Abstract:
:This clinical policy focuses on critical issues in the evaluation and management of patients with acute myocardial infarction or unstable angina. A MEDLINE search for articles published between January 1993 and December 1998 was performed using combinations of the key words chest pain, acute myocardial infarction, unstable angina, thrombolytics, primary angioplasty, 12-lead ECG, ST-segment monitoring, cardiac serum markers, and chest pain centers. Subcommittee members and expert peer reviewers also supplied articles with direct bearing on the policy. This policy focuses on 5 areas of current interest and/or controversy: (1) ECG eligibility criteria for fibrinolytic therapy, (2) role of primary angioplasty in patients with acute myocardial infarction, (3) use of serum markers to diagnose acute myocardial infarction, (4) serial 12-lead ECGs during the initial evaluation, and (5) chest pain evaluation units. Recommendations for patient management are provided for each of these 5 topics based on strength of evidence (Standards, Guidelines, Options). Standards represent patient management principles that reflect a high degree of clinical certainty; Guidelines represent patient management principles that reflect moderate clinical certainty; and Options represent other patient management strategies based on preliminary, inconclusive, or conflicting evidence, or based on panel consensus. This guideline is intended for physicians working in hospital-based emergency departments or chest pain evaluation units. [American College of Emergency Physicians. Clinical policy: critical issues in the evaluation and management of adult patients presenting with suspected acute myocardial infarction or unstable angina. Ann Emerg Med. May 2000;35:521-544.].
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
doi
10.1067/mem.2000.106387subject
Has Abstractpub_date
2000-05-01 00:00:00pages
521-544issue
5eissn
0196-0644issn
1097-6760pii
S0196-0644(00)70018-7journal_volume
35pub_type
杂志文章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::Ketamine produces rapid and consistent pediatric sedation with a predictable onset and recovery time. A wide margin of safety is afforded without the respiratory and cardiovascular depression commonly seen with alternative agents. The efficacy of ketamine is well established in anesthesia and dentistry and has extensi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(05)82569-7
更新日期:1990-09-01 00:00:00
abstract::Activated charcoal is a safe, effective, inexpensive adjunct in the management of most toxic ingestions. It has the ability to adsorb a wide variety of drugs and chemicals, one of which is acetaminophen. N-acetylcysteine (NAC) is the specific antidote available for serious overdoses of acetaminophen. Current managemen...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80781-2
更新日期:1985-06-01 00:00:00
abstract:STUDY OBJECTIVE:Crisis resource management skills are integral to leading the resuscitation of a critically ill patient. Despite their importance, crisis resource management skills (and their associated cognitive processes) have traditionally been difficult to study in the real world. The objective of this study was to...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2018.03.005
更新日期:2018-09-01 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 OBJECTIVE:In patients presenting to the emergency department (ED) with an initial diagnostic impression of noncardiac chest pain, we determine the 30-day incidence of adverse cardiac events and characteristics associated with those events. METHODS:The multicenter, prospectively collected Internet Tracking Regist...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.03.021
更新日期:2004-12-01 00:00:00
abstract::Massive hemoptysis is an uncommon but life-threatening emergency. The loss of at least 600 mL of blood within a 48-hour period has been associated with a high mortality rate. Initial stabilization including airway and ventilation management, IV fluids, oxygen, and laboratory and radiographic studies should be done in ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80686-8
更新日期:1987-05-01 00:00:00
abstract:STUDY OBJECTIVES:We determine whether the addition of heat to topical eutectic mixture of local anesthetic (EMLA) cream shortens the onset time to effective analgesia. We hypothesized that applying EMLA cream for 20 minutes with an external heat pack would be as effective as the standard 60-minute application time. ME...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mem.2003.228
更新日期:2003-07-01 00:00:00
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
更新日期:1997-09-01 00:00:00
abstract:STUDY OBJECTIVE:Atrial flutter is a common arrhythmia seen in the emergency department (ED), yet there is little research describing its management and outcomes. We analyze the success and safety of treatment of ED patients with atrial flutter. METHODS:This was a retrospective cohort study obtained by searching the ED...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.09.027
更新日期:2011-06-01 00:00:00
abstract:STUDY OBJECTIVE:Immobility predisposes to venous thromboembolism, but this risk may vary, depending on the underlying cause of immobility. METHODS:This was a prospective, longitudinal outcome study of self-presenting emergency department (ED) patients who were from 12 hospitals and had suspected venous thromboembolism...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2008.10.033
更新日期:2009-08-01 00:00:00
abstract::Our study was conducted to determine the appropriate dose of lidocaine using the larynx and to characterize the onset and duration of therapeutic serum levels. A mean dose of 5.67 +/- 1.2 mg/kg was topically administered to the subglottic region of seven comatose patients through a cricothyroid membrane puncture. Seri...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80062-0
更新日期:1982-09-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to examine the outcome of a subgroup of patients with extreme carbon monoxide (CO) poisoning, specifically those discovered in cardiac arrest, resuscitated, and subsequently treated with hyperbaric oxygen (HBO(2)). Opinions of hyperbaric medicine physicians regarding the treatment of such pati...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2001.115532
更新日期:2001-07-01 00:00:00
abstract::Presented is a case of idiopathic priapism that was successfully treated with inhalation of amyl nitrite. Routine treatment measures had failed. The same patient presented on several other occasions in a similar fashion. Each time amyl nitrite was successful. An investigation for diseases known to be associated with p...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80602-7
更新日期:1983-04-01 00:00:00
abstract::This article has been withdrawn at the request of the authors and editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal. ...
