Acoustic otoscopy in the diagnosis of otitis media.

Abstract:

:Acoustic otoscopy detects middle ear pathology by measuring the ability of the tympanic membrane to reflect sound. Fluid or thickening of the tympanic membrane increases sound reflection. We conducted a study to compare acoustic otoscopy with pneumatic otoscopy in identifying middle ear pathology in 80 children (160 ears) presenting to the emergency department with ear or upper respiratory complaints. We then evaluated the use of acoustic otoscopy in 34 adults (68 ears) with and without ear complaints. Using a reflectivity of 5 or more units to signify acute pathology in children, the sensitivity was 82%, and the specificity was 100%. Using a reflectivity of 6 or more units to indicate acute suppurative pathology in adults, the sensitivity was 83%, and the specificity was 95%. We found acoustic otoscopy to be objective, practical, and reproducible. We conclude that acoustic otoscopy is a valuable adjunct in the diagnosis of otitis media in children and adults.

journal_name

Ann Emerg Med

authors

Jehle D,Cottington E

doi

10.1016/s0196-0644(89)80578-5

subject

Has Abstract

pub_date

1989-04-01 00:00:00

pages

396-400

issue

4

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(89)80578-5

journal_volume

18

pub_type

临床试验,杂志文章
  • Alveolar-arterial oxygen gradients in elderly patients with suspected pulmonary embolism.

    abstract:STUDY OBJECTIVE:To determine the usefulness of the alveolar-arterial oxygen gradient for detecting pulmonary embolism in elderly patients presenting to the emergency department. DESIGN:Retrospective cohort analysis. SETTING:Two university-affiliated community hospitals. TYPE OF PARTICIPANTS:Consecutive patients more...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)80985-0

    authors: Jones JS,VanDeelen N,White L,Dougherty J

    更新日期:1993-07-01 00:00:00

  • Identifying children at very low risk of clinically important blunt abdominal injuries.

    abstract:STUDY OBJECTIVE:We derive a prediction rule to identify children at very low risk for intra-abdominal injuries undergoing acute intervention and for whom computed tomography (CT) could be obviated. METHODS:We prospectively enrolled children with blunt torso trauma in 20 emergency departments. We used binary recursive ...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,评论,杂志文章,多中心研究

    doi:10.1016/j.annemergmed.2012.11.009

    authors: Holmes JF,Lillis K,Monroe D,Borgialli D,Kerrey BT,Mahajan P,Adelgais K,Ellison AM,Yen K,Atabaki S,Menaker J,Bonsu B,Quayle KS,Garcia M,Rogers A,Blumberg S,Lee L,Tunik M,Kooistra J,Kwok M,Cook LJ,Dean JM,Sokolo

    更新日期:2013-08-01 00:00:00

  • Intravenous access during out-of-hospital emergency care of noninjured patients: a population-based outcome study.

    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

    authors: Seymour CW,Cooke CR,Hebert PL,Rea TD

    更新日期:2012-04-01 00:00:00

  • "Between me and the computer": increased detection of intimate partner violence using a computer questionnaire.

    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

    authors: Rhodes KV,Lauderdale DS,He T,Howes DS,Levinson W

    更新日期:2002-11-01 00:00:00

  • Autonomous departments of emergency medicine in contemporary academic medical centers.

    abstract::There are currently 20 autonomous departments of emergency medicine in United States medical schools. EDs seeking autonomous status should institute a faculty development program to channel faculty energy into worthwhile research projects; establish protected time for clinical faculty to increase research productivity...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)82395-9

    authors: Rusnak RA,Hamilton GC,Allison EJ Jr

    更新日期:1991-06-01 00:00:00

  • Sucrose as an aid to manual reduction of incarcerated rectal prolapse.

    abstract::Incarcerated rectal prolapse is a potential surgical emergency. We report a case in which a simple but effective technique involving the desiccating effect of granulated sugar (sucrose) was used to aid the manual reduction of prolapsed but viable rectal tissue. ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(97)70174-4

    authors: Coburn WM 3rd,Russell MA,Hofstetter WL

    更新日期:1997-09-01 00:00:00

  • Clinical prediction of emergency cranial computed tomography results.

    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

    authors: Reinus WR,Zwemer FL Jr

    更新日期:1994-06-01 00:00:00

  • The Importance of Urine Concentration on the Diagnostic Performance of the Urinalysis for Pediatric Urinary Tract Infection.

    abstract:STUDY OBJECTIVE:The presence of leukocyte esterase by urine dipstick and microscopic pyuria are both indicators of possible urinary tract infection. The effect of urine concentration on the diagnostic performance of the urinalysis for pediatric urinary tract infection has not been studied. Our objective is to determine...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2016.11.042

    authors: Chaudhari PP,Monuteaux MC,Shah P,Bachur RG

    更新日期:2017-07-01 00:00:00

  • Glyburide-ciprofloxacin interaction with resistant hypoglycemia.

