Abstract：
STUDY OBJECTIVE:To determine the concordance of emergency physicians' and cardiologists' interpretations of abnormal ECGs. DESIGN:Retrospective cohort study. SETTING:An urban teaching hospital emergency department. TYPE OF PARTICIPANTS:Patients with an abnormal ED ECG that was interpreted by both an emergency physician and a cardiologist and who were discharged from the ED. MEASUREMENTS AND MAIN RESULTS:Seven hundred sixteen ECGs were reviewed; 143 abnormal ECGs were obtained on patients discharged from the ED. The cardiologist's final interpretation was defined as correct, and discordance was any abnormality not identified by the emergency physician. The overall discordance between emergency physicians' and cardiologists' ECG interpretations was 58.0% (P less than .001). Twenty-five discordant interpretations were likely clinically significant--representing missed ischemia, infarct, and abnormal rhythm. There was no ED interpretation in three of these. The most frequently missed findings by emergency physicians were evidence of ischemia/infarct of the anterior wall and atrial fibrillation. Twenty-one of the 83 patients with discordant interpretations were lost to follow-up. Two cases had a clinically significant discrepancy that would have altered patient care. CONCLUSION:Although the overall discordance was more than 50%, most ED misinterpretations were determined unlikely to have clinical significance. Additional studies are needed to identify variables that contribute to ED ECG misinterpretation and to develop methods to resolve these difficulties.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Westdrop EJ,Gratton MC,Watson WAdoi
10.1016/s0196-0644(05)82521-1subject
Has Abstractpub_date
1992-05-01 00:00:00pages
541-4issue
5eissn
0196-0644issn
1097-6760journal_volume
21pub_type
杂志文章abstract：STUDY OBJECTIVE:We examine the central venous catheter placement rate during the implementation of an ultrasound-guided peripheral intravenous access program. METHODS:We conducted a time-series analysis of the monthly central venous catheter rate among adult emergency department (ED) patients in an academic urban ED b...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2012.09.016
更新日期：2013-02-01 00:00:00
abstract：STUDY OBJECTIVE:To develop management guidelines for the treatment of anaphylactoid reactions to intravenous N-acetylcysteine (NAC) and to assess the safety of restarting the infusion after a reaction. METHODS:In phased 1, we used a 6-year retrospective case series of hospitalized patients and a review of the literatu...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(98)70229-x
更新日期：1998-06-01 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：: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：STUDY OBJECTIVE:We characterize the quantity and quality of data tables and figures in reports of randomized controlled trials (RCTs) submitted to the British Medical Journal (BMJ) and published in peer-reviewed journals. We investigate how the peer review process affected table and figure quality. METHODS:We reviewed...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2006.06.017
更新日期：2006-12-01 00:00:00
abstract：STUDY OBJECTIVE:The number of freestanding emergency departments (EDs) has increased rapidly in the United States, and there is concern that such entities are located near existing EDs rather than in areas lacking emergency care. In 2018, the Medicare Payment Advisory Commission recommended a reduction in Medicare reim...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2020.07.036
更新日期：2021-01-01 00:00:00
abstract：:A treatment protocol for patients with acute bronchospasm was introduced to an adult emergency department in an attempt to decrease treatment time and potentially decrease need for admission. The charts of all patients seen in a control year (before any protocol was in place) and the first three years of the protocol ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80429-2
更新日期：1986-06-01 00:00:00
abstract：STUDY OBJECTIVE:Peripheral intravenous cannulation is procedurally challenging and painful. We perform a systematic review to evaluate ultrasonographic guidance as an aid to peripheral intravenous cannulation. METHODS:We searched MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Cumulative Index to Nurs...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.annemergmed.2012.11.014
更新日期：2013-04-01 00:00:00
abstract：:Creatine phosphokinase (CPK) and creatine kinase-MB (CK-MB) have been used extensively as diagnostic markers for myocardial infarction and skeletal muscle injury. Many factors affect the variability of serum CPK and serum CK-MB activity, especially physical activity. We discuss the influence of physical activity on mu...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(95)70270-9
更新日期：1995-04-01 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：STUDY OBJECTIVE:Dabigatran is a reversible direct thrombin inhibitor recently approved for stroke prevention in patients with atrial fibrillation. An increasing number of patients receiving dabigatran present to the emergency department (ED) with bleeding complications. Unlike vitamin K antagonists, there are no accept...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.02.008
更新日期：2013-04-01 00:00:00
abstract：STUDY OBJECTIVE:Cost concerns may inhibit emergency medical services (EMS) use. Novel tax-based and subscription prepayment programs indemnify patients against the cost of EMS treatment and transport. We determine whether the presence of (or enrollment in) prepayment plans increase EMS use among patients with acute che...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：
更新日期：2000-06-01 00:00:00
abstract：:Many studies of prehospital resuscitation report on selected populations. We examined a series of 445 unselected nontraumatic cardiac arrests. Emergency cardiac care (ECC) was not initiated in 126 (28%). ECC was begun in 319 (78%), but was terminated in 132 (33%). Ninety-four (21%) were admitted to the hospital with p...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80185-8
更新日期：1986-04-01 00:00:00
abstract：STUDY OBJECTIVES:We determine whether the addition of heat to topical eutectic mixture of local anesthetic (EMLA) cream shortens the onset time to effective analgesia. We hypothesized that applying EMLA cream for 20 minutes with an external heat pack would be as effective as the standard 60-minute application time. ME...
