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). We obtained weekly data on laboratory-confirmed influenza and other respiratory virus cases in the community, ED ambulance diversion, and visits to all city EDs (n=20). The main outcome was ambulance diversion, measured as the mean number of hours per week in which EDs were forced to divert all ambulances. RESULTS:A mean of 10,936 ED visits occurred weekly (average age of patients 39.9 years; 51% female patients). EDs diverted ambulances an average of 3.4 hours per week (range 0.3 to 15 hours). Four influenza seasons occurred, lasting between 18 and 30 weeks each, with weekly influenza case counts ranging from 0 to 236. There were fewer than 10 cases per week in 119 of 170 weeks (70%). In time-series models, influenza was independently associated with ED ambulance diversion (P<.0001). For every 100 cases of influenza in the community in a given week, ED ambulance diversion would be expected to increase by 2.5 h/wk at the average ED (95% confidence interval [CI] 1.2 to 3.9 h/wk). During influenza seasons, 24.3% (95% CI 11.3% to 37.2%) of observed weekly ambulance diversion was attributable to influenza. CONCLUSION:Influenza seasons are associated with increased ED ambulance diversion. The impact is substantial but brief because there is little or no influenza activity most of each year.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Schull MJ,Mamdani MM,Fang Jdoi
10.1016/j.annemergmed.2003.12.008subject
Has Abstractpub_date
2004-07-01 00:00:00pages
61-7issue
1eissn
0196-0644issn
1097-6760pii
S0196064403013167journal_volume
44pub_type
杂志文章abstract：:During the past 30 years, emergency medical services (EMS) in the United States have experienced explosive growth. The American health care system is now transforming, providing an opportune time to examine what we have learned over the past three decades in order to create a vision for the future of EMS. Over the cou...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：
更新日期：1998-02-01 00:00:00
abstract：STUDY OBJECTIVE:Apnea is a known complication of pediatric seizures, but patient factors that predispose children are unclear. We seek to quantify the risk of apnea attributable to midazolam and identify additional risk factors for apnea in children transported by paramedics for out-of-hospital seizure. METHODS:This i...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.09.015
更新日期：2014-03-01 00:00:00
abstract：STUDY OBJECTIVE:Experts advocate the use of a standard nasal cannula to provide oxygen at flow rates of up to 15 L/minute during emergency intubation. However, because of concerns about potential patient discomfort, some providers avoid providing nasal cannula oxygen at flow rates greater than 6 L/minute. This trial is...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2014.10.023
更新日期：2015-04-01 00:00:00
abstract：:Excessive brain lactate, as may develop in cerebral ischemia, has been implicated as a major cause of irreversible cell damage. With an experimental model that produces cerebral ischemia by bilateral carotid ligation combined with systemic hypotension, previous studies have shown that treatment with 25 mg/kg sodium di...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80054-x
更新日期：1989-11-01 00:00:00
abstract：STUDY OBJECTIVE:We identify factors that define frequent and highly frequent emergency department (ED) users. METHODS:Administrative health care records were used to define less frequent (1 to 6 visits), frequent (7 to 17 visits), and highly frequent (≥18 visits) ED users. Analyses were conducted to determine the most...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.11.036
更新日期：2012-07-01 00:00:00
abstract：:Despite 3 decades of scientific progress, rates of survival from out-of-hospital cardiac arrest remain low. The Cardiac Arrest Registry to Enhance Survival (CARES) was created to provide communities with a means to identify cases of out-of-hospital cardiac arrest, measure how well emergency medical services (EMS) perf...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2009.03.018
更新日期：2009-11-01 00:00:00
abstract：:We present the case of a 27-year-old man who sustained a minor head injury and presented with complaints of headache and vomiting. The diagnosis of vertex epidural hematoma is discussed. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70145-8
更新日期：1994-08-01 00:00:00
abstract：:The deleterious effects of night shift work are discussed in relation to emergency physicians. Much of the early research is drawn from heavy industry sources and must be extrapolated to medical work. Disruption of circadian rhythms and Zeitgebers, caused by adherence to contemporary social schedules, causes recurrent...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80615-0
更新日期：1984-03-01 00:00:00
abstract：:The sudden emergence of 2009 H1N1 influenza in the spring of that year sparked a surge in visits to emergency departments in New York City and other communities. A larger, second wave of cases was anticipated the following autumn. To reduce a potential surge of health system utilization without denying needed care, we...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2010.04.005
更新日期：2010-09-01 00:00:00
abstract：STUDY OBJECTIVE:We examine whether a specific educational effort reduces emergency department violence in the short term and quantify the amount of violence in the ED. METHODS:Cross-sectional prospective surveys were conducted at a tertiary referral center at baseline (1998) and at 3 and 6 months (1999) after the Prev...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.121202
更新日期：2002-01-01 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：STUDY OBJECTIVES:Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database f...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.115214
更新日期：2001-06-01 00:00:00
abstract：:Abruptio placentae is a complication of pregnancy associated with significant morbidity and mortality for both fetus and mother. The presence of uterine pain and tenderness traditionally has been considered a useful criterion for distinguishing abruptio placentae from other causes of bleeding in pregnancy. We report t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81040-6
