Abstract:
OBJECTIVE:We determine the feasibility and yield of universal opt-out HIV screening among adolescents and adults in a southeastern emergency department (ED) serving a semiurban-semirural population. METHODS:Individuals aged 13 to 64 years who visited the ED during specified hours received the OraQuick rapid HIV test (administered by trained counselors) if they did not opt out. Western blot was used to confirm reactive results. Patients were excluded if they had a history of HIV, had been tested within the past year, were physically or mentally incapacitated, did not understand their right to opt out, or did not speak English or Spanish. Basic demographic information was analyzed by using standard descriptive statistics. Measures of diagnostic test performance were calculated for all valid tests. RESULTS:From March 2008 through August 2009, 91% (n=8,493) of eligible patients accepted testing, and results were valid. Of 41 reactive results, 35 were confirmed HIV positive, 2 were indeterminate by Western blot, and 4 were false positive. Blacks accounted for the largest percentage (0.65%) of newly detected infections, and the percentage among black men (1%) was more than twice the percentage among black women (0.42%). Rapid-test specificity was estimated at 99.95% (95% confidence interval 99.88% to 99.98%). Nearly 75% of patients confirmed as HIV positive kept their first HIV clinic appointment. CONCLUSION:High rates of acceptance of testing in an ED and linkage to HIV care for adolescents and adults with newly detected infection can be achieved by using opt-out testing and trained HIV counselors.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Sattin RW,Wilde JA,Freeman AE,Miller KM,Dias JKdoi
10.1016/j.annemergmed.2011.03.026subject
Has Abstractpub_date
2011-07-01 00:00:00pages
S60-4issue
1 Suppl 1eissn
0196-0644issn
1097-6760pii
S0196-0644(11)00260-5journal_volume
58pub_type
杂志文章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::Two case reports of patients with anion gap metabolic lactic acidosis and hypoglycemia are presented. Both patients subsequently died of acute liver failure secondary to acetaminophen hepatotoxicity. The development of type B lactic acidosis with hypoglycemia might have been caused by a deficit in gluconeogenesis seco...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80674-5
更新日期:1984-10-01 00:00:00
abstract::The insurance market is evolving, with increased emphasis on plans with high deductibles and a large degree of coinsurance. This article serves as an introduction to the defining characteristics of consumer-driven health care plans and their associated health savings accounts. We discuss the most recent evidence on th...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.05.013
更新日期:2005-12-01 00:00:00
abstract:STUDY OBJECTIVES:To assess the safety and efficacy of transcutaneous cardiac pacing using low-impedance defibrillation-type, self-adhesive polymer electrode pads positioned in the same anatomic sites typical of such pad placement in emergency defibrillation attempts. DESIGN:Prospective, randomized, single-blinded norm...
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)80058-7
更新日期:1992-12-01 00:00:00
abstract:STUDY OBJECTIVE:Traumatic eye injuries are common emergency department presentations worldwide, and diagnosis may be delayed because of concurrent injuries and lack of guidelines in regard to the utility of clinical examination, computed tomography (CT), and point-of-care ultrasonography. In this study, we compare poin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.02.001
更新日期:2019-09-01 00:00:00
abstract::Venomous bites and stings are numerous but severe local tissue damage is uncommon. Venoms may be simple substances or complex mixtures of many poorly characterized components whose interactions are still not fully understood. The best studied example of a dermonecrotic venom is that produced by the brown recluse spide...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(88)80360-3
更新日期:1988-12-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate the importance of hospital bed occupancy for 30-day mortality, inhospital mortality, readmission for inpatient care within 30 days, and revisits to the emergency department (ED) within 7 days among all adult patients visiting the ED. METHODS:This was an observational cohort study including ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.11.009
更新日期:2020-08-01 00:00:00
abstract:STUDY OBJECTIVE:Previous studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2018.02.022
更新日期:2018-07-01 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:STUDY OBJECTIVE:Previous studies have suggested that serum markers of smooth muscle destruction have utility in predicting ectopic pregnancy. Our goal was to determine whether a novel marker of muscle destruction, smooth muscle heavy-chain myosin (SMHC), is elevated in the serum of patients with ectopic pregnancy. MET...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1067/mem.2000.109104
更新日期:2000-08-01 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::Life-threatening hypothermia can be treated by active and passive rewarming techniques, the treatment of choice being partial cardiopulmonary bypass. The use of closed thoracic cavity lavage has been evaluated in animals, but no formal presentations in human beings have been reported. We report two cases in which rapi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81810-4
更新日期:1990-02-01 00:00:00
abstract:STUDY OBJECTIVE:Emergency departments (EDs) frequently refer patients for needed outpatient specialty care, but little is known about the dynamics of these referrals when patients are publicly insured. Hence, we explored factors, including the role of ED referrals, associated with specialists' willingness to accept pat...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2012.10.030
更新日期:2013-04-01 00:00:00
