Abstract:
STUDY OBJECTIVE:In recent years, air transport of patients has been associated with disproportionate increases in crashes and deaths. We identify factors related to fatal outcome in air medical helicopter crashes and suggest preventive measures. METHODS:This was a retrospective study using National Transportation Safety Board records for helicopter emergency medical services (EMS) crashes between January 1, 1983, and April 30, 2005. The main outcome measure was the percentage of air medical crashes resulting in 1 or more deaths. RESULTS:There were 182 helicopter EMS crashes during the 22.3-year study period; 39% were fatal. One hundred eighty-four occupants died: 45% of the 44 patients and 32% of the 513 crewmembers. Fifty-six percent of crashes in darkness were fatal compared with 24% of crashes not in darkness. Seventy-seven percent of crashes in instrument meteorological conditions were fatal compared with 31% in visual conditions. Thirty-nine percent of all deaths occurred in crashes with postcrash fires; 76% of crashes with postcrash fire were fatal compared with 29% of other crashes. Multivariate logistic regression revealed that controlling for other factors, the odds of fatal outcome was increased by postcrash fire (odds ratio [OR] 16.1; 95% confidence interval [CI] 5.0 to 51.5], bad weather (OR 8.0; 95% CI 2.4 to 26.0), and darkness (OR 3.2; 95% CI 1.3 to 7.9). CONCLUSION:Fatalities after helicopter EMS crashes are associated especially with postcrash fire and with crashes that occur in darkness or bad weather and can be addressed with improved crashworthiness and measures to reduce flights in hazardous conditions. Further studies will be necessary to determine which changes will decrease the fatal crash rate and which are cost effective.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Baker SP,Grabowski JG,Dodd RS,Shanahan DF,Lamb MW,Li GHdoi
10.1016/j.annemergmed.2005.11.018subject
Has Abstractpub_date
2006-04-01 00:00:00pages
351-6issue
4eissn
0196-0644issn
1097-6760pii
S0196-0644(05)01958-Xjournal_volume
47pub_type
杂志文章abstract::The resuscitation of a patient with failure of a permanent artificial pacemaker is described. A mechanically inactive heart showed a variety of ineffective rhythms, and dissociation could not be overcome by drug therapy. The urgent need for artificial pacing presented problems that eventually were overcome. The time r...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)81036-2
更新日期:1985-12-01 00:00:00
abstract:STUDY OBJECTIVES:By evaluating the efficacy of metoclopramide alone and in combination with ibuprofen versus placebos, this study was designed to both evaluate the efficacy of metoclopramide and elucidate its mechanism of action in the treatment of migraine headache. DESIGN:The study was conducted over a two-year peri...
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(05)80201-x
更新日期:1993-02-01 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:To evaluate the safety of lidocaine in the setting of cocaine-induced myocardial infarction (MI). DESIGN:A retrospective, multicenter study. SETTING:Twenty-nine university, university-affiliated, or community hospitals during a 6-year period (total of 117 cumulative hospital-years). PARTICIPANTS:Pati...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/s0196-0644(95)70041-2
更新日期:1995-12-01 00:00:00
abstract:STUDY OBJECTIVE:An increase in prescriptions for opioid pain medications has coincided with increasing opioid overdose deaths. Guidelines designed to optimize opioid prescriptions written in the emergency department have been implemented, with substantial controversy. Little is known about how physicians perceive and a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.03.015
更新日期:2014-11-01 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 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::The case of a patient with apparent cocaine toxicity and drug-mediated hypertension and tachycardia is presented. IV propranolol was used as the initial treatment for his hyperadrenergic state, resulting in a decrease in heart rate but a paroxsymal increase in blood pressure. The patient required nitroprusside for con...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80934-3
更新日期:1985-11-01 00:00:00
abstract:STUDY OBJECTIVE:We determine the accuracy of an age-adjusted D-dimer threshold to detect pulmonary embolism in emergency department (ED) patients older than 50 years and describe current ED practices when evaluating possible pulmonary embolism. METHODS:This was a retrospective study of ED encounters for suspected pulm...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.07.026
更新日期:2016-02-01 00:00:00
abstract::Gastrointestinal obstruction is a rare complication of multiple-dose administration of activated charcoal. Previous reports deal only with obstruction after ingestion of drugs that impair gastrointestinal motility. This patient developed a small-bowel obstruction associated with the administration of multiple doses of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70170-9
