Abstract：
STUDY OBJECTIVE:The role of emergency department (ED) thoracotomy after blunt trauma is controversial. The objective of this review is to determine whether patients treated with an ED thoracotomy after blunt trauma survive and whether survivors have a good neurologic outcome. METHODS:A structured search was performed with MEDLINE, EMBASE, CINAHL, and PubMed. Inclusion criteria were ED thoracotomy or out-of-hospital thoracotomy, cardiac arrest or periarrest, and blunt trauma. Outcomes assessed were mortality and neurologic result. The articles were appraised with the system designed by the Institute of Health Economics of Canada. A fixed-effects model was used to meta-analyze the data. Heterogeneity was assessed with the I(2) statistic. RESULTS:Twenty-seven articles were included in the review. All were case series. Of 1,369 patients who underwent an ED thoracotomy, 21 (1.5%) survived with a good neurologic outcome. All 21 patients had vital signs present on scene or in the ED and a maximum duration of cardiopulmonary resuscitation of 11 to 15 minutes. Thirteen studies were included in the meta-analysis. If there were either vital signs or signs of life present in the ED, the probability of a poor outcome was 99.2% (95% confidence interval 96.4% to 99.7%). CONCLUSION:There may be a role for ED thoracotomy after blunt trauma, but only in a limited group of patients. Good outcomes have been achieved for patients who had vital signs on admission and for patients who received an ED thoracotomy within 15 minutes of cardiac arrest. The proposed guideline should be used to determine which patients should be considered for an ED thoracotomy, according to level 4 evidence.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Slessor D,Hunter Sdoi
10.1016/j.annemergmed.2014.08.020subject
Has Abstractpub_date
2015-03-01 00:00:00pages
297-307.e16issue
3eissn
0196-0644issn
1097-6760pii
S0196-0644(14)01215-3journal_volume
65pub_type
杂志文章,meta分析,评审abstract：STUDY OBJECTIVE:We evaluate patients with shock and traumatic brain injury who were previously enrolled in an out-of-hospital clinical trial to test the association between out-of-hospital time and outcome. METHODS:This was a secondary analysis of patients with shock and traumatic brain injury who were aged 15 years o...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2014.12.004
更新日期：2015-07-01 00:00:00
abstract：:Colchicine overdose is an uncommon but serious problem that may be missed or ignored unless the physician is aware of the significant potential for, and the various stages of, toxicity. We report two fatal cases in which the potential for lethal complications was not initially realized. Both patients developed multipl...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80239-9
更新日期：1981-07-01 00:00:00
abstract：STUDY OBJECTIVE:To investigate whether the addition of a single aerosolized dose of glycopyrrolate leads to a greater improvement in pulmonary function than treatment with albuterol alone for patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). DESIGN:Prospective, randomized, blinded, cont...
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)70260-1
更新日期：1995-04-01 00:00:00
abstract：:The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in red...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.10.018
更新日期：2012-07-01 00:00:00
abstract：:Acute asthma exacerbations are common complaints in patients who present to the emergency department. A prospective, double-blinded study was designed to evaluate how frequency of dosing of an inhaled beta-agonist, metaproterenol (Alupent inhalation solution) would affect patient response, length of stay in the ED, an...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/s0196-0644(05)82134-1
更新日期：1990-01-01 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：STUDY OBJECTIVE:Scorpion envenomation is a common life-threatening hazard in tropical and subtropical countries. Standard treatment is not clearly defined. Many therapies, such as steroids, are prescribed without experimental justification. We sought to assess the efficacy of systematic administration of intravenous hy...
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(97)70105-7
更新日期：1997-07-01 00:00:00
abstract：:The use of the emergency IV contrast-enhanced abdominal computed tomography (CT) scanning was evaluated in 90 pediatric patients sustaining blunt abdominal trauma. Medical records, CT scans, and operative and postmortem reports, when applicable, were reviewed retrospectively. By identifying the organs of injury, CT sc...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80611-5
更新日期：1988-07-01 00:00:00
abstract：:Numerous interventions have been used to protect organ systems and cellular viability from the lethal injury accompanying hypoperfusion and ischemia. Some measures have been directed toward improving perfusion, while others have attempted to enhance the metabolic processes. Our work has focused for the most part on au...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80946-5
更新日期：1986-12-01 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:To determine the relationship between spinal injuries and helmet use in motorcycle trauma. DESIGN:Retrospective case series. SETTING:Twenty-eight hospitals in four midwestern states--Illinois, Iowa, Nebraska and Wisconsin--representing urban, suburban, and rural settings. PATIENTS AND OTHER PARTICIPA...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/s0196-0644(94)70317-5
更新日期：1994-04-01 00:00:00
abstract：:A 39-year-old woman presented to the emergency department with symptoms of acute knifelike chest pain and was discharged with a diagnosis of musculoskeletal pain syndrome. One day later, she returned with a complaint of persistent chest pain. Physical examination disclosed meningismus, this led to a lumbar puncture an...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80682-6
更新日期：1988-09-01 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 OBJECTIVE:This study investigated the hypothesis that modern computed tomographic (CT) imaging is sufficient to exclude subarachnoid hemorrhage (SAH) in patients with severe headache. METHODS:All 38,730 adult patients who presented to Hermann Hospital in Houston, Texas, during a 16-month period were prospectivel...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：
更新日期：1998-09-01 00:00:00
abstract：STUDY OBJECTIVE:To test the hypothesis that residency-trained emergency physicians who left the practice of emergency medicine do not differ significantly from those who continue to practice. DESIGN:A retrospective cohort study using a mailed questionnaire. TYPE OF PARTICIPANTS:Eight hundred fifty-eight emergency med...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80890-x
更新日期：1992-03-01 00:00:00
abstract：STUDY OBJECTIVE:Training physicians in new skills through classroom-based teaching has inherent cost and time constraints. We seek to evaluate whether Web-based didactics result in similar knowledge improvement and retention of basic ultrasonographic principles and the Extended Focused Assessment with Sonography for Tr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2010.04.019
更新日期：2010-12-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether the use of diclofenac ophthalmic solution is a safe and effective analgesic in the treatment of traumatic corneal abrasions in the emergency department. METHODS:We conducted a prospective, randomized, double-blinded, placebo-controlled clinical trial. Consenting consecutive patient...
