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 nitrogen, ethanol, and osmolality values and the use of spreadsheet software in the generation of a nomogram. SETTING:Emergency department in a university-affiliated county hospital. PARTICIPANTS:Two hundred three adult patients presenting with signs of alcohol intoxication. MAIN RESULTS:When either a common criterion (gap [mosmol/kg H2O] = ethanol [mmol/L]; range, -10 to +10) or a published nomogram was used for determination of consistency of the osmolality gap with the ethanol level, large percentiles of data were classified as inconsistent. Regression analysis and the method of truncated normal distributions were used to prepare a nomogram that better represented the data collected with our formulas and analytical methodologies. CONCLUSION:Interlaboratory analytical bias and the choice of the formula used for calculated osmolality limit the utility of published formulas or nomograms for the assessment of excess osmolality gap. Any laboratory can produce their own nomogram from routine patient data using the described spreadsheet procedure, without the need for measurement of volatiles other than ethanol.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Galvan LA,Watts MTdoi
10.1016/s0196-0644(05)81899-2subject
Has Abstractpub_date
1992-11-01 00:00:00pages
1343-8issue
11eissn
0196-0644issn
1097-6760pii
S0196-0644(05)81899-2journal_volume
21pub_type
杂志文章abstract::In 1976 an independent department was established for the emergency treatment of patients in the county hospital in Szolnok, Hungary. The new system changed the traditional structure of patient flow and the work plan of other departments, and it influenced the curing and nursing activities of the departments. The reor...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80113-2
更新日期:1980-07-01 00:00:00
abstract:STUDY OBJECTIVES:To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN:A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70238-1
更新日期:1994-12-01 00:00:00
abstract::WHAT IS ALREADY KNOWN ON THIS TOPIC: Procalcitonin is a biomarker that appears to correlate with bacterial infection. WHAT QUESTION THIS STUDY ADDRESSED: Does a procalcitonin level add prognostic information for pneumonia patients in conjunction with scoring systems such as the Pneumonia Severity Index or CURB-65? WHA...
journal_title:Annals of emergency medicine
pub_type: 评论,杂志文章
doi:10.1016/j.annemergmed.2008.05.033
更新日期:2008-07-01 00:00:00
abstract:STUDY OBJECTIVE:To be able to adhere to discharge instructions after a visit to the emergency department (ED), patients should understand both the care that they received and their discharge instructions. The objective of this study is to assess, at discharge, patients' comprehension of their ED care and instructions a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.05.016
更新日期:2009-04-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if intramedullary aspirate from intraosseous needle placement can be used as a source for evaluating blood compatibility. DESIGN:A prospective, nonrandomized, crossover study. SETTING/PARTICIPANTS:Patients admitted to the hematology/oncology service undergoing bone marrow aspiration for m...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82661-7
更新日期:1992-04-01 00:00:00
abstract:STUDY OBJECTIVE:Methanol poisoning outbreaks are a global public health issue, with delayed treatment causing poor outcomes. Out-of-hospital ethanol administration may improve outcome, but the difficulty of conducting research in outbreaks has meant that its effects have never been assessed. We study the effect of out-...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2016.01.010
更新日期:2016-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether N-acetylcysteine (NAC reduces methemoglobin. METHODS:We carried out an in vitro laboratory experiment in which five healthy adult volunteers donated blood. Each sample was divided equally among three test tubes. Tube 1 served as a negative control. Sodium nitrite .18 mol/L with dex...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70112-9
更新日期:1996-11-01 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
abstract::Reported are two cases of metallic constricting devices presenting to our emergency department. A 40-year-old man was unable to remove a steel ring from his engorged penile shaft after autostimulation, and a 22-year-old man riveted a metallic nut onto his right index finger proximal to his distal interphalangeal joint...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80368-5
更新日期:1982-07-01 00:00:00
abstract:STUDY OBJECTIVE:There has been increasing attention to screening for health-related social needs. However, little is known about the screening practices of emergency departments (EDs). Within New England, we seek to identify the prevalence of ED screening for health-related social needs, understand the factors associat...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.08.010
更新日期:2021-01-01 00:00:00
abstract::Although a number of studies have described endotracheal intubation of adult patients in the prehospital setting, there are few studies on prehospital endotracheal intubation of pediatric patients. The purposes of our study were to determine how frequently prehospital endotracheal intubation was used in pediatric card...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80830-3
更新日期:1989-05-01 00:00:00
abstract::We report a case of a severe lower gastrointestinal hemorrhage caused by arterioenteric fistula formation in a pancreas transplant patient. A rare but potentially deadly complication of pancreas transplant surgery, arterioenteric fistulas should be considered in every transplant patient presenting with voluminous gast...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/s0196-0644(03)00388-3
