Abstract：
:Early experience with the use of tissue plasminogen activator (tPA) in acute myocardial infarction is reviewed, including comparisons with other thrombolytic agents, a summary of hemorrhagic complications associated with its use, and the rationale for adjunctive therapeutic strategies. The use of tPA has been associated with improvement in left ventricular function, a lower mortality, and a decrease in congestive heart failure signs and symptoms. A protocol for evaluation of patients with possible myocardial infarction for thrombolytic therapy is presented. Consideration must be given to other possible diagnoses, and the ECG must be evaluated carefully to ensure that appropriate criteria are met. Risk factors for hemorrhagic complications include recent trauma, surgery, gastrointestinal and genitourinary bleeding, stroke, and focal neurologic findings. Greater benefit of therapy is expected in patients with larger infarcts who have more marked ST segment changes or evidence of hemodynamic compromise, especially when they are treated early after the onset of symptoms (within the first several hours). Adjunctive measures that can be considered in the emergency department include prophylactic lidocaine, IV nitroglycerin, beta blockade, aspirin, volume replacement and monitoring for dysrhythmias, bleeding, and recurrent ischemia. A comprehensive understanding of these rapidly evolving concepts will assist the emergency physician in the evaluation and management of patients with acute myocardial infarction.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Califf RM,Mantell S,Westawski C,Bride W,Honan MB,Bellinger RL,Wall TCdoi
10.1016/s0196-0644(88)80064-7subject
Has Abstractpub_date
1988-11-01 00:00:00pages
1176-89issue
11eissn
0196-0644issn
1097-6760pii
S0196-0644(88)80064-7journal_volume
17pub_type
临床试验,杂志文章,评审abstract：STUDY OBJECTIVE:We evaluate patients with shock and traumatic brain injury who were previously enrolled in an out-of-hospital clinical trial to test the association between out-of-hospital time and outcome. METHODS:This was a secondary analysis of patients with shock and traumatic brain injury who were aged 15 years o...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2014.12.004
更新日期：2015-07-01 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：: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
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82052-9
更新日期：1990-03-01 00:00:00
abstract：:The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in red...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.10.018
更新日期：2012-07-01 00:00:00
abstract：:The Bahamas is an archipelago of 700 islands with the majority of the population concentrated on just 2 islands: New Providence and Grand Bahama. Most emergency medical services are provided by Princess Margaret Hospital and Rand Memorial Hospital located respectively on those 2 islands. A detailed description of the ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.118865
更新日期：2001-12-01 00:00:00
abstract：STUDY OBJECTIVE:We identify the incidence and predictors of missed fracture and characterize patterns of radiography performance in children with a diagnosis of radial head subluxation in the emergency department (ED) setting. METHODS:We queried the Pediatric Health Information System database for visits by children y...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2020.09.002
更新日期：2021-02-01 00:00:00
abstract：STUDY OBJECTIVE:The necessity for rapid administration of intravenous thrombolysis in patients with acute ischemic stroke may lead to treatment of patients with conditions mimicking stroke. We analyze stroke patients treated with intravenous thrombolysis in our center to characterize cases classified as stroke mimics. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.09.011
更新日期：2012-01-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether nonemergency patients can be prospectively identified by triage nurses and safely triaged out of the emergency department without treatment. METHODS:All adult patients (16 years or older) who presented to a university ED were provided an evaluation by a triage nurse. For a patient'...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(95)70327-6
更新日期：1995-02-01 00:00:00
abstract：:Recent developments, such as the bombings of the World Trade Center in 1993 and the Alfred P. Murrah Federal Building in Oklahoma City in 1995, the sarin attacks in Tokyo and Matsumoto, Japan, and US Embassy bombings in Kenya and Tanzania in 1998, have heightened fears of terrorist attacks. Future terrorist activities...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(99)70228-3
更新日期：1999-08-01 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：:A comparison of several maneuvers that are believed to increase vagal tone was made by measuring the carotid sinus with an ultrasound device. For 20 healthy volunteers the mean carotid sinus diameter was 5.7 mm supine, 6.1 mm in the Trendelenberg position, 6.5 mm after supine medical antishock trousers (MAST) inflatio...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80921-5
更新日期：1985-11-01 00:00:00
abstract：:A prospective study was conducted to test the reliability of at-home observation of head trauma victims in the rural South among a population of low educational level. During a four-month period, 99 patients entered and 90 patients finished the study. In all cases, an individual was identified as willing to accept the...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80297-x
更新日期：1988-02-01 00:00:00
abstract：:The hypotension and myocardial depression that result from calcium channel blocker ingestion often are refractory to standard therapeutic modalities. Anecdotal reports on the use of glucagon have failed to show significant hemodynamic improvement. We report the first case of calcium channel blocker overdose that respo...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80997-7
更新日期：1993-07-01 00:00:00
abstract：:We present the cases of three patients with skin blisters following carbon monoxide (CO) poisoning. Their blisters appeared to be related to the severity of the poisoning (HbCO levels of more than 40%). Two of the three patients died despite aggressive initial 100% surface oxygen followed by hyperbaric oxygen therapy....
