Abstract:
STUDY OBJECTIVE:The relationship between tiredness and medical errors is now commonly accepted. The main objective of this study is to evaluate the cognitive performance of emergency physicians after a night shift of 14 hours (H14) and after a work shift of 24 hours (H24) and to compare it with tests performed after a rest night at home (H0). METHODS:Forty emergency physicians (19 staff physicians and 21 residents) were randomly evaluated at H0, H14, and H24. Four cognitive abilities (processing speed, working memory capacity, perceptual reasoning, and cognitive flexibility) were tested according to the Wechsler Adult Intelligence Scale and the Wisconsin Card Sorting Test. RESULTS:No cognitive ability was significantly altered after H14 compared with H0. Three of 4 cognitive abilities were impaired at H24 compared with H0: processing speed (11.2 [SD 2.7] versus 12.4 [SD 3.2]; mean difference=-1.2 [95% confidence interval -1.9 to -0.5]), working memory capacity (10.1 [SD 2.9] versus 11.6 [SD 3.0]; mean difference=-1.5 [95% confidence interval -2.2 to -0.8]), and perceptual reasoning (8.4 [SD 2.7] versus 10.6 [SD 2.8]; mean difference=-2.2 [95% confidence interval -3.4 to -1.0]). Cognitive abilities were not different between residents and staff physicians (except for perceptual reasoning) and were not affected by the amount of sleep during the night shift. CONCLUSION:The cognitive abilities of emergency physicians were significantly altered after a 24-hour shift, whereas they were not significantly different from the rested condition after a 14-hour night shift. Limiting 24-hour shift work for emergency physicians should be considered and further evaluated.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Persico N,Maltese F,Ferrigno C,Bablon A,Marmillot C,Papazian L,Roch Adoi
10.1016/j.annemergmed.2017.10.005subject
Has Abstractpub_date
2018-08-01 00:00:00pages
171-180issue
2eissn
0196-0644issn
1097-6760pii
S0196-0644(17)31769-9journal_volume
72pub_type
杂志文章abstract:STUDY OBJECTIVE:Although adjunctive intravenous bicarbonate therapy is commonly recommended for children with severe diabetic ketoacidosis (DKA), no studies assessing clinical outcome with this therapy have ever been performed. Our objective was to determine whether bicarbonate therapy influenced outcome for pediatric ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(98)70279-3
更新日期:1998-01-01 00:00:00
abstract::Although most clinical trials comparing therapies are analyzed using classical hypothesis testing and P values, such methods do not yield the information most useful to the clinician, that is, the probability that one treatment is more efficacious than another. Bayesian inference can yield this probability but only if...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80119-2
更新日期:1993-08-01 00:00:00
abstract:STUDY OBJECTIVE:We characterize the quantity and quality of data tables and figures in reports of randomized controlled trials (RCTs) submitted to the British Medical Journal (BMJ) and published in peer-reviewed journals. We investigate how the peer review process affected table and figure quality. METHODS:We reviewed...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2006.06.017
更新日期:2006-12-01 00:00:00
abstract:STUDY OBJECTIVE:To test the hypothesis that intersystem variation in initial rhythm among EMS-witnessed arrests is of sufficient magnitude to warrant standardization of survival by creation of an Utstein-style denominator of EMS-witnessed ventricular fibrillation (VF). METHODS:We conducted a planned subset analysis of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70115-x
更新日期:1997-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the clinical characteristics of endotracheal intubation in the French emergency prehospital medical system and compare these data with those of other systems. METHODS:This study was performed in lle de France (Paris Region) in mobile ICUs staffed by physicians. This prospective, descriptiv...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70175-1
更新日期:1998-10-01 00:00:00
abstract::One hundred twenty-five pediatric emergency department patients were studied prospectively to determine whether any findings on the physical examination were predictive of abnormalities seen on chest radiograph. We attempted to find possible correlations between such clinical examination findings, recorded prior to ra...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80374-2
更新日期:1986-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the feasibility of bilevel positive airway pressure (BiPAP) support for acute respiratory distress (ARD) in the emergency department. METHODS:A convenience sample of patients in ARD as a result of any nontraumatic cause was recruited for a prospective, noncontrolled clinical trial in the E...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(96)70321-9
更新日期:1996-02-01 00:00:00
abstract:STUDY OBJECTIVES:To determine the sensitivity and specificity of the urine ketone dip test as a screening test for ketonemia in hyperglycemic patients and to compare the performance of the urine ketone dip test with the anion gap and serum bicarbonate level. METHODS:This was a prospective study conducted in an urban, ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70128-9
更新日期:1999-09-01 00:00:00
abstract:STUDY OBJECTIVES:By evaluating the efficacy of metoclopramide alone and in combination with ibuprofen versus placebos, this study was designed to both evaluate the efficacy of metoclopramide and elucidate its mechanism of action in the treatment of migraine headache. DESIGN:The study was conducted over a two-year peri...
