Abstract：
STUDY OBJECTIVE:Midazolam is widely used for procedural sedation and analgesia. Etomidate has been studied mostly in adults. Our objective is to compare the efficacy of etomidate and midazolam for achieving procedural sedation and analgesia in children. METHODS:A randomized, double-blind, emergency department and orthopedic clinic-based trial was carried out among patients aged 2 to 18 years with displaced extremity fractures. Patients were administered 1 microg/kg of fentanyl and either 0.2 mg/kg of etomidate or 0.1 mg/kg of midazolam. Adequate sedation was defined, for the purpose of this study, as a score of 4 or more on the Ramsay Sedation Scale. The primary outcome was induction and recovery time. The rates of adverse events, success of fracture reduction, and parent and physician satisfaction were also compared. RESULTS:From April to August 2004, 100 of 128 eligible patients were enrolled (age 8.7+/-3.7 years; 50% male patients). A higher proportion of patients attained adequate sedation among those who received etomidate: 46 of 50 (92%) versus 18 of 50 (36%) (delta 56%; 95% confidence interval [CI] 38% to 69%). Time taken for induction (hazard ratio 4.9; 95% CI 2.2 to 10.9) and time taken for recovery (hazard ratio 2.8; 95% CI 1.5 to 5.1) were lower among patients who received etomidate. The rates of adverse events were similar in both groups, except for myoclonus and pain at the injection site, which was more frequent in the etomidate group. CONCLUSION:Induction and recovery times are shorter with etomidate compared with midazolam. At the dosages used for procedural sedation and analgesia among children with displaced extremity fracture, etomidate has higher efficacy in comparison with midazolam.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Di Liddo L,D'Angelo A,Nguyen B,Bailey B,Amre D,Stanciu Cdoi
10.1016/j.annemergmed.2006.03.004subject
Has Abstractpub_date
2006-10-01 00:00:00pages
433-40, 440.e1issue
4eissn
0196-0644issn
1097-6760pii
S0196-0644(06)00399-4journal_volume
48pub_type
杂志文章,随机对照试验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：:Extraordinary incidents resulting in airborne infectious disease outbreaks could produce patient isolation requirements that exceed most hospitals' capacity. This article investigates expedient methods to establish airborne infection isolation areas using a commercially available portable filtration unit and common ha...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2004.07.451
更新日期：2004-12-01 00:00:00
abstract：:A prospective study was conducted in the emergency departments of two community hospitals to assess the accuracy of Doppler ultrasonography performed by emergency physicians in the evaluation of patients with symptoms suggestive of deep-vein thrombosis. Seventy-eight extremities in 76 patients were evaluated by both D...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82481-3
更新日期：1990-06-01 00:00:00
abstract：STUDY OBJECTIVE:Studies of travel-related mortality and morbidity have been limited to nonfatal events. Causes of travel-related mortality may differ significantly from morbidity and thus have different prevention strategies. DESIGN:We examined the overseas fatalities of US citizen travelers for the years 1975 and 198...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82379-0
更新日期：1991-06-01 00:00:00
abstract：:While advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) courses have become accepted standards for physicians who care for the critically ill and injured patient, only recently have pediatric advanced life support (PALS) courses been developed. The American Academy of Pediatrics has shown re...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80067-0
更新日期：1984-11-01 00:00:00
abstract：:We present the case of a 6-year-old boy with reactive airway disease who developed cervical lung herniation resulting in compression of the trachea and audible stridor. This association has never been reported in the pediatric age group, and a review of the literature revealed that lung herniation is a rare condition ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81574-4
更新日期：1990-08-01 00:00:00
abstract：:This clinical policy focuses on critical issues concerning the management of patients presenting to the emergency department (ED) with acetaminophen overdose. The subcommittee reviewed the medical literature relevant to the questions posed. The critical questions are: 1. What are the indications for N-acetylcysteine (...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,实务指引
doi：10.1016/j.annemergmed.2007.06.014
更新日期：2007-09-01 00:00:00
abstract：STUDY OBJECTIVE:We develop a comprehensive view of aspects of care associated with parental satisfaction with pediatric emergency department (ED) visits, using both quantitative and qualitative data. METHODS:This was a retrospective observational study using data from an institution-wide system to measure patient sati...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.04.025
更新日期：2013-10-01 00:00:00
abstract：STUDY OBJECTIVE:To identify the arterial and mixed venous blood gas changes caused by different ventilatory strategies during resuscitation from ventricular fibrillation in a pig model of closed-chest cardiac compression. METHODS:A prospective randomized animal study was performed using 27 domestic pigs (body weight, ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70203-3
更新日期：1998-05-01 00:00:00
abstract：STUDY OBJECTIVES:To determine whether music significantly reduces the pain and anxiety associated with laceration repair in the emergency department. PARTICIPANTS AND SETTING:Adult patients presenting to the ED at an urban teaching hospital for laceration repair. Exclusion criteria included patients less than 18 years...
