Abstract：
STUDY OBJECTIVES:The syndrome of rhabdomyolysis associated with cocaine use has been recently described, but the incidence, severity, risk factors, and complications are unknown. This study sought to describe the spectrum of the syndrome and identify clinical features of patients at risk. DESIGN:Retrospective case series with analysis of common clinical features. SETTING:Medical emergency department of an urban teaching hospital serving an indigent population. TYPES OF PARTICIPANTS:ED patients with acute cocaine intoxication and a serum creatine kinase (all MM) of more than 500 U/L (8.3 ukat/L) who were admitted for in-hospital management. MEASUREMENTS AND MAIN RESULTS:Twenty-nine patients, representing 5% of cocaine-related patient visits, were identified over 20 months. Patients were divided into three groups: mild, characterized by anxiety, tachycardia, diaphoresis, dyspnea, or chest pain; moderate, characterized by delirium, agitation, fever, leukocytosis, or an elevated serum creatinine; and severe, characterized by seizure, coma, hypotension, arrhythmia, or cardiac arrest. There was a significant association between the rating system for level of intoxication and the severity of rhabdomyolysis and its complications (P less than .01). Patients at highest risk for complications of rhabdomyolysis were those in the moderate or severe groups. CONCLUSION:This classification system may be useful for the management of patients with acute cocaine intoxication, predicting those patients in whom aggressive therapy should be initiated in the ED to minimize the complications of rhabdomyolysis.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Brody SL,Wrenn KD,Wilber MM,Slovis CMdoi
10.1016/s0196-0644(05)81518-5subject
Has Abstractpub_date
1990-10-01 00:00:00pages
1137-43issue
10eissn
0196-0644issn
1097-6760pii
S0196-0644(05)81518-5journal_volume
19pub_type
杂志文章abstract：STUDY OBJECTIVE:We identify factors that define frequent and highly frequent emergency department (ED) users. METHODS:Administrative health care records were used to define less frequent (1 to 6 visits), frequent (7 to 17 visits), and highly frequent (≥18 visits) ED users. Analyses were conducted to determine the most...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.11.036
更新日期：2012-07-01 00:00:00
abstract：:One vital aspect of emergency medicine management is communication after episodes of care to improve future performance through group reflection on the shared experience. This reflective activity in teams is known as debriefing, and despite supportive evidence highlighting its benefits, many practitioners experience b...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2014.10.019
更新日期：2015-06-01 00:00:00
abstract：STUDY OBJECTIVE:We examine the central venous catheter placement rate during the implementation of an ultrasound-guided peripheral intravenous access program. METHODS:We conducted a time-series analysis of the monthly central venous catheter rate among adult emergency department (ED) patients in an academic urban ED b...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2012.09.016
更新日期：2013-02-01 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:To evaluate the cardiovascular effects of carbamazepine in patients presenting to the emergency department. DESIGN:A retrospective case series from February 1, 1985, to July 30, 1993. SETTING:Six urban EDs. PARTICIPANTS:Seventy-two adult and pediatric patients with serum carbamazepine concentrations ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(95)70176-1
更新日期：1995-05-01 00:00:00
abstract：STUDY OBJECTIVE:To compare patient and practitioner assessments of pain associated with commonly performed emergency department procedures and use of anesthetics before these procedures. METHODS:This was a prospective, observational, cross-sectional study conducted at a university-based ED with a convenience sample of...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：
更新日期：1999-06-01 00:00:00
abstract：STUDY OBJECTIVE:Cancer immunotherapy is evolving rapidly and is transforming cancer care. During the last decade, immune checkpoint therapies have been developed to enhance the immune response; however, specific adverse effects related to autoimmunity are increasingly apparent. This study aims to fill the knowledge gap...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2018.04.019
更新日期：2019-01-01 00:00:00
abstract：STUDY OBJECTIVE:To determine if there is a significant prevalence of drug or alcohol use among adolescents evaluated for significant acute trauma. DESIGN:A prospective, age-matched controlled study over a 20-month period. SETTING:Urban pediatric emergency department in a Level I pediatric trauma center. PARTICIPANTS...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81253-3
更新日期：1993-10-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether N-acetylcysteine (NAC reduces methemoglobin. METHODS:We carried out an in vitro laboratory experiment in which five healthy adult volunteers donated blood. Each sample was divided equally among three test tubes. Tube 1 served as a negative control. Sodium nitrite .18 mol/L with dex...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(96)70112-9
更新日期：1996-11-01 00:00:00
abstract：STUDY OBJECTIVE:We compare metoclopramide 20 mg intravenously, combined with diphenhydramine 25 mg intravenously, with ketorolac 30 mg intravenously in adults with tension-type headache and all nonmigraine, noncluster recurrent headaches. METHODS:In this emergency department (ED)-based randomized, double-blind study, ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2013.03.017
更新日期：2013-10-01 00:00:00
abstract：STUDY OBJECTIVE:We compare the performance of a wrist blood pressure oscillometer with the mercury standard in the triage process of an emergency department (ED) and evaluate the impact of wrist blood pressure measurement on triage decision. METHODS:Blood pressure was successively measured with the standard mercury sp...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/j.annemergmed.2004.12.007
更新日期：2005-08-01 00:00:00