更新日期:2003-10-01 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: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 a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70267-2
更新日期:1999-07-01 00:00:00
abstract:STUDY OBJECTIVE:Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented. METHODS:The Trans PULSE Pr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2013.09.027
更新日期:2014-06-01 00:00:00
abstract:STUDY OBJECTIVE:Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of sca...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2013.02.005
更新日期:2013-06-01 00:00:00
abstract:STUDY OBJECTIVE:Severe myocardial ischemia is the leading cause of arrhythmic sudden cardiac death. It is unclear, however, in which percentage of patients sudden cardiac death is triggered by ST-elevation myocardial infarction (STEMI) and whether the diagnosis of STEMI can be reliably established immediately after res...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.06.469
更新日期:2008-12-01 00:00:00
abstract::We present the case of a 21-year-old man who presented to the emergency department with an episode of profound weakness due to thyrotoxic periodic paralysis, a syndrome of muscular weakness occurring in patients with hyperthyroidism. Prior to the diagnosis, the patient was treated with a parenteral tranquilizer. When ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80568-7
更新日期:1988-08-01 00:00:00
abstract::Decisions about medical resource triage during disasters require a planned structured approach, with foundational elements of goals, ethical principles, concepts of operations for reactive and proactive triage, and decision tools understood by the physicians and staff before an incident. Though emergency physicians ar...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2011.06.012
更新日期:2012-03-01 00:00:00
abstract::In an effort to assess the reliability of patient history in excluding pregnancy, we studied the correlation between specific historical factors and the presence of a positive qualitative serum beta-human chorionic gonadotropin assay. Two hundred eight patients were studied, and information was collected prospectively...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80310-5
更新日期:1989-01-01 00:00:00
abstract::We present the case of a patient who presented with persistent hiccups induced by a hair irritating the tympanic membrane and activating the vagally mediated hiccup neural reflex arc. Commonly identified etiologies and treatments of this condition are then reviewed. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80009-7
更新日期:1982-01-01 00:00:00
abstract:STUDY OBJECTIVE:Although the addition of H(2) blockers to H(1) antagonists has been promoted for use in anaphylaxis, there have been no large studies establishing the advantage of this approach in treating acute allergic syndromes. In this study we tested the hypothesis that combined H(1) and H(2) blockage results in i...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mem.2000.109445
更新日期:2000-11-01 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:Patient-centered medical homes are primary care practices that focus on coordinating acute and preventive care. Such practices can obtain patient-centered medical home recognition from the National Committee for Quality Assurance. We compare growth rates for emergency department (ED) use and costs of ED...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.01.002
更新日期:2015-06-01 00:00:00
abstract:STUDY OBJECTIVE:To gather preliminary data on the safety and efficacy of IV magnesium in a rat model of hydrofluoric acid burns. MODEL:Forty-seven anesthetized male rats (200 to 300 g) received a standardized burn with 52% hydrofluoric acid. INTERVENTIONS:Animals were anesthetized with 30 to 50 mg/kg ketamine IM and ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70064-8
更新日期:1994-03-01 00:00:00
abstract:STUDY OBJECTIVES:We sought to compare triage designations derived from in-person and telephone interviews and systematically examine the effect of visual cues, vital signs, and complaint-based protocols on the triage process. METHODS:We conducted a 2-phase, prospective, observational study employing a randomized, cros...
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(98)70063-0
更新日期:1998-12-01 00:00:00
abstract::To evaluate the hypothesis that all victims of severe blunt trauma require a pelvic radiograph, we prospectively studied all such patients admitted to the Southern New Jersey Regional Trauma Center during a seven-month period. All patients were classified as unconscious; impaired; awake, alert, and symptomatic; or ale...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80244-0
更新日期:1988-05-01 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::The use of flumazenil, a benzodiazepine antagonist, was studied in two patients with coma of unknown etiology. One patient ingested 20.5 mg alprazolam before crashing his truck into parked automobiles. The patient was awakened by flumazenil administration, and the severity of his injuries was evaluated reliably. A sec...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0196-0644(05)82054-2
更新日期:1990-03-01 00:00:00
abstract::Sexually transmitted bowel and rectal diseases are common in gay men and are caused by a wide variety of infectious agents. Each of the entities implicated in the gay bowel syndrome is considered separately and epidemiologic considerations responsible for the appearance of such a syndrome are examined. The emergency p...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80310-6
更新日期:1980-09-01 00:00:00