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80792-7
更新日期：1985-06-01 00:00:00
abstract：STUDY OBJECTIVE:Methanol poisoning outbreaks are a global public health issue, with delayed treatment causing poor outcomes. Out-of-hospital ethanol administration may improve outcome, but the difficulty of conducting research in outbreaks has meant that its effects have never been assessed. We study the effect of out-...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.01.010
更新日期：2016-07-01 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：: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 OBJECTIVE:The STONE score is a clinical decision rule that classifies patients with suspected nephrolithiasis into low-, moderate-, and high-score groups, with corresponding probabilities of ureteral stone. We evaluate the STONE score in a multi-institutional cohort compared with physician gestalt and hypothesize...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.annemergmed.2015.08.019
更新日期：2016-04-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the efficacy of emergency practitioner-performed brief intervention for hazardous/harmful drinkers in reducing alcohol consumption and negative consequences in an emergency department (ED) setting. METHODS:A randomized clinical trial (Project ED Health) was conducted in an urban ED from Ma...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2007.11.028
更新日期：2008-06-01 00:00:00
abstract：:Test strips recently have become available to measure theophylline levels. One such test strip (AccuLevel) had not been tested in an actual clinical situation with nontechnician personnel. We prospectively evaluated the test strip on consecutive emergency department patients, comparing it with the agglutination inhibi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80440-2
更新日期：1988-10-01 00:00:00
abstract：STUDY OBJECTIVES:To determine the height of back elevation required to place the cervical spine of children less than 8 years old in neutral position and whether agreement on the height required for neutral position could be reached by two independent observers. STUDY DESIGN:Prospective. SETTING:Pediatric emergency d...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70032-x
更新日期：1994-02-01 00:00:00
abstract：STUDY OBJECTIVE:This study explored how a variety of demographic and illness-related factors were associated with telephone follow-up among patients visiting the emergency department for acute asthma. METHODS:We performed a prospective cohort study as part of the Multicenter Airway Research Collaboration (MARC). The s...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/S0196-0644(00)70027-8
更新日期：2000-06-01 00:00:00
abstract：:Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), is a propionic acid derivative that possesses analgesic and antipyretic properties through inhibition of prostaglandin synthesis. The propionic acids have been considered the least toxic of the NSAIDs, and one, ibuprofen, is currently available as an over-the-co...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80939-4
更新日期：1989-10-01 00:00:00
abstract：:Emergency clinicians often care for patients with terminal illness who are receiving hospice care and many more patients who may be in need of such care. Hospice care has been shown to successfully address the multidimensional aspects of the end-of-life concerns of terminally ill patients: dying with dignity, dying wi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2010.06.569
更新日期：2011-03-01 00:00:00
abstract：STUDY OBJECTIVE:Frequent emergency department (ED) users have been the targets of health care reform proposals and hospital crowding interventions, but it is not clear that common assumptions about this group are supported by data. We review the literature pertaining to frequent ED users, their demographics, acuity of ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2010.01.032
更新日期：2010-07-01 00:00:00
abstract：:Electrolytes, BUN, and creatinine are some of the most frequently ordered laboratory tests. The use of these tests in emergency practice has not been studied critically, and few investigations of their use in other disciplines have been performed. A review of the available literature and an analysis of medical problem...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(86)80586-8
更新日期：1986-03-01 00:00:00
abstract：STUDY OBJECTIVE:We examine how dedicated methodology and statistical review affects the quality of manuscripts published in Annals of Emergency Medicine. DESIGN:The dedicated reviewers developed a manuscript scoring form based on previously used instruments. The form contained 84 unique elements. Eight items sought th...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.127328
更新日期：2002-09-01 00:00:00
abstract：STUDY OBJECTIVE:For an emergency medicine pharmacist to become a well-integrated multidisciplinary team member, his or her services need to be accepted by the emergency department (ED) staff. There have been 2 published studies attesting the value of the emergency medicine pharmacist by ED staff: at an academic medical...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.08.451
更新日期：2017-03-01 00:00:00
abstract：STUDY OBJECTIVE:Prediction rules for pulmonary embolism use variables explicitly shown to estimate the probability of pulmonary embolism. However, clinicians often use variables that have not been similarly validated, yet are implicitly believed to modify probability of pulmonary embolism. The objective of this study i...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.annemergmed.2009.11.010
更新日期：2010-04-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether pediatric patients with acute, mild to moderate acetaminophen exposures, treated with home monitoring alone, develop systemic signs of hepatic injury. METHODS:A prospective, observational study of calls to a regional poison center over a 25-month period was performed. Patients were...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(00)70074-6
更新日期：2000-03-01 00:00:00