journal_title:Annals of emergency medicine
pub_type: 撤回出版物
doi:10.1016/j.annemergmed.2020.04.025
更新日期:2020-06-02 00:00:00
abstract:STUDY OBJECTIVE:The number of freestanding emergency departments (EDs) has increased rapidly in the United States, and there is concern that such entities are located near existing EDs rather than in areas lacking emergency care. In 2018, the Medicare Payment Advisory Commission recommended a reduction in Medicare reim...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.07.036
更新日期:2021-01-01 00:00:00
abstract::We report a case of a severe lower gastrointestinal hemorrhage caused by arterioenteric fistula formation in a pancreas transplant patient. A rare but potentially deadly complication of pancreas transplant surgery, arterioenteric fistulas should be considered in every transplant patient presenting with voluminous gast...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/s0196-0644(03)00388-3
更新日期:2003-10-01 00:00:00
abstract::Autoerythrocyte sensitization syndrome is characterized by sudden and spontaneous painful bruising and swelling occurring in young female patients with psychiatric disorders. This syndrome may present with such severe swelling of involved areas that aspiration or excision may be needed to relieve pressure. The present...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80019-8
更新日期:1989-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether water or 0.9% saline should be used as diluent for endobronchial drug administration. PARTICIPANTS:Twelve adult patients. INTERVENTIONS:Patients were endobronchially administered 2 mg/kg lidocaine as marker substance in either 10 mL 0.9% saline or 10 mL distilled water during gene...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82293-0
更新日期:1990-11-01 00:00:00
abstract::Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy that can be mistaken for a normal intrauterine pregnancy on ultrasonography, leading to catastrophic results. Increasingly, emergency physicians are using ultrasonography to diagnose intrauterine pregnancy. Emergency physicians should be aware of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.125426
更新日期:2002-07-01 00:00:00
abstract:STUDY OBJECTIVE:Publication bias compromises the validity of systematic reviews. This problem can be addressed in part through searching clinical trials registries to identify unpublished studies. This study aims to determine how often systematic reviews published in emergency medicine journals include clinical trials ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.10.001
更新日期:2015-10-01 00:00:00
abstract::Five cases of right-sided rupture of the diaphragm are reviewed. Orthopedic injury, head injury, and shock were the most common associated findings. Apparent elevation of the right hemidiaphragm was seen initially in all cases, but two were misdiagnosed. An algorithm that includes modified peritoneal lavage, CT scan w...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80464-8
更新日期:1983-06-01 00:00:00
abstract:STUDY OBJECTIVE:Pleuritic chest pain is a common presenting complaint in the emergency department (ED) and a symptom of pulmonary embolism. Patients with pleuritic chest pain would benefit from a simple and rapid way of screening for pulmonary embolism. The aim of this study is to assess the utility of Simplify D-dimer...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/j.annemergmed.2005.03.018
更新日期:2005-10-01 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:STUDY OBJECTIVES:To determine the sensitivity, specificity, and predictive values of a new rapid creatine kinase-MB (R-CK-MB) assay compared with a standard CK-MB (S-CK-MB) assay and to determine its potential use in the evaluation of emergency department patients with possible myocardial infarction. DESIGN:Retrospect...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82971-3
更新日期:1991-09-01 00:00:00
abstract:STUDY OBJECTIVE:Factors associated with intraosseous (IO) catheterization are not well described. Our objective is to identify factors associated with the attempt and timing of IO catheterization in a pediatric emergency department (ED) resuscitation setting. METHODS:We completed a video-based, case-control study (1:3...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.09.005
更新日期:2020-06-01 00:00:00
abstract:STUDY OBJECTIVE:Measurement of interval data is important in the accurate recording of events that occur in an emergency medical services system. Measurement of intervals should be a simple task. However, when two separate clocks are needed to record the beginning and end of an interval, accurate measurement may be dif...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70222-1
更新日期:1997-04-01 00:00:00
abstract::We describe a patient with a long history of rheumatoid arthritis who presented in full cardiopulmonary arrest. He was given intracardiac epinephrine. Fibroptic laryngoscopy determined the cause of the arrest to be upper airway obstruction from cricoarytenoid joint ankylosis, a complication of long-standing rheumatoid...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80893-3
更新日期:1985-07-01 00:00:00
abstract:STUDY HYPOTHESIS:To determine the prevalence of antibody to human immunodeficiency virus (HIV) in trauma and nontrauma patients not identified as having known HIV infection in a noninner-city university teaching hospital emergency department, and to determine the frequency with which treating emergency physicians are k...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80842-x
更新日期:1991-07-01 00:00:00
abstract::Annals' 25th anniversary is a cause for celebration, but the future imposes a new set of ethical questions and moral dilemmas for emergency physicians. Each physician will need to make personal choices consistent with the courage, judgment, integrity, and dedication of past leaders when dealing with the moral dilemmas...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70035-0
更新日期:1997-12-01 00:00:00