Abstract:
STUDY OBJECTIVE:We determine whether children with immediate posttraumatic seizures require hospitalization for observation of possible neurologic complications. METHODS:This was a prospective observational cohort study of children younger than 18 years with blunt head trauma resulting in immediate posttraumatic seizures. Patients were examined by faculty emergency physicians and underwent cranial computed tomography (CT) scanning. Children were divided into 2 cohorts according to the presence or absence of traumatic brain injury on cranial CT scan, with the a priori assumption that children with posttraumatic seizures who have abnormal cranial CT scan results require hospitalization. The outcomes of interest were neurologic complications (including further seizure activity or neurologic deficits) or the necessity for neurosurgical intervention. Medical records of hospitalized patients were reviewed, and patients discharged from the emergency department (ED) were contacted by telephone approximately 1 week after hospital discharge to identify those who developed short-term neurologic complications. RESULTS:Sixty-three children with a median age of 7 years (interquartile range 3 to 14 years) had posttraumatic seizures, and all but 1 child underwent cranial CT imaging. Ten (16%; 95% confidence interval [CI] 8% to 27%) patients had traumatic brain injuries on CT scan, and all were hospitalized. Three of these 10 patients underwent craniotomy, and 2 patients had further seizure activity. Fifty-two patients had normal cranial CT scan results, and 20 patients were hospitalized for observation. Telephone follow-up was obtained in 31 of the 32 patients with normal CT scan results who were discharged from the ED. None of the 52 patients (0%; 95% CI 0% to 5.6%) with normal cranial CT scan results had further seizure activity or required neurosurgical interventions. CONCLUSION:Children with normal neurologic examination results and normal cranial CT scan results after immediate posttraumatic seizures are at low risk for further short-term complications that require immediate hospitalization. These children may be considered for discharge home from the ED.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Holmes JF,Palchak MJ,Conklin MJ,Kuppermann Ndoi
10.1016/S0196064403012071subject
Has Abstractpub_date
2004-06-01 00:00:00pages
706-10issue
6eissn
0196-0644issn
1097-6760pii
S0196064403012071journal_volume
43pub_type
杂志文章abstract::A 31-year-old white man with a core temperature of 60.8 F (16 C) and ventricular fibrillation was successfullly resuscitated using active core and external rewarming techniques. Rectal temperature at the time of reestablished electromechanical cardiac activity was 68 F (20 C), a temperature previously thought to be in...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80339-8
更新日期:1980-02-01 00:00:00
abstract:STUDY OBJECTIVE:Salicylate poisoning is a challenging clinical entity associated with substantial morbidity and mortality. The indications for extracorporeal treatments such as hemodialysis are poorly defined. We present a systematic review of the literature along with evidence- and consensus-based recommendations on t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2015.03.031
更新日期:2015-08-01 00:00:00
abstract:STUDY OBJECTIVE:We present our experience with a novel technique for the reduction of acute hip dislocation in the emergency department (ED). METHODS:We searched the medical records of all patients with a hip dislocation treated in our ED during a 4-year period. We recorded patient demographics, reduction technique, o...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.07.010
更新日期:2011-12-01 00:00:00
abstract::Four hundred twenty patients with open dog bite wounds on initial presentation to the emergency department had Gram stains, aerobic and anaerobic cultures, and antibiotic sensitivities of the bacterial isolates of each wound. Forty-eight percent of the wounds evidenced no bacterial growth. Staphylococcus epidermidis w...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80620-5
更新日期:1986-11-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluated the influence of home visiting on the risk for medically attended unintentional injury during home visiting (0 to 3 years) and subsequent to home visiting (3 to 5 years). METHODS:A retrospective, quasi-experimental study was conducted in a cohort of mother-child pairs in Hamilton County, O...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2017.01.029
更新日期:2017-09-01 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:We describe the operators, techniques, success, and adverse event rates of adult emergency department (ED) intubation through multicenter prospective surveillance. METHODS:Eighteen EDs in the United States, Canada, and Australia recorded intubation data onto a Web-based data collection tool, with a gre...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2014.10.036
更新日期:2015-04-01 00:00:00
abstract::Traumatic rupture of the tracheobronchial tree is an increasingly occurring complication of blunt chest trauma. Early detection and surgical repair are important for definitive and successful reconstruction. Bronchoscopy is the most reliable diagnostic procedure. Use of a rigid bronchoscope is difficult and traumatic ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80386-6
更新日期:1980-05-01 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::The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents training in those programs. We present the 2016 annual report on the status of US emergency medicine training programs. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2016.03.031
更新日期:2016-05-01 00:00:00
abstract::Our study was conducted to determine the appropriate dose of lidocaine using the larynx and to characterize the onset and duration of therapeutic serum levels. A mean dose of 5.67 +/- 1.2 mg/kg was topically administered to the subglottic region of seven comatose patients through a cricothyroid membrane puncture. Seri...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80062-0
更新日期:1982-09-01 00:00:00
abstract:STUDY OBJECTIVE:We hypothesize that emergency department (ED) volume and increased patient complexity are associated with lower quality of care, as measured by time to antibiotics for patients being admitted with community-acquired pneumonia. METHODS:This was a cross-sectional study at a university tertiary care hospi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2007.08.003
更新日期:2007-11-01 00:00:00
abstract:STUDY OBJECTIVE:We assess the effectiveness of patient-controlled analgesia in the emergency department (ED). We hypothesized that decline in pain intensity from 30 to 120 minutes after initial intravenous opioid administration is greater in patients receiving morphine by patient-controlled analgesia compared with usua...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2017.03.064
更新日期:2017-12-01 00:00:00
abstract:STUDY OBJECTIVE:The benefit of epinephrine in cardiac arrest is controversial and has not been conclusively shown in any human clinical study. We seek to assess the effect of introducing intravenous epinephrine on the survival outcomes of out-of-hospital cardiac arrest patients in an emergency medical services (EMS) sy...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2007.03.028
更新日期:2007-12-01 00:00:00
abstract::Colchicine overdose is an uncommon but serious problem that may be missed or ignored unless the physician is aware of the significant potential for, and the various stages of, toxicity. We report two fatal cases in which the potential for lethal complications was not initially realized. Both patients developed multipl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80239-9
更新日期:1981-07-01 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::This study was undertaken to determine the clinical circumstances of femoral fractures in children. The study was a retrospective investigation of 117 consecutive patients with femoral fractures admitted to The Children's Mercy Hospital, Kansas City, Missouri, from December 1975 to September 1979. Of the 117 patients....
