当前位置： SCI文献检索 > ANNALS OF EMERGENCY MEDICINE期刊下所有文献 > Effect of emergency department crowding on time to antibiotics in patients admitted with community-acquired pneumonia.

Effect of emergency department crowding on time to antibiotics in patients admitted with community-acquired pneumonia.

Abstract：

STUDY OBJECTIVE:We hypothesize that emergency department (ED) volume and increased patient complexity are associated with lower quality of care, as measured by time to antibiotics for patients being admitted with community-acquired pneumonia. METHODS:This was a cross-sectional study at a university tertiary care hospital ED. Community-acquired pneumonia patients admitted from the ED and discharged between January 2004 and June 2005 were reviewed by our institution for The Joint Commission's antibiotic timing core measure. Medical records were abstracted for patient age, sex, race, mode of transport, arrival time, triage acuity, inpatient level of care, and arrival-to-antibiotic-administration times. Controlling for patient characteristics, multivariate logistic regression determined association of antibiotic administration within 4 hours of arrival, with total ED volume at the time of the community-acquired pneumonia patient's arrival, and with number of ED patients requiring admission at the time of arrival. RESULTS:Four hundred eighty-six patients were eligible for the study; antibiotic administration time was available for 405. Sixty-one percent of patients received antibiotics within 4 hours. Antibiotic administration within 4 hours was less likely with a greater number of patients (odds ratio 0.96 per additional patient; 95% confidence interval 0.93 to 0.99) and a greater number of patients ultimately admitted (odds ratio 0.93 per patient; 95% confidence interval 0.88 to 0.99) in the ED. The effect of additional patients was present below total ED capacity. CONCLUSION:As ED volume increases, ED patients with community-acquired pneumonia are less likely to receive timely antibiotic therapy. The effect of additional patients appears to occur even at volumes below the maximum bed capacity. Measures to ensure that quality targets are met in the ED should consider the impact of ED volume.

journal_name

Ann Emerg Med

journal_title

Annals of emergency medicine

authors

Fee C,Weber EJ,Maak CA,Bacchetti P

doi

10.1016/j.annemergmed.2007.08.003

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

501-9, 509.e1

issue

5

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(07)01382-0

journal_volume

50

pub_type

杂志文章

相关文献

ANNALS OF EMERGENCY MEDICINE文献大全
  • Near-fatal intoxication by 1, 1, 1-trichloroethane.

    abstract：:This report describes a case of near-fatal intoxication following accidental exposure to 1, 1, 1-trichloroethane in a child. This solvent, generally safe, is widely used to 1, 1, 1-trichloroethane in a child. This solvent, generally safe, is widely used in industrial and domestic preparations. Exposure to high levels ...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(81)80011-x

    authors： Gerace RV

    更新日期：1981-10-01 00:00:00

  • Hantavirus: emergency department response to a disaster from an emerging pathogen.

    abstract：:In May 1993, the appearance of critically ill patients with unexplained respiratory distress was noted in the Four Corners area formed by New Mexico, Arizona, and Colorado. This epidemic was ultimately linked to a hantavirus, an emerging pathogen. The impact on the emergency department of a new infectious disease with...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(94)70179-2

    authors： Brillman JC,Sklar DP,Davis KD,Beamsely A

    更新日期：1994-09-01 00:00:00

  • Glyburide-ciprofloxacin interaction with resistant hypoglycemia.

    abstract：:Glyburide, a second-generation sulfonylurea hypoglycemic agent, is metabolized by the P-450 hepatic enzyme system. Ciprofloxacin, a widely used quinolone antibiotic, is a recognized P-450 enzyme inhibitor. Conflicting data exist in the medical literature on the ability of quinolone antibiotics to inhibit glyburide hep...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1067/mem.2000.108617

    authors： Roberge RJ,Kaplan R,Frank R,Fore C

    更新日期：2000-08-01 00:00:00

  • The 1988 earthquake in Soviet Armenia: a case study.

