Abstract:
STUDY OBJECTIVE:Throughout the coronavirus disease 2019 pandemic, many emergency departments have been using passive protective enclosures ("intubation boxes") during intubation. The effectiveness of these enclosures remains uncertain. We sought to quantify their ability to contain aerosols using industry standard test protocols. METHODS:We tested a commercially available passive protective enclosure representing the most common design and compared this with a modified enclosure that incorporated a vacuum system for active air filtration during simulated intubations and negative-pressure isolation. We evaluated the enclosures by using the same 3 tests air filtration experts use to certify class I biosafety cabinets: visual smoke pattern analysis using neutrally buoyant smoke, aerosol leak testing using a test aerosol that mimics the size of virus-containing particulates, and air velocity measurements. RESULTS:Qualitative evaluation revealed smoke escaping from all passive enclosure openings. Aerosol leak testing demonstrated elevated particle concentrations outside the enclosure during simulated intubations. In contrast, vacuum-filter-equipped enclosures fully contained the visible smoke and test aerosol to standards consistent with class I biosafety cabinet certification. CONCLUSION:Passive enclosures for intubation failed to contain aerosols, but the addition of a vacuum and active air filtration reduced aerosol spread during simulated intubation and patient isolation.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Turer DM,Good CH,Schilling BK,Turer RW,Karlowsky NR,Dvoracek LA,Ban H,Chang JS,Rubin JPdoi
10.1016/j.annemergmed.2020.08.033subject
Has Abstractpub_date
2021-01-01 00:00:00pages
1-10issue
1eissn
0196-0644issn
1097-6760pii
S0196-0644(20)30707-1journal_volume
77pub_type
杂志文章abstract::Lisfranc fracture-dislocations are rare, and their correct diagnosis is important. Misdiagnosis is common and can lead to grave, chronic disability. We present two cases of Lisfranc fracture-dislocation to highlight the mechanisms of injury, clinical presentation, diagnosis, and treatment. Accurate diagnosis by emerge...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70156-7
更新日期:1995-08-01 00:00:00
abstract:STUDY OBJECTIVE:We examine whether using public National Hospital Ambulatory Medical Care Survey (NHAMCS) data with masked design variables produces different estimates, standard errors, and confidence intervals (CIs) for the temporal trend of overall and injury-related emergency department (ED) visits compared with us...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.12.025
更新日期:2011-06-01 00:00:00
abstract:STUDY OBJECTIVE:Epinephrine autoinjector use for anaphylaxis is increasing. There are reports of digit injections because of incorrect autoinjector use, but no previous reports of lacerations, to our knowledge. We report complications of epinephrine autoinjector use in children and discuss features of these devices, an...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.07.011
更新日期:2016-03-01 00:00:00
abstract:STUDY OBJECTIVE:To characterize the role of emergency medicine residency programs in determining emergency medicine career choice among medical students. DESIGN:Observational, cross-sectional, descriptive study. Information on student career choice was obtained through a targeted query of the National Resident Matchin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70104-0
更新日期:1994-05-01 00:00:00
abstract::Ten healthy male volunteers were studied to compare the effects of simultaneous versus sequential inflation of antishock trousers (AST) and simultaneous inflation pressures of 20, 40, and 100 mm Hg on blood volume displacement centrally. Radioisotope scans were used to determine the change in blood volume distribution...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80877-5
更新日期:1985-07-01 00:00:00
abstract::The World Health Assembly 2007 Resolution 60.22 tasked the global health community to address the lack of emergency care in low- and middle-income countries. Little progress has yet been made in integrating emergency care into most low- and middle-income-country health systems. At a rural Ugandan district hospital, ho...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.01.035
更新日期:2014-11-01 00:00:00
abstract::Temporary ventricular pacing was successfully employed in two patients suffering refractory bradycardia following traumatic cardiac arrest. The hemodynamic response to pacing was dramatic and both patients eventually recovered fully from an apparent moribund state. Cardiac pacing may be an effective adjuvant in the ea...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80233-2
更新日期:1980-11-01 00:00:00
abstract:STUDY OBJECTIVE:We aim to evaluate the accuracy of the broad-range 16S polymerase chain reaction test in the diagnosis of bacterial meningitis through a systematic review and meta-analysis. METHODS:We searched MEDLINE, EMBASE, and the Cochrane Controlled Trials Registry, using the Medical Subject Headings terms "polym...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.annemergmed.2012.05.040
更新日期:2012-11-01 00:00:00
abstract:STUDY OBJECTIVE:The objective was to quantify the analgesic effect of a dose of intravenous morphine, 0.1 mg/kg, to emergency department (ED) patients presenting in acute, severe pain. METHODS:This was a prospective convenience cohort of patients aged 21 to 65 years and presenting to an academic urban ED with acute, s...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.03.010
更新日期:2005-10-01 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:STUDY OBJECTIVE:To compare the speed of IV access and the rate of infusion for saphenous venous cutdown and percutaneous femoral catheterization. DESIGN:Prospective, randomized, multicentered trial. Patient enrollment occurred from September 1990 through September 1991. SETTING:Patients were enrolled at three urban L...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0196-0644(94)70074-5
更新日期:1994-03-01 00:00:00