更新日期:1994-07-01 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 sought to develop and validate standardized clinical criteria to identify patients presenting to the emergency department whose care may be safely deferred to a later date in a nonemergency setting. METHODS:Using a modified Delphi process, a 17-member multidisciplinary physician panel developed expl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2000.107003
更新日期:2000-07-01 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::The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in red...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.10.018
更新日期:2012-07-01 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:STUDY OBJECTIVE:Machine-learning algorithms allow improved prediction of sepsis syndromes in the emergency department (ED), using data from electronic medical records. Transfer learning, a new subfield of machine learning, allows generalizability of an algorithm across clinical sites. We aim to validate the Artificial ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.11.007
更新日期:2021-01-15 00:00:00
abstract::Cardiac arrest caused by massive pulmonary embolism is highly refractory to conventional resuscitation. Emergency surgical embolectomy has been considered the only effective intervention. We present the case of a 33-year-old woman who suffered a massive pulmonary embolism with circulatory arrest refractory to one half...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80527-x
更新日期:1989-06-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the experience of croup at Princess Margaret Hospital for Children (PMH), the only tertiary pediatric hospital in Western Australia, from 1980 through 1995 with reference to the introduction of routine steroid treatment in the ICU in 1989, in the general hospital wards from 1989 through 1993...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70084-7
更新日期:1996-12-01 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::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::Acute asthma exacerbations are common complaints in patients who present to the emergency department. A prospective, double-blinded study was designed to evaluate how frequency of dosing of an inhaled beta-agonist, metaproterenol (Alupent inhalation solution) would affect patient response, length of stay in the ED, an...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(05)82134-1
更新日期:1990-01-01 00:00:00
abstract:STUDY OBJECTIVE:The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2016.10.007
更新日期:2017-04-01 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::Ethanol disrupts the physical structure of cell membranes. The most fluid membranes, including those that are low in cholesterol, are the most easily disordered by ethanol. Although the membrane-disordering effect is small, there is pharmacological, temporal, and genetic evidence that it is important. Animals that are...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(86)80120-2
更新日期:1986-09-01 00:00:00
abstract:STUDY OBJECTIVE:We measure the rate of emergency department (ED) specimen processing error reduction after implementation of an electronic physician order entry system paired with a bar-coded specimen labeling process. METHODS:A cohort pre- and postintervention study was conducted in the ED during a 61-month period en...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.05.028
更新日期:2010-12-01 00:00:00
abstract:STUDY OBJECTIVE:Video capsule endoscopy has been used to diagnose gastrointestinal hemorrhage and other small bowel diseases but has not been tested in an emergency department (ED) setting. The objectives in this pilot study are to demonstrate the ability of emergency physicians to detect blood in the upper gastrointes...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/j.annemergmed.2012.11.008
更新日期:2013-04-01 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::A seven-year-old boy ingested 3,000 mg (125 mg/kg) of isoniazid. Initial blood levels of isoniazid were 250 micrograms/mL approximately six hours after ingestion. Despite IV treatment in the emergency department with 3,000 mg pyridoxine and a repeat of the same antidote one hour later in the intensive care unit, the h...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80509-2
更新日期:1988-01-01 00:00:00
abstract::Admixture of erythrocytes (packed red blood cells) with heated saline solutions may provide a faster and safer method of bloodwarming and infusion than is currently available. We developed and tested such a system for ease and efficacy. One-day-old aliquots of erythrocytes (6 to 10 C) were combined with equal amounts ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80362-1
更新日期:1987-04-01 00:00:00
abstract:STUDY OBJECTIVE:We assessed the independent relationship between age and the quality of medical care provided to patients presenting to the emergency department (ED) with acute myocardial infarction. METHODS:We conducted a 2-year retrospective cohort study of 2,216 acute myocardial infarction patients presenting urgen...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.12.012
更新日期:2005-07-01 00:00:00