    abstract：:A major earthquake devastated the Armenian Republic of the Soviet Union on December 7, 1988, resulting in thousands of deaths and injuries. In a postearthquake investigation of three towns seriously affected by the earthquake, we studied earthquake-related injury patterns, made observations on rescue and medical effor...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(05)81563-x

    authors： Noji EK,Kelen GD,Armenian HK,Oganessian A,Jones NP,Sivertson KT

    更新日期：1990-08-01 00:00:00

  • The bacteriology of dog bite wounds on initial presentation.

    abstract：:Four hundred twenty patients with open dog bite wounds on initial presentation to the emergency department had Gram stains, aerobic and anaerobic cultures, and antibiotic sensitivities of the bacterial isolates of each wound. Forty-eight percent of the wounds evidenced no bacterial growth. Staphylococcus epidermidis w...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(86)80620-5

    authors： Ordog GJ

    更新日期：1986-11-01 00:00:00

  • An analysis of Part II of the National Board of Medical Examiners Test with regard to questions in emergency medicine.

    abstract：:We conducted a study to determine the number of items and successful response rate to questions specific to emergency medicine on the National Board of Medical Examiners Test, Part II (NBME-II). The 1979 and 1983 NBME-II examinations were reviewed by a subcommittee of the Society of Teachers of Emergency Medicine. Ite...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(86)80479-6

    authors： Sanders AB,Burdick WP,Stair TO,Witzke D

    更新日期：1986-01-01 00:00:00

  • Distance From Freestanding Emergency Departments to Nearby Emergency Care.

    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

    authors： Freeman RE,Boggs KM,Sullivan AF,Faridi MK,Freid RD,Camargo CA Jr

    更新日期：2021-01-01 00:00:00

  • Can broad-range 16S ribosomal ribonucleic acid gene polymerase chain reactions improve the diagnosis of bacterial meningitis? A systematic review and meta-analysis.

    abstract：STUDY OBJECTIVE:We aim to evaluate the accuracy of the broad-range 16S polymerase chain reaction test in the diagnosis of bacterial meningitis through a systematic review and meta-analysis. METHODS:We searched MEDLINE, EMBASE, and the Cochrane Controlled Trials Registry, using the Medical Subject Headings terms "polym...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,meta分析,评审

    doi：10.1016/j.annemergmed.2012.05.040

    authors： Srinivasan L,Pisapia JM,Shah SS,Halpern CH,Harris MC

    更新日期：2012-11-01 00:00:00

  • Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial.

    abstract：STUDY OBJECTIVE:Annually, 38 million people are evaluated for trauma, the leading cause of death in persons younger than 45 years. The primary objective is to assess whether using a protocol inclusive of point-of-care, limited ultrasonography (PLUS), compared to usual care (control), among patients presenting to the em...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,随机对照试验

    doi：10.1016/j.annemergmed.2006.01.008

    authors： Melniker LA,Leibner E,McKenney MG,Lopez P,Briggs WM,Mancuso CA

    更新日期：2006-09-01 00:00:00

  • Preliminary program evaluation of emergency department HIV prevention counseling.

    abstract：OBJECTIVE:Controversy surrounds the linkage of prevention counseling with emergency department (ED)-based HIV testing. Further, the effectiveness and feasibility of prevention counseling in the ED setting is unknown. We investigate these issues by conducting a preliminarily exploration of several related aspects of our...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2011.03.036

    authors： Sitlinger AP,Lindsell CJ,Ruffner AH,Wayne DB,Hart KW,Trott AT,Fichtenbaum CJ,Lyons MS

    更新日期：2011-07-01 00:00:00

  • Emergency department two-dimensional echocardiography in the diagnosis of nontraumatic cardiac rupture.

    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

    authors： Plummer D,Dick C,Ruiz E,Clinton J,Brunette D

    更新日期：1994-06-01 00:00:00

  • EMS agenda for the future: where we are ... where we want to be. EMS Agenda for the Future Steering Committee.

    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：

    authors： Delbridge TR,Bailey B,Chew JL Jr,Conn AK,Krakeel JJ,Manz D,Miller DR,O'Malley PJ,Ryan SD,Spaite DW,Stewart RD,Suter RE,Wilson EM

    更新日期：1998-02-01 00:00:00

  • Observation of head trauma patients at home: a prospective study of compliance in the rural south.