abstract:STUDY OBJECTIVE:Recent data suggest that emergency airway preoxygenation with a bag-valve-mask (BVM) device (held with a tight mask seal but without squeezing the bag) is superior to a nonrebreather (NRB) mask at standard oxygen flow rates. We seek to determine whether preoxygenation with an NRB mask with flush rate ox...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2016.06.018
更新日期:2017-01-01 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::Twenty cases of shaken baby syndrome are reviewed to determine important signs, symptoms, physical findings, laboratory parameters, and prognosis. The signs and symptoms of this form of head trauma are nonspecific. The findings may mimic infection, intoxication, or metabolic abnormalities. Diagnosis depends on a high ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80571-5
更新日期:1984-02-01 00:00:00
abstract::This multiorganizational literature review was undertaken to provide an evidence base for determining whether or not recommendations for out-of-hospital termination of resuscitation could be made for children who are victims of traumatic cardiopulmonary arrest. Although there is increasing acceptance of out-of-hospita...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,实务指引,评审
doi:10.1016/j.annemergmed.2014.01.013
更新日期:2014-04-01 00:00:00
abstract:STUDY OBJECTIVE:We assess the prognostic role of initial glucose levels in patients with a first acute myocardial infarction in the emergency department (ED). METHODS:We conducted a 3-year retrospective cohort study. Patients with a first acute myocardial infarction were recruited from the ED of a tertiary hospital fr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2006.10.023
更新日期:2007-05-01 00:00:00
abstract:STUDY OBJECTIVE:Allergic reactions are common presentations to the emergency department (ED). An unknown proportion of patients will develop biphasic reactions, and patients are often monitored for prolonged periods to manage potential reactions. We seek to determine the incidence of clinically important biphasic react...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2013.10.017
更新日期:2014-06-01 00:00:00
abstract:STUDY OBJECTIVE:It is often taught that acetaminophen-induced liver dysfunction occurs only after a latent period of 24 to 48 hours. This study was designed to evaluate the temporal profile of transaminase levels in patients with acetaminophen-induced hepatotoxicity. DESIGN:Prospective data collection using standard p...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70237-7
更新日期:1995-07-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluated a strategy to increase use of the test (Dix-Hallpike's test [DHT]) and treatment (canalith repositioning maneuver [CRM]) for benign paroxysmal positional vertigo in emergency department (ED) dizziness visits. METHODS:We conducted a stepped-wedge randomized trial in 6 EDs. The population wa...
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.2019.09.017
更新日期:2020-04-01 00:00:00
abstract:STUDY OBJECTIVE:To determine antibody titers to hepatitis B surface antigen (anti-HBsAg) among previously vaccinated emergency physicians and to assess the degree of compliance with Centers for Disease Control and Prevention (CDC) postvaccination guidelines. METHODS:A descriptive analysis was performed of anti-HBsAg t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70388-4
更新日期:1999-02-01 00:00:00
abstract::We have developed a new method of implementing a transcribed emergency record at minimum cost. Dictated emergency records are typed immediately by a transcriber located in the emergency department. This member of the medical record transcriber pool is given other non-urgent medical record material to type when there a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80297-2
更新日期:1983-09-01 00:00:00
abstract::A 27-year-old man was admitted to the emergency department with a fluphenazine decanoate-induced dystonia. He was treated with 125 mg diphenhydramine IV in four doses and 2 mg benztropine IM. A fluctuating response was observed before continued remission of the dystonia. Possible reasons for variable patient responses...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80077-x
更新日期:1987-06-01 00:00:00
abstract:STUDY OBJECTIVE:Antithrombins are among standard treatment agents for patients with non-ST-segment elevation acute coronary syndromes. We aimed to determine the association between time from emergency department (ED) presentation to treatment with an antithrombin and adverse cardiac events. METHODS:The study cohort wa...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2010.06.567
更新日期:2011-03-01 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: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::The American Board of Emergency Medicine gathers extensive background information on emergency medicine residents and the programs in which they train. We present the third annual report on the status of US emergency medicine residency programs. [American Board of Emergency Medicine. Report of the Task Force on Reside...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2000.106388
更新日期:2000-05-01 00:00:00
abstract:STUDY OBJECTIVE:We determine whether children with immediate posttraumatic seizures require hospitalization for observation of possible neurologic complications. METHODS:This was a prospective observational cohort study of children younger than 18 years with blunt head trauma resulting in immediate posttraumatic seizu...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/S0196064403012071
更新日期:2004-06-01 00:00:00
abstract:STUDY OBJECTIVE:The objective was to quantify the analgesic effect of a dose of intravenous morphine, 0.1 mg/kg, to emergency department (ED) patients presenting in acute, severe pain. METHODS:This was a prospective convenience cohort of patients aged 21 to 65 years and presenting to an academic urban ED with acute, s...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.03.010
更新日期:2005-10-01 00:00:00