Abstract:
STUDY OBJECTIVE:Physicians often prescribe antibiotics to patients even when there is no clear indication for their use. Previous studies examining antibiotic use in acute bronchitis and upper respiratory infections have been conducted in primary care settings. We evaluate the factors that physicians in the emergency department (ED) consider when prescribing antibiotics (eg, patient expectations) and the factors associated with patient satisfaction. METHODS:Ten academic EDs enrolled adults and children presenting with symptoms consistent with upper respiratory infection. Enrolled patients were interviewed before their physician encounter and were reinterviewed before discharge and 2 weeks later. Physicians were interviewed about factors that influenced their management decisions, including their perceptions of patients' expectations. Patients with a single diagnosis of uncomplicated acute bronchitis or upper respiratory infection were included for analysis. RESULTS:Of 272 patients enrolled, 68% of bronchitis patients and 9% of upper respiratory infection patients received antibiotics. Physicians were more likely to prescribe antibiotics when they believed that patients expected them (odds ratio [OR] 5.3; 95% confidence interval [CI] 2.9 to 9.6), although they were able to correctly identify only 27% of the patients who expected antibiotics. Satisfaction with the ED visit was reported by 87% of patients who received antibiotics and 89% of those not receiving antibiotics. Satisfaction with the visit was reported by 92% of patients who believed they had a better understanding of their illness but only by 72% of those who thought they had no better understanding (OR 4.4; 95% CI 2.0 to 8.4). CONCLUSION:Physicians in our academic EDs prescribed antibiotics to 68% of acute bronchitis patients and to fewer than 10% of upper respiratory infection patients. Physicians were more likely to prescribe antibiotics to patients who they believed expected them, although they correctly identified only about 1 in 4 of those patients. Patient satisfaction was not related to receipt of antibiotics but was related to the belief they had a better understanding of their illness.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Ong S,Nakase J,Moran GJ,Karras DJ,Kuehnert MJ,Talan DA,EMERGEncy ID NET Study Group.doi
10.1016/j.annemergmed.2007.03.026subject
Has Abstractpub_date
2007-09-01 00:00:00pages
213-20issue
3eissn
0196-0644issn
1097-6760pii
S0196-0644(07)00387-3journal_volume
50pub_type
杂志文章,多中心研究abstract::Pancreatic injury after blunt abdominal trauma can be subtle and delayed in its onset. We present a 24-year-old man who became jaundiced 16 days after he experienced blunt trauma. He was found to have an isolated pancreatic contusion. We discuss the initial evaluation for blunt pancreatic injury, the differential diag...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70171-3
更新日期:1996-05-01 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::A 24-year-old woman had a clinically occult injury of the carotid artery from the shoulder seat belt restraint in a motor vehicle accident. Acute thromboembolism and hemiplegia occurred two hours after her admission to the emergency department. There were contusions of the neck and chest (seat belt sign) but no associ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80452-9
更新日期:1988-10-01 00:00:00
abstract::A young woman presented with acute abdominal pain, anemia, and a positive pregnancy test. At surgery a large retroperitoneal hematoma secondary to a ruptured right kidney was found. Pathological examination revealed a hematogenic necrosis of a choriocarcinoma of the kidney. The patient tolerated subsequent chemotherap...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80432-8
更新日期:1987-12-01 00:00:00
abstract:STUDY OBJECTIVE:Women and students underrepresented in medicine are less likely to apply for residency in emergency medicine. The latter are from racial or ethnic populations that are underrepresented as physicians relative to the general population. The factors that result in lower application rates from women and gro...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2019.04.008
更新日期:2019-12-01 00:00:00
abstract::In a prospective investigation of isolated simple pneumothorax, the treatment of 35 patients with a total of 37 pneumothoraces was studied. A standardized sequential treatment approach was followed for evacuation of the pneumothorax and maintenance of lung reexpansion. The protocol involved catheter placement using a ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80676-0
更新日期:1988-09-01 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::A 19-year-old man who attempted suicide by ingesting approximately 600 mg fluoxetine (Prozac) and 140 mg loxapine (Loxitane) had two episodes of atrial flutter shortly thereafter. Admission serum fluoxetine, norfluoxetine, and loxapine levels were 1,053 ng/mL, 702 ng/mL, and 40 ng/mL, respectively. This case of atrial...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70083-4
更新日期:1994-03-01 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::Five cases of right-sided rupture of the diaphragm are reviewed. Orthopedic injury, head injury, and shock were the most common associated findings. Apparent elevation of the right hemidiaphragm was seen initially in all cases, but two were misdiagnosed. An algorithm that includes modified peritoneal lavage, CT scan w...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80464-8