更新日期：1992-07-01 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：STUDY OBJECTIVE:Frequent emergency department (ED) users have been the targets of health care reform proposals and hospital crowding interventions, but it is not clear that common assumptions about this group are supported by data. We review the literature pertaining to frequent ED users, their demographics, acuity of ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2010.01.032
更新日期：2010-07-01 00:00:00
abstract：STUDY OBJECTIVE:Although adjunctive intravenous bicarbonate therapy is commonly recommended for children with severe diabetic ketoacidosis (DKA), no studies assessing clinical outcome with this therapy have ever been performed. Our objective was to determine whether bicarbonate therapy influenced outcome for pediatric ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(98)70279-3
更新日期：1998-01-01 00:00:00
abstract：STUDY OBJECTIVE:We compare metoclopramide 20 mg intravenously, combined with diphenhydramine 25 mg intravenously, with ketorolac 30 mg intravenously in adults with tension-type headache and all nonmigraine, noncluster recurrent headaches. METHODS:In this emergency department (ED)-based randomized, double-blind study, ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2013.03.017
更新日期：2013-10-01 00:00:00
abstract：:The ability of military anti-shock trousers (MAST) to increase central venous pressure and improve cardiac filling pressure suggests that they might be useful in the prehospital treatment of pericardial tamponade. This study utilizes a canine model to examine the hemodynamic effects of MAST inflation on experimentally...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80158-8
更新日期：1981-04-01 00:00:00
abstract：STUDY OBJECTIVE:Throughout the coronavirus disease 2019 pandemic, many emergency departments have been using passive protective enclosures ("intubation boxes") during intubation. The effectiveness of these enclosures remains uncertain. We sought to quantify their ability to contain aerosols using industry standard test...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2020.08.033
更新日期：2021-01-01 00:00:00
abstract：:Three children who presented with localized vesicular rash in the diaper area were found to have primary varicella-zoster infections. Primary varicella can closely mimic genital herpes simplex virus (HSV 1 or 2), which may be an indicator of sexual abuse. To avoid unfounded investigation for sexual abuse, primary vari...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(95)70365-9
更新日期：1995-01-01 00:00:00
abstract：:Presented is the case of a motor vehicle accident (MVA) victim with hypotension and evisceration of small intestine. Vigorous resuscitation in the emergency department was required, after which a portion of small bowel was resected at laparotomy. Evisceration secondary to trauma in an MVA is a rare injury. Significant...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80296-6
更新日期：1984-08-01 00:00:00
abstract：:Stellate ganglion blockade has been previously suggested as a treatment option for intractable ventricular arrhythmia; however, its use in emergency department management of pulseless arrest with shockable rhythm has not been described. We report the case of a 65-year-old man brought in by ambulance who complained of ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2019.07.026
更新日期：2020-02-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether reminder signs placed at the exits to parking decks increase the rate of safety belt use. METHODS:The subjects in this study were drivers of automobiles with permits to park in campus decks at a major university. Volunteer observers were positioned near the exits of 5 parking decks...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2000.111059
更新日期：2000-12-01 00:00:00
abstract：STUDY OBJECTIVE:The Utstein guidelines recommend that emergency medical services (EMS)-witnessed cardiac arrests be considered separately from other out-of-hospital cardiac arrest cases. The objective of this study was to assess EMS-witnessed cardiac arrest and to determine predictors of survival in this group. METHOD...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/S0196-0644(00)70133-8
更新日期：2000-02-01 00:00:00
abstract：:Leeches have been used as a medicinal remedy for years untold. Recently, there appears to have been a resurgence in the use of the medicinal leech, Hirudo medicinalis. Presented is the case of a patient who called the emergency department for advice concerning the management of a bleeding leech bite. We discuss briefl...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80422-6
更新日期：1989-03-01 00:00:00
abstract：:The World Health Assembly 2007 Resolution 60.22 tasked the global health community to address the lack of emergency care in low- and middle-income countries. Little progress has yet been made in integrating emergency care into most low- and middle-income-country health systems. At a rural Ugandan district hospital, ho...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2014.01.035
更新日期：2014-11-01 00:00:00
abstract：:Barium is a divalent alkaline earth metal used as the insoluble sulfate salt in contrast radiography and soluble acid salts in industry. Barium poisoning results from ingestion or inhalation of the acid salts; the most common poisoning occurs after ingestion of the rodenticide barium carbonate (BaCO3). We report seven...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(05)81393-9
更新日期：1991-10-01 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: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 OBJECTIVE:We determine the cost-effectiveness of out-of-hospital continuous positive airway pressure (CPAP) compared with standard care for adults presenting to emergency medical services with acute respiratory failure. METHODS:We developed an economic model using a United Kingdom health care system perspective ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2014.12.028
更新日期：2015-05-01 00:00:00
