Abstract:
STUDY OBJECTIVE:We seek to describe the medical history and clinical findings of patients attending the emergency department (ED) with suspected coronavirus disease 2019 (COVID-19) and estimate the diagnostic accuracy of patients' characteristics for predicting COVID-19. METHODS:We prospectively enrolled all patients tested for severe acute respiratory syndrome coronavirus 2 by reverse-transcriptase polymerase chain reaction in our ED from March 9, 2020, to April 4, 2020. We abstracted medical history, physical examination findings, and the clinical probability of COVID-19 (low, moderate, and high) rated by emergency physicians, depending on their clinical judgment. We assessed diagnostic accuracy of these characteristics for COVID-19 by calculating positive and negative likelihood ratios. RESULTS:We included 391 patients, of whom 225 had positive test results for severe acute respiratory syndrome coronavirus 2. Reverse-transcriptase polymerase chain reaction result was more likely to be negative when the emergency physician thought that clinical probability was low, and more likely to be positive when he or she thought that it was high. Patient-reported anosmia and the presence of bilateral B lines on lung ultrasonography had the highest positive likelihood ratio for the diagnosis of COVID-19 (7.58, 95% confidence interval [CI] 2.36 to 24.36; and 7.09, 95% CI 2.77 to 18.12, respectively). The absence of a high clinical probability determined by the emergency physician and the absence of bilateral B lines on lung ultrasonography had the lowest negative likelihood ratio for the diagnosis of COVID-19 (0.33, 95% CI 0.25 to 0.43; and 0.26, 95% CI 0.15 to 0.45, respectively). CONCLUSION:Anosmia, emergency physician estimate of high clinical probability, and bilateral B lines on lung ultrasonography increased the likelihood of identifying COVID-19 in patients presenting to the ED.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Peyrony O,Marbeuf-Gueye C,Truong V,Giroud M,Rivière C,Khenissi K,Legay L,Simonetta M,Elezi A,Principe A,Taboulet P,Ogereau C,Tourdjman M,Ellouze S,Fontaine JPdoi
10.1016/j.annemergmed.2020.05.022subject
Has Abstractpub_date
2020-10-01 00:00:00pages
405-412issue
4eissn
0196-0644issn
1097-6760pii
S0196-0644(20)30393-0journal_volume
76pub_type
杂志文章abstract:STUDY OBJECTIVE:To document prehospital and inhospital time intervals from stroke onset to emergency department evaluation and to identify factors associated with presentation to the ED within 3 hours of symptom onset, the current time window for thrombolytic therapy. METHODS:Patients admitted through the ED with a di...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70431-2
更新日期:1999-01-01 00:00:00
abstract:STUDY OBJECTIVE:We compare the association between barriers to timely primary care and emergency department (ED) utilization among adults with Medicaid versus private insurance. METHODS:We analyzed 230,258 adult participants of the 1999 to 2009 National Health Interview Survey. We evaluated the association between 5 s...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2012.01.035
更新日期:2012-07-01 00:00:00
abstract:STUDY OBJECTIVE:We assess the effectiveness of patient-controlled analgesia in the emergency department (ED). We hypothesized that decline in pain intensity from 30 to 120 minutes after initial intravenous opioid administration is greater in patients receiving morphine by patient-controlled analgesia compared with usua...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2017.03.064
更新日期:2017-12-01 00:00:00
abstract:STUDY OBJECTIVE:In recent years, air transport of patients has been associated with disproportionate increases in crashes and deaths. We identify factors related to fatal outcome in air medical helicopter crashes and suggest preventive measures. METHODS:This was a retrospective study using National Transportation Safe...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.11.018
更新日期:2006-04-01 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::Paliperidone, or 9-hydroxy risperidone, is the newest atypical antipsychotic agent to be approved for use by the Food and Drug Administration. Despite being the primary active metabolite of risperidone, paliperidone differs in several ways from risperidone. The most notable difference is that paliperidone is formulate...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.10.015
更新日期:2011-07-01 00:00:00
abstract::Many patients seeking care in the modern emergency center are capable of participating in treatment decision making. In the traditional emergency center consent process, the patient or a surrogate is asked to sign a general consent form purporting to authorize any treatment the emergency physician deems necessary. We ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80289-5
更新日期:1987-01-01 00:00:00
abstract::This clinical policy focuses on critical issues concerning the management of patients presenting to the emergency department (ED) with acetaminophen overdose. The subcommittee reviewed the medical literature relevant to the questions posed. The critical questions are: 1. What are the indications for N-acetylcysteine (...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,实务指引
doi:10.1016/j.annemergmed.2007.06.014
更新日期:2007-09-01 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::The Prehospital Index (PHI) is a triage-oriented trauma severity scoring system comprising four components: systolic blood pressure, pulse, respiratory status, and level of consciousness, each scored 0 to 5. The PHI was developed after analysis of 313 cases to provide an objective prehospital scoring system for distin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80016-6
更新日期:1986-02-01 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: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
更新日期:1995-05-01 00:00:00
abstract::Reported is a case of a 34-year-old man, previously in good health, who underwent chiropractic manipulation of the cervical spine for treatment of a recent whiplash injury. Immediately following manipulation, the patient became unresponsive and was found to have sustained a brain stem infarction resulting in the "Lock...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80217-0
更新日期:1983-10-01 00:00:00
