Abstract：
STUDY OBJECTIVE:Epinephrine autoinjector use for anaphylaxis is increasing. There are reports of digit injections because of incorrect autoinjector use, but no previous reports of lacerations, to our knowledge. We report complications of epinephrine autoinjector use in children and discuss features of these devices, and their instructions for use, and how these may contribute to injuries. METHODS:We queried emergency medicine e-mail discussion lists and social media allergy groups to identify epinephrine autoinjector injuries involving children. RESULTS:Twenty-two cases of epinephrine autoinjector-related injuries are described. Twenty-one occurred during intentional use for the child's allergic reaction. Seventeen children experienced lacerations. In 4 cases, the needle stuck in the child's limb. In 1 case, the device lacerated a nurse's finger. The device associated with the injury was operated by health care providers (6 cases), the patient's parent (12 cases, including 2 nurses), educators (3 cases), and the patient (1 case). Of the 3 epinephrine autoinjectors currently available in North America, none include instructions to immobilize the child's leg. Only 1 has a needle that self-retracts; the others have needles that remain in the thigh during the 10 seconds that the user is instructed to hold the device against the leg. Instructions do not caution against reinjection if the needle is dislodged during these 10 seconds. CONCLUSION:Epinephrine autoinjectors are lifesaving devices in the management of anaphylaxis. However, some have caused lacerations and other injuries in children. Minimizing needle injection time, improving device design, and providing instructions to immobilize the leg before use may decrease the risk of these injuries.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Brown JC,Tuuri RE,Akhter S,Guerra LD,Goodman IS,Myers SR,Nozicka C,Manzi S,Long K,Turner T,Conners GP,Thompson RW,Park Edoi
10.1016/j.annemergmed.2015.07.011subject
Has Abstractpub_date
2016-03-01 00:00:00pages
307-315.e8issue
3eissn
0196-0644issn
1097-6760pii
S0196-0644(15)00588-0journal_volume
67pub_type
杂志文章abstract：:A 19-year-old pedestrian who was the victim of a motor vehicle accident had a left pneumothorax with a large air leak. Despite a well-placed chest tube, a chest radiograph showed that the left lung had fallen down and away from the mediastinum and that no hilar structures were visible. This "fallen lung with an absent...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：
更新日期：1991-03-01 00:00:00
abstract：STUDY OBJECTIVE:The effect of urgent cares on local emergency department (ED) patient volumes is presently unknown. In this paper, we aimed to assess the change in low-acuity ED utilization at 2 academic medical centers in relation to patient proximity to an affiliated urgent care. METHODS:We created a geospatial data...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2019.06.024
更新日期：2020-03-01 00:00:00
abstract：STUDY OBJECTIVE:Inflammation plays an important role in acute coronary syndromes, and some evidence indicates that patients with a more pronounced vascular inflammatory response have a poorer outcome. Soluble intercellular adhesion molecule-1 (sICAM-1) is a specific marker for vascular endothelial cell activation. The ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.117199
更新日期：2001-09-01 00:00:00
abstract：:We report a case of traumatic arterial hemorrhage from the posterior urethral artery, refractory to traditional hemostatic technique, and successfully managed with intraurethral thrombin hemostatic matrix (FloSeal [Baxter Healthcare Corporation, Deerfield, Illinois, US]). We believe that this demonstrates a safe, effe...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.07.012
更新日期：2016-12-01 00:00:00
abstract：:To evaluate the effects of acute alcohol intoxication on serum amylase and isoamylase levels, 58 clinically intoxicated patients with blood alcohol levels greater than 100 mg/dL were studied. Comparisons were made to normal control and a sober chronic alcoholic group. Admitting serum isoamylase levels were determined ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80511-3
更新日期：1983-05-01 00:00:00
abstract：:Despite 3 decades of scientific progress, rates of survival from out-of-hospital cardiac arrest remain low. The Cardiac Arrest Registry to Enhance Survival (CARES) was created to provide communities with a means to identify cases of out-of-hospital cardiac arrest, measure how well emergency medical services (EMS) perf...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2009.03.018
更新日期：2009-11-01 00:00:00
abstract：:Hemodynamically unstable patients will benefit from therapy to control their blood pressure only if this pressure can be determined with accuracy. We compared the accuracy of arterial blood pressure measurements taken aboard helicopters by palpation with a Doppler device and with an oscillometric device. Twenty critic...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80401-3
更新日期：1988-06-01 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：: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：STUDY OBJECTIVES:The health care needs of the elderly population are significantly different from those of younger patients and require special knowledge and skills on the part of emergency physicians. The purpose of this study was to identify the nature and extent of geriatric training currently provided to emergency ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81029-7
更新日期：1992-07-01 00:00:00
abstract：:To evaluate the hypothesis that all victims of severe blunt trauma require a pelvic radiograph, we prospectively studied all such patients admitted to the Southern New Jersey Regional Trauma Center during a seven-month period. All patients were classified as unconscious; impaired; awake, alert, and symptomatic; or ale...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80244-0
更新日期：1988-05-01 00:00:00
abstract：STUDY OBJECTIVE:The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. METHODS:We used Ohio's prescription drug monitoring pr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2017.03.057
更新日期：2017-12-01 00:00:00