    abstract::Glyburide, a second-generation sulfonylurea hypoglycemic agent, is metabolized by the P-450 hepatic enzyme system. Ciprofloxacin, a widely used quinolone antibiotic, is a recognized P-450 enzyme inhibitor. Conflicting data exist in the medical literature on the ability of quinolone antibiotics to inhibit glyburide hep...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2000.108617

    authors: Roberge RJ,Kaplan R,Frank R,Fore C

    更新日期:2000-08-01 00:00:00

  • Use of pulsed-field gel electrophoresis for investigation of a cluster of invasive group a streptococcal illness-Spokane, Washington, 1999.

    abstract::[Centers for Disease Control and Prevention. Use of pulsed-field gel electrophoresis for investigation of a cluster of invasive group A streptococcal illness-Spokane, Washington, 1999. MMWR Morb Mortal Wkly Rep. 1999;48:681-683.]. ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/S0196-0644(00)70088-6

    authors:

    更新日期:2000-03-01 00:00:00

  • Should payment policy be changed to allow a wider range of EMS transport options?

    abstract::The Institute of Medicine and other national organizations have asserted that current payment policies strongly discourage emergency medical services (EMS) providers from transporting selected patients who call 911 to non-ED settings (eg, primary care clinics, mental health centers, dialysis centers) or from treating ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2013.09.025

    authors: Morganti KG,Alpert A,Margolis G,Wasserman J,Kellermann AL

    更新日期:2014-05-01 00:00:00

  • Rapid HIV testing in a southeastern emergency department serving a semiurban-semirural adolescent and adult population.

    abstract:OBJECTIVE:We determine the feasibility and yield of universal opt-out HIV screening among adolescents and adults in a southeastern emergency department (ED) serving a semiurban-semirural population. METHODS:Individuals aged 13 to 64 years who visited the ED during specified hours received the OraQuick rapid HIV test (...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2011.03.026

    authors: Sattin RW,Wilde JA,Freeman AE,Miller KM,Dias JK

    更新日期:2011-07-01 00:00:00

  • Clinical safety of lidocaine in patients with cocaine-associated myocardial infarction.

    abstract:STUDY OBJECTIVE:To evaluate the safety of lidocaine in the setting of cocaine-induced myocardial infarction (MI). DESIGN:A retrospective, multicenter study. SETTING:Twenty-nine university, university-affiliated, or community hospitals during a 6-year period (total of 117 cumulative hospital-years). PARTICIPANTS:Pati...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/s0196-0644(95)70041-2

    authors: Shih RD,Hollander JE,Burstein JL,Nelson LS,Hoffman RS,Quick AM

    更新日期:1995-12-01 00:00:00

  • Emergency thrombolysis in acute myocardial infarction.

    abstract::The goal of thrombolytic treatment in acute myocardial infarction is to reestablish permanent blood flow, salvage ischemic myocardium, and reduce mortality. If patency is achieved sufficiently early and is maintained, left ventricular function is preserved and mortality decreases. The recent experience with tissue pla...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(88)80063-5

    authors: Heras M,Chesebro JH,Gersh BG,Holmes DR,Mock MB,Fuster V

    更新日期:1988-11-01 00:00:00

  • Alternating day emergency medicine and anesthesia resident responsibility for management of the trauma airway: a study of laryngoscopy performance and intubation success.

    abstract:STUDY OBJECTIVE:We compare laryngoscopy performance and overall intubation success in trauma airways when primary airway management alternated between emergency medicine and anesthesia residents on an every-other-day basis. METHODS:Data on all trauma intubations during approximately 3 years were prospectively collecte...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(03)00638-3

    authors: Levitan RM,Rosenblatt B,Meiner EM,Reilly PM,Hollander JE

    更新日期:2004-01-01 00:00:00

  • Cardiovascular effects of carbamazepine toxicity.

    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

    authors: Apfelbaum JD,Caravati EM,Kerns WP 2nd,Bossart PJ,Larsen G

    更新日期:1995-05-01 00:00:00

  • Variation in communication loads on clinical staff in the emergency department.

    abstract:STUDY OBJECTIVE:We determine whether there are differences in role-related communication patterns in the emergency department (ED). METHODS:This was an observational study of a metropolitan ED. Four medical officers and 4 nurses were observed for 19 hours and 52 minutes. Communication load was measured by proportion o...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2004.04.006

    authors: Spencer R,Coiera E,Logan P

    更新日期:2004-09-01 00:00:00

  • Probabilistic linkage of computerized ambulance and inpatient hospital discharge records: a potential tool for evaluation of emergency medical services.

    abstract:STUDY OBJECTIVES:Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database f...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2001.115214

    authors: Dean JM,Vernon DD,Cook L,Nechodom P,Reading J,Suruda A

    更新日期:2001-06-01 00:00:00

  • Diagnosis of Traumatic Eye Injuries With Point-of-Care Ocular Ultrasonography in the Emergency Department.

    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

    authors: Ojaghihaghighi S,Lombardi KM,Davis S,Vahdati SS,Sorkhabi R,Pourmand A

    更新日期:2019-09-01 00:00:00

  • Are rotating tourniquets useful for left ventricular preload reduction in patients with acute myocardial infarction and heart failure?

