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 department with abdominal CT using intravenous contrast were eligible. Oral contrast use was based on the participating centers' guidelines and discretions. Clinical courses were followed to identify patients with intra-abdominal injuries. Abdominal CTs were considered positive for intra-abdominal injury if a specific intra-abdominal injury was identified and considered abnormal if any findings suggestive of intra-abdominal injury were identified on the CT. RESULTS:A total of 12,044 patients were enrolled, with 5,276 undergoing abdominal CT with intravenous contrast. Of the 4,987 CTs (95%) with documented use or nonuse of oral contrast, 1,010 (20%) were with and 3,977 (80%) were without oral contrast; 686 patients (14%) had intra-abdominal injuries, including 127 CTs (19%) with and 559 (81%) without oral contrast. The sensitivity in the detection of any intra-abdominal injury in the oral contrast versus no oral contrast groups was sensitivitycontrast 99.2% (95% confidence interval [CI] 95.7% to 100.0%) versus sensitivityno contrast 97.7% (95% CI 96.1% to 98.8%), difference 1.5% (95% CI -0.4% to 3.5%). The specificity of the oral contrast versus no oral contrast groups was specificitycontrast 84.7% (95% CI 82.2% to 87.0%) versus specificityno contrast 80.8% (95% CI 79.4% to 82.1%), difference 4.0% (95% CI 1.3% to 6.7%). CONCLUSION:Oral contrast is still used in a substantial portion of children undergoing abdominal CT after blunt torso trauma. With the exception of a slightly better specificity, test characteristics for detecting intra-abdominal injury were similar between CT with and without oral contrast.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Ellison AM,Quayle KS,Bonsu B,Garcia M,Blumberg S,Rogers A,Wootton-Gorges SL,Kerrey BT,Cook LJ,Cooper A,Kuppermann N,Holmes JF,Pediatric Emergency Care Applied Research Network (PECARN).,Pediatric Emergency Care Applied Researchdoi
10.1016/j.annemergmed.2015.01.014subject
Has Abstractpub_date
2015-08-01 00:00:00pages
107-114.e4issue
2eissn
0196-0644issn
1097-6760pii
S0196-0644(15)00031-1journal_volume
66pub_type
杂志文章,多中心研究abstract:STUDY OBJECTIVE:We perform a videographic analysis of external laryngeal manipulation (ELM) by novice intubators using a direct laryngoscopic imaging system and a validated means of assessing laryngeal view (percentage of glottic opening [POGO] score). METHODS:Nine first-year emergency medicine residents performed a t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.125716
更新日期:2002-07-01 00:00:00
abstract::Descriptive statistics include measures of central tendency and variability. Measures of central tendency include mean, median, and mode. The mean is the arithmetic average of data from interval or ratio scales. The median reflects the 50th percentile score. The mode is the most frequently occurring value of a data di...
journal_title:Annals of emergency medicine
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doi:10.1016/s0196-0644(05)82052-9
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abstract::Inconsistency in contacting the families of acutely ill patients can negatively affect relatives and induce stress in emergency department staff. Role clarification and performance guidelines are discussed in the context of a telephone notification of relatives checklist, with staff advised in six specific interventio...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80204-7
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abstract:STUDY OBJECTIVE:To evaluate the effect of different doses of the vasopressor angiotensin II on aortic diastolic and coronary perfusion pressures in a swine model of cardiac arrest. DESIGN:Immature swine were anesthetized and hemodynamically monitored. Ventricular fibrillation was induced; CPR was begun after ten minut...
journal_title:Annals of emergency medicine
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abstract:STUDY OBJECTIVE:To determine the effects of early fluid resuscitation on the rate, volume, and duration of hemorrhage using a sheep model of uncontrolled pulmonary vascular hemorrhage. METHODS:Sixteen adult sheep were anesthetized and fitted with catheters to measure systemic and pulmonary artery pressures. A branch o...
journal_title:Annals of emergency medicine
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abstract::We examined the performance of a hospital-based mobile coronary care unit staffed by emergency physicians, coronary care nurses, and ambulance personnel in a metropolitan setting (Brisbane, Australia). Our unit attended 2,260 calls during 18 months of operation. Standard dispatched ambulances arrived first to 78% of t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80462-7
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abstract::We examined the hemodynamic effects of congesting cuffs (rotating tourniquets) in 12 patients with first acute myocardial infarction and new onset of congestive heart failure 24 to 48 hours after admission. Congesting cuffs were applied for two periods of 15 minutes each, 15 minutes apart, and inflated to 30 mm Hg and...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
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更新日期:1987-07-01 00:00:00
abstract::Blacks, Hispanics/Latinos, American Indians, Pacific Islanders, Alaska Natives, and Native Hawaiians make up 33% of the US population. These same groups are underrepresented in medicine. In 2013, the physician workforce was 4.1% black, 4.4% Hispanic/Latino, 0.4% American Indian or Alaska Native, 11.7% Asian, and 48.9%...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
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abstract:STUDY OBJECTIVE:To develop management guidelines for the treatment of anaphylactoid reactions to intravenous N-acetylcysteine (NAC) and to assess the safety of restarting the infusion after a reaction. METHODS:In phased 1, we used a 6-year retrospective case series of hospitalized patients and a review of the literatu...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
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更新日期:1998-06-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.annemergmed.2014.08.020
更新日期:2015-03-01 00:00:00
abstract::This clinical policy focuses on critical issues in the evaluation and management of adult patients with seizures. The medical literature was reviewed for articles that pertained to the critical questions posed. Subcommittee members and expert peer reviewers also supplied articles with direct bearing on this policy. Th...
journal_title:Annals of emergency medicine
pub_type: 指南,杂志文章,实务指引
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更新日期:2004-05-01 00:00:00
abstract:STUDY OBJECTIVE:The prevalence of agitation among emergency department (ED) patients is increasing. Physical restraints are routinely used to prevent self-harm and to protect staff, but are associated with serious safety risks. To date, characterization of physical restraint use in the emergency setting has been limite...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2018.06.020
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abstract::In 1976 an independent department was established for the emergency treatment of patients in the county hospital in Szolnok, Hungary. The new system changed the traditional structure of patient flow and the work plan of other departments, and it influenced the curing and nursing activities of the departments. The reor...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80113-2
更新日期:1980-07-01 00:00:00
abstract:STUDY OBJECTIVE:Medication history is an essential part of patient assessment in emergency care. Patient-reported medication history can be incomplete. We study whether an electronic pharmacy-sourced prescription record can supplement the patient-reported history. METHODS:In a community hospital, we compared the patie...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2013.04.014
更新日期:2013-09-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80478-4
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journal_title:Annals of emergency medicine
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更新日期:2020-06-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
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journal_title:Annals of emergency medicine
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doi:10.1016/j.annemergmed.2010.07.001
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journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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pub_type: 杂志文章
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journal_title:Annals of emergency medicine
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abstract::A technique of direct mechanical ventricular assistance (DMVA) has been available since 1966. Ventricular assistance is provided by a glass cup lined with a Silastic diaphragm. It is held on the cardiac ventricles by suction. Alternating positive and negative pressure in the space between the cup and the diaphragm pro...
journal_title:Annals of emergency medicine
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abstract::Ultrasonography in the emergency department is being used for many purposes, including the evaluation of patients with cardiac arrest. Ultrasound testing has been shown to be useful in such patients in determining the presence of true electromechanical dissociation and pericardial effusions. We report a case of ventri...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
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journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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