abstract::In May 1993, the appearance of critically ill patients with unexplained respiratory distress was noted in the Four Corners area formed by New Mexico, Arizona, and Colorado. This epidemic was ultimately linked to a hantavirus, an emerging pathogen. The impact on the emergency department of a new infectious disease with...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70179-2
更新日期:1994-09-01 00:00:00
abstract::While remaining prominent in paramedic care and beneficial to some patients, out-of-hospital endotracheal intubation has not clearly improved survival or reduced morbidity from critical illness or injury when studied more broadly. Recent studies identify equivocal or unfavorable clinical effects, adverse events and er...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2006.01.016
更新日期:2006-06-01 00:00:00
abstract:STUDY OBJECTIVE:Experts advocate the use of a standard nasal cannula to provide oxygen at flow rates of up to 15 L/minute during emergency intubation. However, because of concerns about potential patient discomfort, some providers avoid providing nasal cannula oxygen at flow rates greater than 6 L/minute. This trial is...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2014.10.023
更新日期:2015-04-01 00:00:00
abstract:STUDY HYPOTHESIS:Risk factors associated with unintentional gunshot fatalities among children include gender and race of the decedent, type of firearm used, and whether loaded guns are stored within the home. STUDY POPULATION:All New Mexico children 0 to 14 years old unintentionally killed by a firearm between 1984 an...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81120-5
更新日期:1991-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if intramedullary aspirate from intraosseous needle placement can be used as a source for evaluating blood compatibility. DESIGN:A prospective, nonrandomized, crossover study. SETTING/PARTICIPANTS:Patients admitted to the hematology/oncology service undergoing bone marrow aspiration for m...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82661-7
更新日期:1992-04-01 00:00:00
abstract:STUDY OBJECTIVES:To assess the timing of key decisions and clinical events in the treatment of acute myocardial infarction with thrombolytic therapy. DESIGN:Prospective study of emergency department patients. SETTING:EDs in 11 urban and two rural hospitals. TYPES OF PARTICIPANTS:Patients with presumed acute myocardi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/s0196-0644(05)81749-4
更新日期:1992-10-01 00:00:00
abstract::Although a number of studies have described endotracheal intubation of adult patients in the prehospital setting, there are few studies on prehospital endotracheal intubation of pediatric patients. The purposes of our study were to determine how frequently prehospital endotracheal intubation was used in pediatric card...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80830-3
更新日期:1989-05-01 00:00:00
abstract:STUDY OBJECTIVE:Adverse drug events represent the most common cause of preventable nonsurgical adverse events in medicine but may remain undetected. Our objective is to determine the proportion of drug-related visits emergency physicians attribute to medication-related problems. METHODS:This prospective observational ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2009.10.008
更新日期:2010-06-01 00:00:00
abstract::To simulate the effect of sublingual injections on pediatric patients, open-chested kid goats were injected sublingually or peripherally with Cardio-Green while being supported by internal cardiac massage. Our study demonstrates that there is statistically a ten-fold lower central blood level after sublingual injectio...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80005-0
更新日期:1984-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the relative importance of variables correlated with patient satisfaction with emergency department care and service. DESIGN:Retrospective telephone survey targeting all patients who visited the Panorama City Kaiser Permanente ED from April 4 to April 17, 1991. Patients were contacted with...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81947-x
更新日期:1993-03-01 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::A 43-year-old woman presented to the emergency department with acute agitation, confusion, and tonic seizures. She had a history of drug abuse, most notably beer, which constituted her major dietary intake. The patient's seizures were at first thought to be factitious in association with an acute psychosis; however, h...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80442-5
更新日期:1986-06-01 00:00:00
abstract:STUDY OBJECTIVES:To demonstrate the degree to which pulse oximetry overestimates actual oxyhemoglobin (O2Hb) saturation in patients with carbon monoxide (CO) poisoning. This phenomenon has been reported in fewer than 20 humans in the English medical literature. METHODS:A retrospective chart review of 191 patients eval...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70077-5
更新日期:1997-11-01 00:00:00
abstract:STUDY OBJECTIVE:Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of sca...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2013.02.005
更新日期:2013-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine emergency department patients' behaviors during informed consent for an intimate partner violence survey. METHODS:We conducted a cross-sectional study during administration of informed consent. Research assistants recorded whether informed consent was read, time spent reading it, whether q...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2009.09.023
更新日期:2010-01-01 00:00:00
abstract::The epidemiology of pediatric fever has changed considerably during the past 2 decades with the development of vaccines against the most common bacterial pathogens causing bacteremia and meningitis. The decreasing incidence of these 2 conditions among vaccinated children has led to an emphasis on urinary tract infecti...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2012.10.034
更新日期:2013-05-01 00:00:00
abstract:STUDY OBJECTIVE:We describe and analyze a recent rapid deployment of disaster medical assistance teams and other government agencies to provide medical screening and anthrax prophylaxis to New York City US Postal Service employees potentially exposed to letters contaminated with anthrax spores. METHODS:A description o...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2003.105
更新日期:2003-04-01 00:00:00