    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

    doi:10.1016/s0196-0644(87)80570-x

    authors: Roth A,Hochenberg M,Keren G,Terdiman R,Laniado S

    更新日期:1987-07-01 00:00:00

  • Reperfusion arrhythmia: myth or reality?

    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

    authors: Burney RE,Walsh D,Kaplan LR,Fraser S,Tung B,Overmyer J

    更新日期:1989-03-01 00:00:00

  • How do physicians adopt and apply opioid prescription guidelines in the emergency department? A qualitative study.

    abstract:STUDY OBJECTIVE:An increase in prescriptions for opioid pain medications has coincided with increasing opioid overdose deaths. Guidelines designed to optimize opioid prescriptions written in the emergency department have been implemented, with substantial controversy. Little is known about how physicians perceive and a...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2014.03.015

    authors: Kilaru AS,Gadsden SM,Perrone J,Paciotti B,Barg FK,Meisel ZF

    更新日期:2014-11-01 00:00:00

  • Zigadenus poisoning.

    abstract::Significant toxicity can result from ingestion of certain species of the Zigadenus plant, an herb occasionally confused with nontoxic wild onions. A 50-year-old man inadvertently ingested Z paniculatus and presented to the emergency department with profound gastrointestinal toxicity, hypotension, and bradycardia. The ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(95)70336-5

    authors: Heilpern KL

    更新日期:1995-02-01 00:00:00

  • Methamphetamine body stuffers: an observational case series.

    abstract:STUDY OBJECTIVE:We describe the demographics, characteristics, treatment, and clinical course of methamphetamine body stuffers. We also determine the clinical characteristics of methamphetamine body stuffers who have severe outcomes. METHODS:A 6.5-year descriptive nonconcurrent observational case series evaluated meth...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2009.08.005

    authors: West PL,McKeown NJ,Hendrickson RG

    更新日期:2010-02-01 00:00:00

  • Use of thrombolysis in acute ischemic stroke: analysis of the Nationwide Inpatient Sample 1999 to 2004.

    abstract:STUDY OBJECTIVE:The aim of this study is to characterize hospital and patient characteristics associated with administration of thrombolysis in acute ischemic stroke patients in the United States. METHODS:This retrospective, observational, cohort study used data from the Nationwide Inpatient Sample, an administrative ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2007.01.021

    authors: Schumacher HC,Bateman BT,Boden-Albala B,Berman MF,Mohr JP,Sacco RL,Pile-Spellman J

    更新日期:2007-08-01 00:00:00

  • Community trends in CPR training and use: the Minnesota Heart Survey.

    abstract:STUDY OBJECTIVE:To examine community changes in self-reported CPR training and use from 1980-82 to 1985-87 using data obtained from the Minnesota Heart Survey. A comparative investigation of CPR training among blacks and whites in 1985-86 also was completed. DESIGN:Data were obtained in 1980-81, 1981-82, 1985-86, and ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)82782-9

    authors: Naughton MJ,Luepker RV,Sprafka JM,McGovern PG,Burke GL

    更新日期:1992-06-01 00:00:00

  • EMS agenda for the future: where we are ... where we want to be. EMS Agenda for the Future Steering Committee.

    abstract::During the past 30 years, emergency medical services (EMS) in the United States have experienced explosive growth. The American health care system is now transforming, providing an opportune time to examine what we have learned over the past three decades in order to create a vision for the future of EMS. Over the cou...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Delbridge TR,Bailey B,Chew JL Jr,Conn AK,Krakeel JJ,Manz D,Miller DR,O'Malley PJ,Ryan SD,Spaite DW,Stewart RD,Suter RE,Wilson EM

    更新日期:1998-02-01 00:00:00

  • Blood flow with ventilation alone in a child with cardiac arrest.

    abstract::Recent investigations suggest that increased intrathoracic pressure causing compression of the heart and great vessels in the thorax plays an important role in providing blood flow during cardiopulmonary resuscitation. This communication reports the case of a four-year-old asphyxiated girl found to have a small amount...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(80)80474-4

    authors: Forney J,Ornato JP

    更新日期:1980-12-01 00:00:00

  • Pediatric fatalities associated with over the counter (nonprescription) cough and cold medications.

    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

    authors: Dart RC,Paul IM,Bond GR,Winston DC,Manoguerra AS,Palmer RB,Kauffman RE,Banner W,Green JL,Rumack BH

    更新日期:2009-04-01 00:00:00

  • Effect of out-of-hospital albuterol inhalation treatments on patient comfort and morbidity.

    abstract:STUDY OBJECTIVE:To determine the effect of the institution of out-of-hospital albuterol treatments for acute asthma on out-of-hospital time intervals emergency department (ED) morbidity. DESIGN:Retrospective chart and ambulance run report review. PARTICIPANTS:All patients who presented with a diagnosis of asthma on t...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0196-0644(94)70205-5

    authors: Weiss SJ,Anand P,Ernst AA,Orgeron D,May WL

    更新日期:1994-11-01 00:00:00