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 or older and enrolled in a Resuscitation Outcomes Consortium out-of-hospital clinical trial by 81 emergency medical services agencies transporting to 46 Level I and II trauma centers in 11 sites (May 2006 through May 2009). Inclusion criteria were systolic blood pressure less than or equal to 70 mm Hg or systolic blood pressure 71 to 90 mm Hg with pulse rate greater than or equal to 108 beats/min (shock cohort) and Glasgow Coma Scale score less than or equal to 8 (traumatic brain injury cohort); patients meeting both criteria were placed in the shock cohort. Primary outcomes were 28-day mortality (shock cohort) and 6-month Glasgow Outcome Scale-Extended score less than or equal to 4 (traumatic brain injury cohort). RESULTS:There were 778 patients in the shock cohort (26% 28-day mortality) and 1,239 patients in the traumatic brain injury cohort (53% 6-month Glasgow Outcome Scale-Extended score ≤4). Out-of-hospital time greater than 60 minutes was not associated with worse outcomes after accounting for important confounders in the shock cohort (adjusted odds ratio [aOR] 1.42; 95% confidence interval [CI] 0.77 to 2.62) or traumatic brain injury cohort (aOR 0.77; 95% CI 0.51 to 1.15). However, shock patients requiring early critical hospital resources and arriving after 60 minutes had higher 28-day mortality (aOR 2.37; 95% CI 1.05 to 5.37); this finding was not observed among a similar traumatic brain injury subgroup. CONCLUSION:Among out-of-hospital trauma patients meeting physiologic criteria for shock and traumatic brain injury, there was no association between time and outcome. However, the subgroup of shock patients requiring early critical resources and arriving after 60 minutes had higher mortality.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Newgard CD,Meier EN,Bulger EM,Buick J,Sheehan K,Lin S,Minei JP,Barnes-Mackey RA,Brasel K,ROC Investigators.doi
10.1016/j.annemergmed.2014.12.004subject
Has Abstractpub_date
2015-07-01 00:00:00pages
30-41, 41.e1-3issue
1eissn
0196-0644issn
1097-6760pii
S0196-0644(14)01572-8journal_volume
66pub_type
杂志文章,随机对照试验abstract::Three children who presented with localized vesicular rash in the diaper area were found to have primary varicella-zoster infections. Primary varicella can closely mimic genital herpes simplex virus (HSV 1 or 2), which may be an indicator of sexual abuse. To avoid unfounded investigation for sexual abuse, primary vari...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70365-9
更新日期:1995-01-01 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::Communication at discharge is an important part of high-quality emergency department (ED) care. This review describes the existing literature on patient understanding and implementation of discharge instructions, discusses previous interventions aimed at improving the discharge process, and recommends best practices a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2011.10.023
更新日期:2012-08-01 00:00:00
abstract:STUDY OBJECTIVE:The necessity for rapid administration of intravenous thrombolysis in patients with acute ischemic stroke may lead to treatment of patients with conditions mimicking stroke. We analyze stroke patients treated with intravenous thrombolysis in our center to characterize cases classified as stroke mimics. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.09.011
更新日期:2012-01-01 00:00:00
abstract:STUDY OBJECTIVE:I evaluate the variation in requirements for informed consent in studies evaluating chemical tranquilization of agitated patients. METHODS:A computer-assisted literature search of the National Library of Medicine was performed. Additional use of the references listed in the articles identified with the...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.08.025
更新日期:2006-01-01 00:00:00
abstract:STUDY OBJECTIVE:First-aid guidelines recommend the administration of cool running water in the early management of thermal injury. Our objective is to analyze the associations between first aid and skin-grafting requirements in children with burns. METHODS:This cohort study used a prospectively collected registry of p...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.06.028
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the interrater reliability of previously defined risk criteria for cervical spine injury. METHODS:Two emergency physicians independently evaluated patients with blunt trauma to determine whether they exhibited any of four risk criteria: (1) altered neurologic function; (2) evidence of into...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70306-3
更新日期:1998-02-01 00:00:00
abstract:STUDY OBJECTIVES:To demonstrate the degree to which pulse oximetry overestimates actual oxyhemoglobin (O2Hb) saturation in patients with carbon monoxide (CO) poisoning. This phenomenon has been reported in fewer than 20 humans in the English medical literature. METHODS:A retrospective chart review of 191 patients eval...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70077-5
更新日期:1997-11-01 00:00:00
abstract:STUDY OBJECTIVE:The use of nonprescription cough and cold medicines is widespread, but their use has been sporadically associated with severe toxicity and death. We evaluate the role of these medications in pediatric fatalities and identified factors that contributed to the death. METHODS:Fatalities that involved a ch...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.09.015
更新日期:2009-04-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81853-0
更新日期:1993-04-01 00:00:00