abstract::This report describes a case of acquired eventration of a hemidiaphragm after insertion of a chest tube for treatment of an iatrogenic pneumothorax. Partial withdrawal of the chest tube resulted in immediate return of the hemidiaphragm to its original position. This is believed to be the first report of the resolution...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(95)70275-x
更新日期:1995-04-01 00:00:00
abstract:STUDY OBJECTIVE:The optimal ratio of chest compressions to ventilations during cardiopulmonary resuscitation (CPR) is unknown. We determine 24-hour survival and neurologic outcome, comparing 4 different chest compression-ventilation CPR ratios in a porcine model of prolonged cardiac arrest and bystander CPR. METHODS:F...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.129507
更新日期:2002-12-01 00:00:00
abstract::A prospective study was conducted in the emergency departments of two community hospitals to assess the accuracy of Doppler ultrasonography performed by emergency physicians in the evaluation of patients with symptoms suggestive of deep-vein thrombosis. Seventy-eight extremities in 76 patients were evaluated by both D...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82481-3
更新日期:1990-06-01 00:00:00
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
更新日期:2013-08-01 00:00:00
abstract::We describe the case of a 41-year-old man who suffered a bite to the tongue from the Western Diamondback rattlesnake (C atrox). Life-threatening obstruction of his upper airway secondary to massive edema of the tongue and other soft tissue structures quickly followed envenomation. Nasotracheal intubation, IV antivenin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80584-x
更新日期:1987-07-01 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::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
abstract::Extraordinary incidents resulting in airborne infectious disease outbreaks could produce patient isolation requirements that exceed most hospitals' capacity. This article investigates expedient methods to establish airborne infection isolation areas using a commercially available portable filtration unit and common ha...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.07.451
更新日期:2004-12-01 00:00:00
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
更新日期:2011-07-01 00:00:00
abstract::A seven-year-old boy ingested 3,000 mg (125 mg/kg) of isoniazid. Initial blood levels of isoniazid were 250 micrograms/mL approximately six hours after ingestion. Despite IV treatment in the emergency department with 3,000 mg pyridoxine and a repeat of the same antidote one hour later in the intensive care unit, the h...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80509-2
更新日期:1988-01-01 00:00:00
abstract:STUDY OBJECTIVE:We examine whether a specific educational effort reduces emergency department violence in the short term and quantify the amount of violence in the ED. METHODS:Cross-sectional prospective surveys were conducted at a tertiary referral center at baseline (1998) and at 3 and 6 months (1999) after the Prev...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.121202
更新日期:2002-01-01 00:00:00
abstract::Niacin (vitamin B3) is promoted for rapidly clearing the body of drugs of abuse, such as cocaine and cannabis, and is alleged to interfere with urine drug screening. We present 4 cases of such novel use associated with significant adverse effects. Two cases had isolated skin manifestations, whereas the other 2 present...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2007.01.014
更新日期:2007-11-01 00:00:00
abstract::A double-blind prospective study of 98 patients was carried out, but 57 (58%) returned for follow-up and form the basis of this report. Wound irrigation and debridement were found to be important in reducing infection. Hand wounds were most likely to become infected; face and scalp wounds were at low risk. Puncture wo...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(80)80153-3
更新日期:1980-08-01 00:00:00
abstract::We report the cases of two children with acute plastic fractures of the long bones following trauma. Bowing deformity was evident clinically and radiographically in both cases. The unique radiologic features consisted of absence of fracture lines and of periosteal new bone formation during the healing phase. The mecha...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80997-0
更新日期:1986-05-01 00:00:00
abstract::The prevalence of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in 232 sexual assault victims who presented for examinations between August 1, 1987, and July 31, 1988, was determined. Results are reported for cervical, rectal, and oropharyngeal NG cultures and for cervical and rectal CT smears. Results fro...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82197-3
更新日期:1990-05-01 00:00:00
abstract::Many of the approximately 400,000 deaths that occur outside of hospitals or chronic care facilities each year in the United States are not only expected but also welcomed as relief from terminal disease. However, patients who lack decision-making capacity cannot communicate to emergency medical services system and eme...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81309-5
更新日期:1993-11-01 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:STUDY OBJECTIVE:This study seeks to examine whether the finding of an abnormal estimated glomerular filtration rate (eGFR) in the emergency department (ED) was associated with acute coronary syndrome in the population of patients presenting for investigation of chest pain. METHODS:We used prospectively collected data ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2013.01.011
更新日期:2013-07-01 00:00:00
abstract::When the abdomen is compressed manually in counterpoint to the rhythm of chest compression, in the performance of interposed abdominal compression-CPR, artificial circulation is approximately doubled in animal experiments and in electronic models of the circulatory system. These studies suggest that external manual co...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80245-8
更新日期:1993-01-01 00:00:00