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.2003.228
更新日期：2003-07-01 00:00:00
abstract：:Epiglottitis in adults, while uncommon, is certainly not rare. Despite the increasing reports of the disorder in the literature, it continues to be misdiagnosed in emergency departments. The first step in the diagnosis of acute epiglottitis is for the emergency physician to think of it. The literature concerning the e...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80463-5
更新日期：1981-01-01 00:00:00
abstract：STUDY OBJECTIVE:Hospital-based emergency departments (EDs) are the gateway to hospital admissions for many Americans. Approximately half of all US hospital admissions originate from EDs, and more than 3 in 4 are among Medicare beneficiaries. Recent literature has demonstrated nearly 2-fold variation in both physician- ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.03.019
更新日期：2016-10-01 00:00:00
abstract：:The Advanced Trauma Life Support (ATLS) course is sponsored by the American College of Surgeons Committee on Trauma. This course was developed to provide a consistent method of care for the resuscitation and evaluation of the injured patient. The ATLS course provides an easily remembered method for evaluating and trea...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(99)70238-6
更新日期：1999-08-01 00:00:00
abstract：STUDY OBJECTIVE:To assess the need for cranial computed tomography (CT) in the emergency department evaluation of children with Glasgow Coma Scale (GCS) score of 15 after mild head injury with loss of consciousness. DESIGN:Retrospective case series of children aged 2 to 17 years with documented loss of consciousness a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70273-x
更新日期：1994-10-01 00:00:00
abstract：STUDY OBJECTIVE:To examine community changes in self-reported CPR training and use from 1980-82 to 1985-87 using data obtained from the Minnesota Heart Survey. A comparative investigation of CPR training among blacks and whites in 1985-86 also was completed. DESIGN:Data were obtained in 1980-81, 1981-82, 1985-86, and ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82782-9
更新日期：1992-06-01 00:00:00
abstract：STUDY OBJECTIVE:We determine whether there are differences in role-related communication patterns in the emergency department (ED). METHODS:This was an observational study of a metropolitan ED. Four medical officers and 4 nurses were observed for 19 hours and 52 minutes. Communication load was measured by proportion o...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2004.04.006
更新日期：2004-09-01 00:00:00
abstract：:A prospective study was conducted to test the reliability of at-home observation of head trauma victims in the rural South among a population of low educational level. During a four-month period, 99 patients entered and 90 patients finished the study. In all cases, an individual was identified as willing to accept the...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80297-x
更新日期：1988-02-01 00:00:00
abstract：STUDY OBJECTIVE:Scorpion envenomation is a common life-threatening hazard in tropical and subtropical countries. Standard treatment is not clearly defined. Many therapies, such as steroids, are prescribed without experimental justification. We sought to assess the efficacy of systematic administration of intravenous hy...
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(97)70105-7
更新日期：1997-07-01 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：:A team of missionary doctors from Ecuador recently described striking success in the treatment of venomous snakebites with a series of brief, high-voltage, low-current electric shocks applied to the bit site. We designed a randomized, controlled, blinded test of their methods in laboratory rats. Venom of the fer-de-la...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80118-5
更新日期：1988-03-01 00:00:00
abstract：:A retrospective review of all patients admitted to an urban teaching hospital emergency department with the complaint of overdose, poisoning, or ingestion during a 10-month period was conducted. Analysis of these 82 episodes involving 69 individuals revealed: 1) a preponderance of women in the 20- to 40-year old range...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80453-2
更新日期：1981-01-01 00:00:00
abstract：:We present a framework for understanding calculations of continuous infusions of vasoactive substances. Several simplified methods for establishing initial concentrations and infusion rates of drug are derived, their applicability is discussed, and examples are given. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80418-1
更新日期：1983-11-01 00:00:00
abstract：STUDY OBJECTIVE:Intravenous metoclopramide is effective as primary therapy for acute migraine, but the optimal dose of this medication is not yet known. The objective of this study is to compare the efficacy and safety of 3 different doses of intravenous metoclopramide for the treatment of acute migraine. METHODS:This...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2010.11.023
更新日期：2011-05-01 00:00:00
abstract：:We conducted a study to assess the efficacy of the dipstick leukocyte esterase test (LET) in the detection of cerebrospinal fluid (CSF) leukocytosis as a quick screen for bacterial meningitis. Nine hundred forty-two CSF samples were collected from 800 patients. The LET was compared in a double-blinded fashion with rou...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/s0196-0644(89)80058-7
更新日期：1989-11-01 00:00:00
abstract：STUDY OBJECTIVE:We examine whether using public National Hospital Ambulatory Medical Care Survey (NHAMCS) data with masked design variables produces different estimates, standard errors, and confidence intervals (CIs) for the temporal trend of overall and injury-related emergency department (ED) visits compared with us...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2010.12.025
更新日期：2011-06-01 00:00:00
abstract：:Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy that can be mistaken for a normal intrauterine pregnancy on ultrasonography, leading to catastrophic results. Increasingly, emergency physicians are using ultrasonography to diagnose intrauterine pregnancy. Emergency physicians should be aware of...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.125426
更新日期：2002-07-01 00:00:00