    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

    authors： Cline DM,Whitley TW

    更新日期：1988-02-01 00:00:00

  • Management and Outcomes of Children With Nursemaid's Elbow.

    abstract：STUDY OBJECTIVE:We identify the incidence and predictors of missed fracture and characterize patterns of radiography performance in children with a diagnosis of radial head subluxation in the emergency department (ED) setting. METHODS:We queried the Pediatric Health Information System database for visits by children y...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2020.09.002

    authors： Genadry KC,Monuteaux MC,Neuman MI,Lipsett SC

    更新日期：2021-02-01 00:00:00

  • Emergency medicine in Switzerland.

    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

    authors： Osterwalder JJ

    更新日期：1998-08-01 00:00:00

  • Breath alcohol analyzer mistakes methanol poisoning for alcohol intoxication.

    abstract：:Breath alcohol analyzers are used to detect ethanol in motorists and others suspected of public intoxication. One concern is their ability to detect interfering substances that may falsely increase the ethanol reading. A 47-year-old-man was found in a public park, acting intoxicated. A breath analyzer test (Intoxilyze...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2009.07.021

    authors： Caravati EM,Anderson KT

    更新日期：2010-02-01 00:00:00

  • Diagnostic Accuracy of High-Sensitivity Cardiac Troponin T at Presentation Combined With History and ECG for Ruling Out Major Adverse Cardiac Events.

    abstract：STUDY OBJECTIVE:We evaluate the diagnostic accuracy of a high-sensitivity cardiac troponin T (hs-cTnT) level less than 5 ng/L or less than or equal to 14 ng/L at emergency department (ED) presentation, combined with the emergency physician's assessment of history and ECG, for ruling out major adverse cardiac events wit...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2016.06.008

    authors： Mokhtari A,Lindahl B,Smith JG,Holzmann MJ,Khoshnood A,Ekelund U

    更新日期：2016-12-01 00:00:00

  • Patient perceptions of computed tomographic imaging and their understanding of radiation risk and exposure.

    abstract：STUDY OBJECTIVE:We describe patient perceptions of computed tomography (CT) and their understanding of radiation exposure and risk. METHODS:This was a cross-sectional study of acute abdominal pain patients aged 18 years or older. Confidence in medical evaluations with increasing levels of laboratory testing and imagin...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2010.10.018

    authors： Baumann BM,Chen EH,Mills AM,Glaspey L,Thompson NM,Jones MK,Farner MC

    更新日期：2011-07-01 00:00:00

  • Occult carotid artery injury related to automobile seat belts.

    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

    authors： Ernst A,Robertson HJ,Bercier ML,Kline DG

    更新日期：1988-10-01 00:00:00

  • Jujitsu kick to the abdomen: a case of blunt abdominal trauma resulting in hematochezia and transient ischemic colitis.

    abstract：:Blunt abdominal trauma is a common presentation to the emergency department. Ischemic colitis is a rare complication of this and its possible sequelae are important for an emergency physician to recognize. A 21-year-old man presented to the emergency department with abdominal pain and hourly episodes of bright red blo...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2011.01.014

    authors： Rosenberg H,Beck J

    更新日期：2011-08-01 00:00:00

  • Automated linking of free-text complaints to reason-for-visit categories and International Classification of Diseases diagnoses in emergency department patient record databases.

    abstract：STUDY OBJECTIVE:The use of the International Classification of Diseases system to describe emergency department (ED) case mix has disadvantages. We therefore developed computer algorithms that recognize a combination of words, word fragments, and word patterns to link free-text complaint fields to 20 reason-for-visit c...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(03)00748-0

    authors： Day FC,Schriger DL,La M

    更新日期：2004-03-01 00:00:00

  • The accuracy of an out-of-hospital 12-lead ECG for the detection of ST-elevation myocardial infarction immediately after resuscitation.