abstract:STUDY OBJECTIVE:This study explored how a variety of demographic and illness-related factors were associated with telephone follow-up among patients visiting the emergency department for acute asthma. METHODS:We performed a prospective cohort study as part of the Multicenter Airway Research Collaboration (MARC). The s...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/S0196-0644(00)70027-8
更新日期:2000-06-01 00:00:00
abstract:STUDY OBJECTIVE:Midazolam is widely used for procedural sedation and analgesia. Etomidate has been studied mostly in adults. Our objective is to compare the efficacy of etomidate and midazolam for achieving procedural sedation and analgesia in children. METHODS:A randomized, double-blind, emergency department and orth...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2006.03.004
更新日期:2006-10-01 00:00:00
abstract::The physician assistant (PA) has become an integral part of urban health care. The roles chosen are diverse and often meet the particular needs of physicians or hospitals. We have developed a unique program in emergency services that allows for training and development of PAs in two distinctly different hospital setti...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80338-6
更新日期:1980-02-01 00:00:00
abstract::Exposure to blood and body fluids that may be contaminated with infectious agents is a common occupational hazard for health care workers. Health care workers in the emergency department or out-of-hospital setting are at especially high risk for exposure to blood or body fluids. Nonemergency health care workers are fr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(00)70104-1
更新日期:2000-01-01 00:00:00
abstract::A team of missionary doctors from Ecuador recently described striking success in the treatment of venomous snakebites with a series of brief, high-voltage, low-current electric shocks applied to the bit site. We designed a randomized, controlled, blinded test of their methods in laboratory rats. Venom of the fer-de-la...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80118-5
更新日期:1988-03-01 00:00:00
abstract::Epiglottitis in adults, while uncommon, is certainly not rare. Despite the increasing reports of the disorder in the literature, it continues to be misdiagnosed in emergency departments. The first step in the diagnosis of acute epiglottitis is for the emergency physician to think of it. The literature concerning the e...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80463-5
更新日期:1981-01-01 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: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: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
更新日期:2012-11-01 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::This article summarizes the current requirements for a waiver of informed consent for emergency research and analyzes ethical issues that are involved. Researchers who intend to apply for a waiver of informed consent for emergency research must understand that they are asking for the major protector of human subjects,...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70398-7
更新日期:1999-02-01 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: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:STUDY OBJECTIVE:We examine racial and ethnic differences in opioid prescribing and dosing for long bone fractures at emergency department (ED) discharge. METHODS:We conducted an electronic health records-based cross-sectional study of adults with long bone fractures who presented to the ED across 22 sites from a healt...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.05.018
更新日期:2019-11-01 00:00:00
abstract::This clinical policy focuses on critical issues concerning the management of patients presenting to the emergency department (ED) with acetaminophen overdose. The subcommittee reviewed the medical literature relevant to the questions posed. The critical questions are: 1. What are the indications for N-acetylcysteine (...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,实务指引
doi:10.1016/j.annemergmed.2007.06.014
更新日期:2007-09-01 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
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更新日期:2000-02-01 00:00:00
abstract::Severe sepsis and septic shock are as common and lethal as other acute life-threatening conditions that emergency physicians routinely confront such as acute myocardial infarction, stroke, and trauma. Recent studies have led to a better understanding of the pathogenic mechanisms and the development of new or newly app...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2006.02.015
更新日期:2006-07-01 00:00:00
abstract::Sodium dichloroacetate (DCA) has been shown to lower elevated serum lactate levels produced by hypoxia, exercise, and phenformin. We conducted a study to investigate the effect of DCA treatment on lactic acidosis following resuscitation from asphyxial cardiac arrest. Conditioned dogs were anesthetized with pentobarbit...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80239-7
更新日期:1988-05-01 00:00:00
abstract::Traumatic dislocation of the hip joint is relatively uncommon in children. The trauma required to produce a dislocation can vary from minimal to severe, high-energy force. We report a case of posterior hip dislocation in a 9-year-old boy who received relatively minor trauma to his leg but who did not seek medical atte...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80298-6
更新日期:1987-01-01 00:00:00
abstract::Clinical presentations and pathogeneses of endocarditis and aspects of its diagnosis and management relevant to emergency department practice are reviewed. Guidelines for admission, laboratory evaluation, and decisions regarding the initiation of therapy in the ED are offered. Also discussed are the role of the emerge...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
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更新日期:1991-04-01 00:00:00