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)81652-x
更新日期：1991-04-01 00:00:00
abstract：:Several clinical studies have yielded conflicting results in examining the effectiveness of bystander CPR (BCPR). The purpose of this pilot study was to determine the effectiveness of BCPR in an animal model of cardiac arrest and resuscitation. Ten swine were instrumented for hemodynamic and regional blood flow measur...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81561-6
更新日期：1990-08-01 00:00:00
abstract：:Cocaine use and abuse continue to overwhelm urban economic, social, and health care systems. Patients frequently present to the emergency department with life-threatening manifestations of cocaine use, including trauma, acquired immune deficiency syndrome, psychomotor agitation, and cardiovascular collapse. Adequate t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(05)81217-x
更新日期：1991-02-01 00:00:00
abstract：STUDY OBJECTIVE:The STONE score is a clinical decision rule that classifies patients with suspected nephrolithiasis into low-, moderate-, and high-score groups, with corresponding probabilities of ureteral stone. We evaluate the STONE score in a multi-institutional cohort compared with physician gestalt and hypothesize...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.annemergmed.2015.08.019
更新日期：2016-04-01 00:00:00
abstract：STUDY OBJECTIVE:We compare test characteristics of abdominal computed tomography (CT) with and without oral contrast for identifying intra-abdominal injuries. METHODS:This was a planned subanalysis of a prospective, multicenter study of children (<18 years) with blunt torso trauma. Children imaged in the emergency dep...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.annemergmed.2015.01.014
更新日期：2015-08-01 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：:Pneumothorax and pneumomediastinum are rare complications of athletic activity. Spontaneous pneumothorax has been reported in association with several sports, but reports of pneumothorax associated with blunt trauma sustained during sporting activity are rare. We present a case series of patients in whom pneumothorax ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70018-0
更新日期：1997-10-01 00:00:00
abstract：STUDY OBJECTIVE:Emergency department (ED) patients with atrial fibrillation or flutter are at risk of stroke, and guidelines recommend anticoagulation for patients with increased cardiovascular risk. Emergency physicians have a unique opportunity to provide appropriate anticoagulation for such patients, and we wished t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.04.004
更新日期：2013-12-01 00:00:00
abstract：STUDY OBJECTIVE:Increasingly, hospitals are using utilization review software to reduce hospital admissions in an effort to contain costs. Such practices have the potential to increase the number of unsafe discharges, particularly in public safety-net hospitals. Utilization review software tools are not well studied wi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2017.03.043
更新日期：2017-11-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the timeliness of response of consultants called to evaluate patients in the emergency department of a community hospital. METHODS:Consultation requests from an ED located in a medium-sized community hospital were studied for a 1-month period. Data collected included name and specialty of ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70035-6
更新日期：1998-11-01 00:00:00
abstract：:The management of HIV disease has evolved into a complicated and sophisticated subspecialty in recent years. Fourteen drugs, in various combinations, are being used in increasingly complex treatment regimens. The side effects of some of these drugs, as well as certain drug-drug interactions may mimic signs and symptom...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(99)70341-0
更新日期：1999-05-01 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：:Although we commonly assume that because residents spend a given number of months in the emergency department they achieve adequate exposure to all necessary clinical entities, this has never been shown. We suspect, rather, that great variability exists among residents in the number and variety of patients they see; a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81700-7
更新日期：1990-07-01 00:00:00
abstract：STUDY OBJECTIVE:Medication history is an essential part of patient assessment in emergency care. Patient-reported medication history can be incomplete. We study whether an electronic pharmacy-sourced prescription record can supplement the patient-reported history. METHODS:In a community hospital, we compared the patie...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.04.014
更新日期：2013-09-01 00:00:00
abstract：:Situated in the heart of Europe, Switzerland's 7 million inhabitants, including 1 million foreigners, live in an area of 41,000 km2. German, French, Italian, and Rhaeto-Romanic are the official languages. The Swiss health service stands out because of the high quality and efficiency of its ambulatory and hospitalized ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70144-1
更新日期：1998-08-01 00:00:00
abstract：:The development of an organized filing system for referencing articles pertinent to emergency medicine is presented. This simple and flexible system allows for modification for the individual needs of the emergency physician. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80306-4
更新日期：1980-09-01 00:00:00
abstract：STUDY OBJECTIVE:The effect of urgent cares on local emergency department (ED) patient volumes is presently unknown. In this paper, we aimed to assess the change in low-acuity ED utilization at 2 academic medical centers in relation to patient proximity to an affiliated urgent care. METHODS:We created a geospatial data...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2019.06.024
更新日期：2020-03-01 00:00:00
abstract：STUDY OBJECTIVE:The objective of this study is to derive a clinical decision instrument with a sensitivity of at least 95% (with upper and lower bounds of the 95% confidence intervals [CIs] within a 5% range) to identify adult emergency department patients with mild traumatic intracranial hemorrhage who are at low risk...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.11.003
更新日期：2014-04-01 00:00:00
abstract：:Sodium metabisulfite (MBS) is a commonly used food and drug preservative. We report the case of a 32-year-old man with a documented history of allergy to MBS who developed an anaphylactic reaction after ingestion of MBS-treated foods. The patient had a prolonged clinical course requiring two emergency department visit...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80492-9
更新日期：1986-01-01 00:00:00
abstract：STUDY OBJECTIVE:This study measures the degree to which parents of patients, in the course of evaluation and treatment in a pediatric emergency department (ED), could report what they were waiting for. METHODS:Brief in-person interviews were conducted with parents of nonemergency patients during an ED visit. After the...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2007.09.032
更新日期：2008-04-01 00:00:00
abstract：:The Bahamas is an archipelago of 700 islands with the majority of the population concentrated on just 2 islands: New Providence and Grand Bahama. Most emergency medical services are provided by Princess Margaret Hospital and Rand Memorial Hospital located respectively on those 2 islands. A detailed description of the ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.118865
更新日期：2001-12-01 00:00:00