abstract：:Since September 11, 2001, concern about potential terrorist attacks has increased in the United States. To reduce morbidity and mortality from outbreaks of illness from the intentional release of chemical agents, we examine data from the Toxic Exposure Surveillance System (TESS). TESS, a national system for timely col...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2005.09.016
更新日期：2006-02-01 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
doi：10.1016/s0196-0644(05)81663-4
更新日期：1991-04-01 00:00:00
abstract：:We conducted a study to determine the number of items and successful response rate to questions specific to emergency medicine on the National Board of Medical Examiners Test, Part II (NBME-II). The 1979 and 1983 NBME-II examinations were reviewed by a subcommittee of the Society of Teachers of Emergency Medicine. Ite...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80479-6
更新日期：1986-01-01 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：:A treatment protocol for patients with acute bronchospasm was introduced to an adult emergency department in an attempt to decrease treatment time and potentially decrease need for admission. The charts of all patients seen in a control year (before any protocol was in place) and the first three years of the protocol ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80429-2
更新日期：1986-06-01 00:00:00
abstract：STUDY OBJECTIVE:We evaluate the effectiveness and safety of an outpatient clinical care pathway for the initial treatment of acute proximal lower-extremity deep venous thrombosis (DVT) with low molecular weight heparin (LMWH) managed by the emergency department of 2 affiliated community hospitals. METHODS:This observa...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1067/mem.2001.113703
更新日期：2001-03-01 00:00:00
abstract：:We investigated the compliance of emergency department health care workers with barrier precaution policies adapted from the Centers for Disease Control's "Recommendations for Prevention of HIV Transmission in Health-Care Settings." One hundred sixty-nine health care worker encounters with 97 patients were observed. O...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80522-0
更新日期：1989-06-01 00:00:00
abstract：STUDY OBJECTIVE:We describe the characteristics and outcomes of enrollee-health plan disputes over insurance coverage for emergency department (ED) services at 2 large health maintenance organizations (HMOs) that apply the prudent layperson standard. METHODS:We abstracted information from a stratified random sample of...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(03)00637-1
更新日期：2004-02-01 00:00:00
abstract：:A case is presented of a vaginal foreign body. A drinking glass was inserted in the vagina of an intoxicated patient by her irate lover. Infection followed. The emergency care is described, including the method of extraction of the object, along with discussion of the principles involved and associated complications. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80287-9
更新日期：1981-09-01 00:00:00
abstract：:Abruptio placentae is a complication of pregnancy associated with significant morbidity and mortality for both fetus and mother. The presence of uterine pain and tenderness traditionally has been considered a useful criterion for distinguishing abruptio placentae from other causes of bleeding in pregnancy. We report t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81040-6
更新日期：1992-07-01 00:00:00
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
更新日期：1982-11-01 00:00:00
abstract：STUDY OBJECTIVE:We evaluate associations between pairs of discordant cardiac biomarkers (positive MB band of creatine kinase [CKMB] with negative creatine kinase, positive CKMB with negative cardiac troponin, and positive troponin with negative CKMB) and the presence of acute coronary syndromes in emergency department ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2006.05.016
更新日期：2006-12-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the efficacy of IM ketorolac versus that of oral ibuprofen in acute musculoskeletal pain. DESIGN:Randomized, prospective, double-blind clinical trial. SETTING:Urban teaching emergency department with an annual census of 43,000. PARTICIPANTS:Convenience sample of 82 patients aged 18 to 70 ...
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)70138-9
更新日期：1995-08-01 00:00:00
abstract：STUDY PURPOSE:To determine the ability of clinicians to predict the results of emergency head computed tomography (CT) scans. METHODS:Clinicians requesting cranial CT scans from the emergency department prospectively filled out a form detailing their patients' complaints, possible diagnoses, and the likelihood of find...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70351-5
更新日期：1994-06-01 00:00:00
abstract：STUDY OBJECTIVES:To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN:A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70238-1
更新日期：1994-12-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the safety and efficacy of a systematic evaluation and triage strategy including immediate resting myocardial perfusion imaging in patients presenting to the emergency department with chest pain of possible ischemic origin. METHODS:We conducted an observational study of 1,187 consecutive pa...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70317-2
更新日期：1997-01-01 00:00:00
abstract：STUDY OBJECTIVES:To survey faculty attrition in emergency medicine and compare it with faculty attrition in the specialties of orthopedic surgery and cardiology. DESIGN:Chairmen of the three departments were surveyed regarding faculty attrition, work hours, and motivation for leaving. Those emergency physicians having...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81110-2
更新日期：1991-01-01 00:00:00
abstract：:A 45-year-old man ate the liver of the toxic pufferfish (Diodron hystrix) and developed mild tetrodotoxication consisting of hyperemesis, bradycardia, hypotension, generalized numbness, and a generalized paresis. He was treated with atropine, normal saline IV infusions, nasogastric suction, and oxygen, and he recovere...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80135-4
更新日期：1986-09-01 00:00:00
