METHODS:This was a prospective cohort study of infants younger than 12 months who were treated at an urban children's hospital ED during 1 year and w...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2008.12.037
更新日期：2009-10-01 00:00:00
abstract：STUDY OBJECTIVE:The aim of this study is to characterize hospital and patient characteristics associated with administration of thrombolysis in acute ischemic stroke patients in the United States. METHODS:This retrospective, observational, cohort study used data from the Nationwide Inpatient Sample, an administrative ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2007.01.021
更新日期：2007-08-01 00:00:00
abstract：STUDY OBJECTIVE:Midazolam is widely used for procedural sedation and analgesia. Etomidate has been studied mostly in adults. Our objective is to compare the efficacy of etomidate and midazolam for achieving procedural sedation and analgesia in children. METHODS:A randomized, double-blind, emergency department and orth...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2006.03.004
更新日期：2006-10-01 00:00:00
abstract：:Communication at discharge is an important part of high-quality emergency department (ED) care. This review describes the existing literature on patient understanding and implementation of discharge instructions, discusses previous interventions aimed at improving the discharge process, and recommends best practices a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2011.10.023
更新日期：2012-08-01 00:00:00
abstract：STUDY OBJECTIVE:We perform a videographic analysis of external laryngeal manipulation (ELM) by novice intubators using a direct laryngoscopic imaging system and a validated means of assessing laryngeal view (percentage of glottic opening [POGO] score). METHODS:Nine first-year emergency medicine residents performed a t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.125716
更新日期：2002-07-01 00:00:00
abstract：:Gastrointestinal decontamination has been practiced for hundreds of years; however, only in the past few years have data emerged that demonstrate a clinical benefit in some patients. Because most potentially toxic ingestions involve agents that are not toxic in the quantity consumed, the exact circumstances in which d...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1067/mem.2002.122058
更新日期：2002-03-01 00:00:00
abstract：:Patients frequently arrive in the emergency department under the influence of alcohol after exposure to extreme conditions of heat or cold. While ethanol ingestion and ambient heat are recognized to have vasodilatory action, previous studies of their interactive effect are limited and guidelines for patient care are v...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/s0196-0644(84)80282-6
更新日期：1984-08-01 00:00:00
abstract：:To evaluate the effects of acute alcohol intoxication on serum amylase and isoamylase levels, 58 clinically intoxicated patients with blood alcohol levels greater than 100 mg/dL were studied. Comparisons were made to normal control and a sober chronic alcoholic group. Admitting serum isoamylase levels were determined ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80511-3
更新日期：1983-05-01 00:00:00
abstract：STUDY OBJECTIVE:We describe current alcohol screening and brief intervention practices in emergency departments (EDs) at Level I and Level II trauma centers and characterize ED directors' attitudes and perceived barriers associated with these practices among injured patients in the ED. METHODS:ED directors at Level I ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2010.03.004
更新日期：2010-06-01 00:00:00
abstract：STUDY OBJECTIVE:This study tests the effect of a brief intervention with emergency department (ED) patients to reduce at-risk drinking. METHODS:We enrolled patients aged 18 years or older who screened positive for at-risk drinking in an urban academic ED and used alternative allocation to assign them to control or int...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2004.10.014
更新日期：2005-07-01 00:00:00
abstract：:To define a subset of injured children for whom emergency cervical spine radiography may be unnecessary, we performed a retrospective chart and radiologic review. Two entry methods were used: All injured children, from birth through 16 years, who had received cervical spine radiographs at The Children's Memorial Hospi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80171-3
更新日期：1987-03-01 00:00:00
abstract：:Presented is a case of idiopathic priapism that was successfully treated with inhalation of amyl nitrite. Routine treatment measures had failed. The same patient presented on several other occasions in a similar fashion. Each time amyl nitrite was successful. An investigation for diseases known to be associated with p...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80602-7
更新日期：1983-04-01 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：:A 27-year-old man was admitted to the emergency department with a fluphenazine decanoate-induced dystonia. He was treated with 125 mg diphenhydramine IV in four doses and 2 mg benztropine IM. A fluctuating response was observed before continued remission of the dystonia. Possible reasons for variable patient responses...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80077-x
更新日期：1987-06-01 00:00:00
abstract：:Significant evidence identifies point-of-care ultrasound (PoCUS) as an important diagnostic and therapeutic tool in resource-limited settings. Despite this evidence, local health care providers on the African continent continue to have limited access to and use of ultrasound, even in potentially high-impact fields suc...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.07.030
更新日期：2017-02-01 00:00:00
abstract：:The esophageal obturator airway (EOA) is in common use throughout the country. This report outlines an unexpected and serious complication: gastric rupture due to overinsufflation. A survey of the literature revealed that most of the known complications involve direct trauma to the esophagus or trachea. In our case, t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80240-5
更新日期：1981-07-01 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：:WHAT IS ALREADY KNOWN ON THIS TOPIC: Previous out-of-hospital studies indicate that selective spinal immobilization may miss patients with cervical injury. WHAT QUESTION THIS STUDY ADDRESSED: Can paramedics apply the Canadian C-Spine Rule in alert, stable, cooperative, blunt-trauma patients to reserve spinal immobiliz...
journal_title：Annals of emergency medicine
pub_type： 评论,杂志文章
doi：10.1016/j.annemergmed.2009.09.015
更新日期：2009-11-01 00:00:00
abstract：STUDY OBJECTIVE:We estimate the occupational fatality rate among emergency medical services (EMS) personnel in the United States. METHODS:We undertook descriptive epidemiology of occupational fatalities among EMS providers. Analysis was conducted by using data from 3 independent fatality databases: the Census of Fatal...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.128681
更新日期：2002-12-01 00:00:00
abstract：:Niacin (vitamin B3) is promoted for rapidly clearing the body of drugs of abuse, such as cocaine and cannabis, and is alleged to interfere with urine drug screening. We present 4 cases of such novel use associated with significant adverse effects. Two cases had isolated skin manifestations, whereas the other 2 present...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2007.01.014
更新日期：2007-11-01 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：STUDY OBJECTIVES:To determine the height of back elevation required to place the cervical spine of children less than 8 years old in neutral position and whether agreement on the height required for neutral position could be reached by two independent observers. STUDY DESIGN:Prospective. SETTING:Pediatric emergency d...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70032-x
更新日期：1994-02-01 00:00:00
abstract：STUDY OBJECTIVE:To compare patient and practitioner assessments of pain associated with commonly performed emergency department procedures and use of anesthetics before these procedures. METHODS:This was a prospective, observational, cross-sectional study conducted at a university-based ED with a convenience sample of...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：
更新日期：1999-06-01 00:00:00
abstract：:Curricula in pediatric resuscitation must be based on adult learning principles. The Pediatric Basic and Advanced Life Support Courses (PBLS, PALS) should use educational strategies fostering positive interactions between the instructor and learners and should take into consideration the learner's motivation for takin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80482-2
更新日期：1993-02-01 00:00:00
abstract：:Massive hemoptysis is an uncommon but life-threatening emergency. The loss of at least 600 mL of blood within a 48-hour period has been associated with a high mortality rate. Initial stabilization including airway and ventilation management, IV fluids, oxygen, and laboratory and radiographic studies should be done in ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80686-8
更新日期：1987-05-01 00:00:00