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80492-7
更新日期:1982-04-01 00:00:00
abstract:STUDY OBJECTIVES:To characterize the attendance at and presenters of conferences given to emergency medicine residents and to determine the ability of emergency medicine residents to attend conferences while working in the emergency department and on off-service rotations. DESIGN:Descriptive study of an anonymous mail...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70288-1
更新日期:1995-03-01 00:00:00
abstract::The goal of thrombolytic treatment in acute myocardial infarction is to reestablish permanent blood flow, salvage ischemic myocardium, and reduce mortality. If patency is achieved sufficiently early and is maintained, left ventricular function is preserved and mortality decreases. The recent experience with tissue pla...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(88)80063-5
更新日期:1988-11-01 00:00:00
abstract::In response to public pressure for greater accountability from the medical profession, a transformation is occurring in the approach to medical education and assessment of physician competency. Over the past 5 years, the Accreditation Council for Graduate Medical Education (ACGME) has implemented the Outcomes and Gene...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/S0196064403013532
更新日期:2004-06-01 00:00:00
abstract:STUDY OBJECTIVE:Influenza has been linked to emergency department (ED) crowding, yet few studies have examined this association. We describe the relationship between ED crowding and influenza outbreaks. METHODS:A retrospective time series analysis was conducted in Toronto from January 1996 to April 1999 (n=170 weeks)....
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2003.12.008
更新日期:2004-07-01 00:00:00
abstract::Right ventricular infarction due to ischemic heart disease can be diagnosed by a right precordial electrogram or by first-pass radionuclide angiography (FPRNA). Prior FPRNA studies have shown that cardiac dysfunction after blunt chest trauma (myocardial contusion) is most often due to right ventricular dysfunction. We...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80665-6
更新日期:1988-09-01 00:00:00
abstract::Test strips recently have become available to measure theophylline levels. One such test strip (AccuLevel) had not been tested in an actual clinical situation with nontechnician personnel. We prospectively evaluated the test strip on consecutive emergency department patients, comparing it with the agglutination inhibi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80440-2
更新日期:1988-10-01 00:00:00
abstract::We present a case of delay in diagnosis of diaphragmatic rupture and herniation in a pregnant 25-year-old woman. The diaphragmatic rupture was secondary to trauma sustained five months prior to presentation. Subsequent to her accident, she was provided medical care on multiple occasions for symptoms of intractable nau...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80780-7
更新日期:1988-04-01 00:00:00
abstract:STUDY OBJECTIVE:Abdominal compressions can be interposed between the thoracic compressions of standard CPR (SCPR). The resulting interposed abdominal compression CPR (IAC-CPR) may increase blood pressures and patient survival, particularly if applied as a primary technique after in-hospital cardiac arrest. We used a pr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70298-9
更新日期:1995-03-01 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::Myocardial rupture is a catastrophic complication of acute myocardial infarction that usually results in sudden death. If diagnosed quickly, patients with myocardial rupture may be salvaged. This report describes the application of emergency department two-dimensional echocardiography in the diagnosis of six cases of ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70361-2
更新日期:1994-06-01 00:00:00
abstract::A profoundly hypothermic 5-hour-old infant in cardiac arrest was brought to the emergency department by paramedics. The infant was found wrapped in a garbage bag inside a freezer. She had been in the freezer for approximately four hours. Her initial rectal temperature was 16.2 degrees C. Active external and core warmi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70369-8
更新日期:1994-06-01 00:00:00
abstract::Severe sepsis and septic shock are as common and lethal as other acute life-threatening conditions that emergency physicians routinely confront such as acute myocardial infarction, stroke, and trauma. Recent studies have led to a better understanding of the pathogenic mechanisms and the development of new or newly app...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2006.02.015
更新日期:2006-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the feasibility of managing patients with acute pyelonephritis as outpatients after initial treatment with IV antibiotics in an emergency department observation unit. DESIGN:Prospective and uncontrolled. SETTING:ED observation unit. TYPE OF PARTICIPANTS:Nonpregnant female patients 14 yea...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80935-7
更新日期:1991-03-01 00:00:00