abstract：STUDY OBJECTIVES:This study measures the effect of meeting emergency department (ED) patients' expectations for diagnostic and therapeutic interventions on patient satisfaction. METHODS:This was a cross-sectional study of consecutive patients during block enrollment periods surveyed at the beginning and end of their E...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2009.01.024
更新日期：2009-09-01 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 prospective, randomized, blinded study was conducted to evaluate the efficacy of standard compared with high-dose epinephrine in cardiac arrest in dogs. Twenty-five mongrel dogs were anesthetized and monitored by central venous catheter, intra-arterial catheter, and ECG. A left lateral thoracotomy was performed, and...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82130-4
更新日期：1990-01-01 00:00:00
abstract：:Although ingestions of button batteries can have serious complications, the majority of these ingestions will be benign. Button batteries that lodge in the esophagus should be removed immediately by endoscopy. Other ingestions can be managed with observation at home unless symptoms develop. Weekly radiographic examina...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(89)80417-2
更新日期：1989-03-01 00:00:00
abstract：STUDY OBJECTIVE:Emergency department records are an important source of injury surveillance data. However, documentation regarding intentional assault has not been studied and may be suboptimal. The purpose of this study was to analyze physician documentation of assailant, site, and object used in intentional assault. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(99)70096-x
更新日期：1999-12-01 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：:Cardiac ultrasound quickly provides both anatomic and physiologic assessment of the heart at the bedside, permitting rapid diagnosis and triage of patients presenting to the emergency department with chest pain, hypotension, or dyspnea. The identification and quantification of left ventricular dysfunction by ultrasoun...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80264-1
更新日期：1989-12-01 00:00:00
abstract：:Mechanical interventions in acute ischemic stroke promise to provide emergency physicians with tools to treat patients in whom conventional thrombolysis might be ineffective or contraindicated, including most patients with stroke who arrive at the emergency department beyond the 3-hour time window for intravenous tiss...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1067/mem.2003.194
更新日期：2003-06-01 00:00:00
abstract：STUDY OBJECTIVE:Methanol poisoning outbreaks are a global public health issue, with delayed treatment causing poor outcomes. Out-of-hospital ethanol administration may improve outcome, but the difficulty of conducting research in outbreaks has meant that its effects have never been assessed. We study the effect of out-...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.01.010
更新日期：2016-07-01 00:00:00
abstract：STUDY OBJECTIVE:The emergency department is a problem-focused environment in which routine screening for intimate partner violence (IPV) is difficult. We hypothesized that screening for IPV during computer-based health-risk assessment would be acceptable to patients and improve detection. METHODS:We performed a descri...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.127181
更新日期：2002-11-01 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：:A patient with a 70% hydrofluoric acid burn developed systemic dissemination of fluoride ion from a 9% to 10% body surface area exposure on the lower extremities. Severe hypocalcemia and intractable ventricular arrhythmias resulted. This case is the second documented occurrence of hypocalcemia from hydrofluoric acid b...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)81078-7
更新日期：1985-02-01 00:00:00
abstract：STUDY OBJECTIVES:To determine the height of back elevation required to place the cervical spine of children less than 8 years old in neutral position and whether agreement on the height required for neutral position could be reached by two independent observers. STUDY DESIGN:Prospective. SETTING:Pediatric emergency d...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70032-x
更新日期：1994-02-01 00:00:00
abstract：STUDY OBJECTIVE:To test the hypothesis that intersystem variation in initial rhythm among EMS-witnessed arrests is of sufficient magnitude to warrant standardization of survival by creation of an Utstein-style denominator of EMS-witnessed ventricular fibrillation (VF). METHODS:We conducted a planned subset analysis of...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70115-x
更新日期：1997-07-01 00:00:00
abstract：:The case of a 28-year-old multiparous woman with an incarcerated gravid uterus is presented. This largely unknown entity invariably results in spontaneous abortion if untreated. Patients present with a characteristic and readily recognizable sign and symptom complex and ultrasonographic findings. Early diagnosis is em...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80534-6
更新日期：1987-08-01 00:00:00
abstract：:A research project was developed to study the process of professional socialization in graduate medical education by describing and analyzing the development of emergency medicine residencies in comparison to those of surgery and internal medicine. Based on the assumption that residency programs have a profound impact...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80332-5
更新日期：1980-02-01 00:00:00
abstract：:In rescue medicine, a suction apparatus must function in a variety of environmental conditions. To find an appropriate device for the Swedish Air Force air rescue service the Laerdal suction device 790,000 was selected for further testing according to international standards for aviation safety. Tests showed that vibr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80419-5
更新日期：1987-12-01 00:00:00
abstract：:We present a framework for understanding calculations of continuous infusions of vasoactive substances. Several simplified methods for establishing initial concentrations and infusion rates of drug are derived, their applicability is discussed, and examples are given. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80418-1
更新日期：1983-11-01 00:00:00
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
更新日期：2011-08-01 00:00:00