更新日期:1983-06-01 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::Levels of nitrous oxide were monitored in the emergency department during the use of a Nitronox machine after four and eight minutes of breathing gas. Levels near the user's head were found to be 800 to 1,200 parts per million. Levels at the center of the room peaked at 300 ppm after eight minutes of use, and spot che...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80195-3
更新日期:1981-11-01 00:00:00
abstract::A method is presented for reviewing the taped radio-telemetry records of paramedic calls managed by hospital-based emergency medicine residents. All paramedic calls to the LAC/USC base station are reviewed by an emergency medicine resident using a special tape review form which focuses on communication skills, initial...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80458-1
更新日期:1981-01-01 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:STUDY OBJECTIVE:Nearly 3 million patients present to US emergency departments (EDs) annually with undifferentiated musculoskeletal low back pain. Little is known about short- and longer-term outcomes in this group. We seek to describe the pain and functional outcomes 1 week and 3 months after discharge in a sample of E...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.09.012
更新日期:2012-02-01 00:00:00
abstract:STUDY OBJECTIVE:We examine how dedicated methodology and statistical review affects the quality of manuscripts published in Annals of Emergency Medicine. DESIGN:The dedicated reviewers developed a manuscript scoring form based on previously used instruments. The form contained 84 unique elements. Eight items sought th...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.127328
更新日期:2002-09-01 00:00:00
abstract::The efficiency of cross clamping the thoracic aorta for cases of massive hemorrhage and impending cardiac arrest is questionable. We present two cases of major intra-abdominal aortic injury in which the bleeding could not be controlled by cross clamping the thoracic aorta. Multiple collateral pathways around the clamp...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80241-2
更新日期:1982-03-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy of a 4-day "burst" course of prednisone added to standard treatment with H1 antihistamines for the management of acute urticaria in outpatients. DESIGN:Prospective, randomized, double-blinded, clinical trial. SETTING:Emergency department of an urban tertiary care teaching hosp...
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(95)70002-1
更新日期:1995-11-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the presence of cocaethylene, an active metabolite of the combination of cocaine and ethanol, among trauma patients who test positive for cocaine. METHODS:We assembled a case series of 416 consecutive urban trauma center patients with major trauma. Urine was tested for the presence of the ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70266-4
更新日期:1996-03-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2009.08.005
更新日期:2010-02-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.02.013
更新日期:2014-06-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.01.024
更新日期:2005-08-01 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:STUDY OBJECTIVE:We describe the characteristics and outcomes of enrollee-health plan disputes over insurance coverage for emergency department (ED) services at 2 large health maintenance organizations (HMOs) that apply the prudent layperson standard. METHODS:We abstracted information from a stratified random sample of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(03)00637-1
更新日期:2004-02-01 00:00:00
abstract::This double-blind study compared the analgesic effects of morphine with those of butorphanol in patients who presented with pain because of sickle cell crisis. Patients were placed at bed rest, administered IV hydration, and randomly assigned on each visit to receive either 2 mg IM butorphanol or 6 mg IM morphine ever...
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(88)80554-7
更新日期:1988-08-01 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::First-responding emergency medical technicians (EMTs) trained to defibrillate have been shown to increase survival from prehospital ventricular fibrillation (VF) almost fourfold in Washington's King County. Using Nebraska ambulance rescue run data from 1982 and published information relating ambulance response time to...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80331-5
更新日期:1984-12-01 00:00:00
abstract:STUDY OBJECTIVE:To derive a highly sensitive decision rule for the selective use of radiography in acute knee injuries. DESIGN:Prospectively administered survey. SETTING:Emergency departments of two university hospitals. PARTICIPANTS:Convenience sample of 1,047 adults with acute knee injuries. RESULTS:Attending eme...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70106-0
更新日期:1995-10-01 00:00:00
abstract:STUDY OBJECTIVE:We determine the association between use of specific cephalosporins and macrolides and hospital length of stay in patients with sickle cell disease (SCD) who are admitted with acute chest syndrome, and determine treatment risk factors for acute chest syndrome-related 30-day readmission. METHODS:Patient...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.08.011
更新日期:2020-09-01 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