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(05)80201-x
更新日期:1993-02-01 00:00:00
abstract::Maprotiline, a new tetracyclic antidepressant, has a pattern of toxicity that is different from that of tricyclics. Maprotiline overdosage appears more likely to cause seizures but less likely to cause the peripheral autonomic and cardiac manifestations seen with tricyclics. Two cases of maprotiline overdose resulting...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80016-5
更新日期:1984-06-01 00:00:00
abstract:STUDY OBJECTIVE:Recent data suggest that emergency airway preoxygenation with a bag-valve-mask (BVM) device (held with a tight mask seal but without squeezing the bag) is superior to a nonrebreather (NRB) mask at standard oxygen flow rates. We seek to determine whether preoxygenation with an NRB mask with flush rate ox...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2016.06.018
更新日期:2017-01-01 00:00:00
abstract::We examined the question of what determines the toxicity of alkaline solutions--pH, viscosity, or other factors. Our experiments have identified pH measurement as the simplest and most easily measured parameter for determining initial management of caustic ingestions. Viscosity is not a clinically useful measurement. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80264-2
更新日期:1980-03-01 00:00:00
abstract:STUDY OBJECTIVE:We compare the ability of 5 established risk scores to identify patients with suspected acute coronary syndromes who are suitable for discharge after a modified single-presentation high-sensitivity troponin result. METHODS:This was a prospective observational study conducted in a UK district general ho...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.07.006
更新日期:2015-12-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluated a strategy to increase use of the test (Dix-Hallpike's test [DHT]) and treatment (canalith repositioning maneuver [CRM]) for benign paroxysmal positional vertigo in emergency department (ED) dizziness visits. METHODS:We conducted a stepped-wedge randomized trial in 6 EDs. The population wa...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.annemergmed.2019.09.017
更新日期:2020-04-01 00:00:00
abstract::Nine dogs were hemorrhaged to approximately 40% of their blood volume and then were resuscitated with a crystalloid solution (Normosol) at various flow rates. Three study groups with three dogs in each group were resuscitated at 15 mL/min/kg (Group 1), 6 mL/min/kg (Group 2), and 4 mL/min/kg (Group 3). Central venous p...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80091-3
更新日期:1985-04-01 00:00:00
abstract:STUDY OBJECTIVE:We compare metoclopramide 20 mg intravenously, combined with diphenhydramine 25 mg intravenously, with ketorolac 30 mg intravenously in adults with tension-type headache and all nonmigraine, noncluster recurrent headaches. METHODS:In this emergency department (ED)-based randomized, double-blind study, ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2013.03.017
更新日期:2013-10-01 00:00:00
abstract::This study was undertaken to determine the clinical circumstances of femoral fractures in children. The study was a retrospective investigation of 117 consecutive patients with femoral fractures admitted to The Children's Mercy Hospital, Kansas City, Missouri, from December 1975 to September 1979. Of the 117 patients....
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80492-7
更新日期:1982-04-01 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:STUDY OBJECTIVE:We compare the efficacy and safety of intravenous lidocaine with that of hydromorphone for the treatment of acute abdominal pain in the emergency department (ED). METHODS:This was a randomized, double-blind, clinical trial conducted in 2 EDs in the Bronx, NY. Adults weighing 60 to 120 kg were randomize...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2019.01.021
更新日期:2019-08-01 00:00:00
abstract::Axial (in-line) traction is recommended as a stabilizing maneuver during orotracheal intubation of a trauma victim with a potential cervical spine injury. There are no published data demonstrating the safety of this technique in trauma patients with an unstable cervical spine. In our study, 17 victims of blunt traumat...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80498-0
更新日期:1988-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the timeliness of response of consultants called to evaluate patients in the emergency department of a community hospital. METHODS:Consultation requests from an ED located in a medium-sized community hospital were studied for a 1-month period. Data collected included name and specialty of ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70035-6
更新日期:1998-11-01 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:STUDY OBJECTIVE:To identify the arterial and mixed venous blood gas changes caused by different ventilatory strategies during resuscitation from ventricular fibrillation in a pig model of closed-chest cardiac compression. METHODS:A prospective randomized animal study was performed using 27 domestic pigs (body weight, ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70203-3
更新日期:1998-05-01 00:00:00
abstract::We present the case of a 27-year-old man who sustained a minor head injury and presented with complaints of headache and vomiting. The diagnosis of vertex epidural hematoma is discussed. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70145-8
更新日期:1994-08-01 00:00:00
abstract::A prospective study of emergency physician whole body and extremity exposure to ionizing radiation during trauma resuscitation over a three-month period was conducted. Radiation film badges and thermoluminescent dosimeter finger rings were permanently attached to leaded aprons worn by emergency medicine residents duri...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81797-4
更新日期:1990-02-01 00:00:00
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:
更新日期:1998-02-01 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::A prospective, randomized study of 500 consecutive emergency department patients with traumatic lacerations requiring sutures was performed comparing use of topical 1% povidone-iodine (Betadine) and scrubbing with wound management by irrigation with normal saline without scrubbing. A 60-second wound irrigation and scr...
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(87)80008-2
更新日期:1987-02-01 00:00:00
abstract::Ornithine transcarbamylase deficiency (OTCD) is an X-linked inherited disease and the most common inborn error in urea synthesis in human patients. In adult heterozygous patients, OTCD can be responsible for life-threatening hyperammonemic coma. We report the case of a 32-year-old woman admitted to our hospital with s...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2003.6
更新日期:2003-01-01 00:00:00
abstract::To define a subset of injured children for whom emergency cervical spine radiography may be unnecessary, we performed a retrospective chart and radiologic review. Two entry methods were used: All injured children, from birth through 16 years, who had received cervical spine radiographs at The Children's Memorial Hospi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80171-3
更新日期:1987-03-01 00:00:00