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(00)70132-6
更新日期：2000-02-01 00:00:00
abstract：:Test strips recently have become available to measure theophylline levels. One such test strip (AccuLevel) had not been tested in an actual clinical situation with nontechnician personnel. We prospectively evaluated the test strip on consecutive emergency department patients, comparing it with the agglutination inhibi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80440-2
更新日期：1988-10-01 00:00:00
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：:A 43-year-old woman presented to the emergency department with acute agitation, confusion, and tonic seizures. She had a history of drug abuse, most notably beer, which constituted her major dietary intake. The patient's seizures were at first thought to be factitious in association with an acute psychosis; however, h...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80442-5
更新日期：1986-06-01 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：STUDY OBJECTIVE:In recent years, air transport of patients has been associated with disproportionate increases in crashes and deaths. We identify factors related to fatal outcome in air medical helicopter crashes and suggest preventive measures. METHODS:This was a retrospective study using National Transportation Safe...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2005.11.018
更新日期：2006-04-01 00:00:00
abstract：:Early reports of "reperfusion arrhythmia" after experimental temporary coronary occlusion raised concern that these arrhythmias, particularly ventricular fibrillation and ventricular tachycardia, might occur in association with reperfusion of an occluded coronary vessel during thrombolysis. Such an occurrence could in...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80404-4
更新日期：1989-03-01 00:00:00
abstract：:Varicella (Chicken pox) is a contagious disease common in childhood but uncommon in adulthood. Pneumonia, however, is a relatively common complication of the disease in adults. Recognition of the potential for this complication in adult patients with varicella is essential for the emergency physician. Three cases of v...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80679-5
更新日期：1986-08-01 00:00:00
abstract：STUDY OBJECTIVE:Advanced, out-of-hospital procedures such as intravenous access are commonly performed by emergency medical services (EMS) personnel, yet little evidence supports their use among noninjured patients. We evaluate the association between out-of-hospital, intravenous access and mortality among noninjured, ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.07.021
更新日期：2012-04-01 00:00:00
abstract：:Temporary ventricular pacing was successfully employed in two patients suffering refractory bradycardia following traumatic cardiac arrest. The hemodynamic response to pacing was dramatic and both patients eventually recovered fully from an apparent moribund state. Cardiac pacing may be an effective adjuvant in the ea...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80233-2
更新日期：1980-11-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the public health impact of a hurricane on an inland area. DESIGN:Descriptive study. SETTING:Seven hospital emergency departments. PARTICIPANTS:Patients who were treated from September 22 to October 6, 1989, for an injury or illness related to Hurricane Hugo. INTERVENTION:None. MEASUREM...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70307-8
更新日期：1994-04-01 00:00:00
abstract：:Injury severity determination serves multiple purposes in trauma care systems by aiding prehospital triage, assisting clinical management, and facilitating outcome evaluation. Numerous authors have described methods for quantifying injury severity, most of which use physiologic status or anatomic injury. For prehospit...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(86)80936-2
更新日期：1986-12-01 00:00:00
abstract：:We present a case of delay in diagnosis of diaphragmatic rupture and herniation in a pregnant 25-year-old woman. The diaphragmatic rupture was secondary to trauma sustained five months prior to presentation. Subsequent to her accident, she was provided medical care on multiple occasions for symptoms of intractable nau...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80780-7
更新日期：1988-04-01 00:00:00
abstract：:A fatal case of ascending tonic-clonic seizure (ATCS) syndrome resulted from the inadvertent, unrecognized use of a hyperosmolar ionic contrast agent during myelography. The patient presented with lower-extremity myoclonic jerking, agitation, hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation. Em...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70045-9
更新日期：1998-11-01 00:00:00