    abstract：STUDY OBJECTIVE:Severe myocardial ischemia is the leading cause of arrhythmic sudden cardiac death. It is unclear, however, in which percentage of patients sudden cardiac death is triggered by ST-elevation myocardial infarction (STEMI) and whether the diagnosis of STEMI can be reliably established immediately after res...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2008.06.469

    authors： Müller D,Schnitzer L,Brandt J,Arntz HR

    更新日期：2008-12-01 00:00:00

  • Emergency department and inpatient hospital use by Medicare beneficiaries in patient-centered medical homes.

    abstract：STUDY OBJECTIVE:Patient-centered medical homes are primary care practices that focus on coordinating acute and preventive care. Such practices can obtain patient-centered medical home recognition from the National Committee for Quality Assurance. We compare growth rates for emergency department (ED) use and costs of ED...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2015.01.002

    authors： Pines JM,Keyes V,van Hasselt M,McCall N

    更新日期：2015-06-01 00:00:00

  • What are you waiting for? A study of resident physician-parent communication in a pediatric emergency department.

    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

    authors： Cramm KJ,Dowd MD

    更新日期：2008-04-01 00:00:00

  • Comprehensive strategy for the evaluation and triage of the chest pain patient.

    abstract：STUDY OBJECTIVE:To evaluate the safety and efficacy of a systematic evaluation and triage strategy including immediate resting myocardial perfusion imaging in patients presenting to the emergency department with chest pain of possible ischemic origin. METHODS:We conducted an observational study of 1,187 consecutive pa...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/s0196-0644(97)70317-2

    authors： Tatum JL,Jesse RL,Kontos MC,Nicholson CS,Schmidt KL,Roberts CS,Ornato JP

    更新日期：1997-01-01 00:00:00

  • Limitation on effectiveness of rapid defibrillation by emergency medical technicians in a rural setting.

    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

    authors： Ornato JP,McNeill SE,Craren EJ,Nelson NM

    更新日期：1984-12-01 00:00:00

  • Cardiac arrest witnessed by emergency medical services personnel: descriptive epidemiology, prodromal symptoms, and predictors of survival.

    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

    authors： De Maio VJ,Stiell IG,Wells GA,Spaite DW,OPALS Study Group.

    更新日期：2000-02-01 00:00:00

  • The Efficacy of Antivenin Latrodectus (Black Widow) Equine Immune F(ab')2 Versus Placebo in the Treatment of Latrodectism: A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial.

    abstract：STUDY OBJECTIVE:The antivenom currently available for treatment of systemic black widow envenomation (latrodectism) is composed of equine whole immunoglobin. Although considered effective, it has been associated with anaphylaxis and 2 reported fatalities. We test the efficacy and safety of new equine antivenom composed...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章,多中心研究,随机对照试验

    doi：10.1016/j.annemergmed.2019.02.007

    authors： Dart RC,Bush SP,Heard K,Arnold TC,Sutter M,Campagne D,Holstege CP,Seifert SA,Lo JCY,Quan D,Borron S,Meurer DA,Burnham RI,McNally J,Garcia-Ubbelohde W,Anderson VE

    更新日期：2019-09-01 00:00:00

  • Paliperidone overdose with delayed onset of toxicity.

    abstract：:Paliperidone, or 9-hydroxy risperidone, is the newest atypical antipsychotic agent to be approved for use by the Food and Drug Administration. Despite being the primary active metabolite of risperidone, paliperidone differs in several ways from risperidone. The most notable difference is that paliperidone is formulate...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2010.10.015

    authors： Levine M,Lovecchio F,Tafoya P,Graham R

    更新日期：2011-07-01 00:00:00

  • National survey of emergency department alcohol screening and intervention practices.

    abstract：STUDY OBJECTIVE:We describe current alcohol screening and brief intervention practices in emergency departments (EDs) at Level I and Level II trauma centers and characterize ED directors' attitudes and perceived barriers associated with these practices among injured patients in the ED. METHODS:ED directors at Level I ...

    journal_title：Annals of emergency medicine

    pub_type： 杂志文章

    doi：10.1016/j.annemergmed.2010.03.004

    authors： Cunningham RM,Harrison SR,McKay MP,Mello MJ,Sochor M,Shandro JR,Walton MA,D'Onofrio G

    更新日期：2010-06-01 00:00:00