Effect of a treatment protocol on the efficiency of care of the adult acute asthmatic.

Abstract:

:A treatment protocol for patients with acute bronchospasm was introduced to an adult emergency department in an attempt to decrease treatment time and potentially decrease need for admission. The charts of all patients seen in a control year (before any protocol was in place) and the first three years of the protocol were reviewed. All care was given by medical housestaff. The first year after the protocol was introduced showed no change in either admission rate or stay in the ED. During this time, however, the protocol was used only 33% of the time. In the following two years, the protocol was used 93% of the time, and the admission rate decreased from 36.4% to 23.3% (P less than .02). The length of stay for all patients seen fell from a mean of 3.6 hours to 2.8 hours (P less than .005). The length of stay for those discharged fell from an average of 4.3 hours to 3.6 hours (P less than .02). Among the patients admitted, there was also a less striking but similar decrease from 3.0 hours to 2.4 hours. An organized treatment protocol was effective in increasing the efficiency of care given by the housestaff. The routine use of the protocol was not immediate and required time for acceptance by the housestaff.

journal_name

Ann Emerg Med

authors

Schneider SM

doi

10.1016/s0196-0644(86)80429-2

subject

Has Abstract

pub_date

1986-06-01 00:00:00

pages

703-6

issue

6

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(86)80429-2

journal_volume

15

pub_type

杂志文章
  • Lumbar spine x-rays: a multihospital study.

    abstract::To define the usefulness of the lumbar spine x-ray series in the emergency department and to generate clinical criteria for optimizing its application, we retrospectively studied 552 consecutive emergency department patients for whom lumbar spine x-rays were ordered. Patients were divided into traumatic (47.6%) and no...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(83)80378-3

    authors: Patrick JD,Doris PE,Mills ML,Friedman J,Johnston C

    更新日期:1983-02-01 00:00:00

  • Intravenous morphine plus ketorolac is superior to either drug alone for treatment of acute renal colic.

    abstract:STUDY OBJECTIVE:To study the efficacy of intravenous ketorolac, morphine, and both drugs in combination in reducing pain in acute renal colic. METHODS:We conducted a prospective, double-blinded, randomized controlled trial in an urban, teaching emergency department. Patients aged 18 to 55 years and with a clinical dia...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.annemergmed.2006.03.013

    authors: Safdar B,Degutis LC,Landry K,Vedere SR,Moscovitz HC,D'Onofrio G

    更新日期:2006-08-01 00:00:00

  • Effect of magnesium sulfate on ventricular rate control in atrial fibrillation.

    abstract:STUDY OBJECTIVES:The objectives of this study were to assess the efficacy of parenteral magnesium sulfate (MgSO4), digoxin, and combined MgSO4-digoxin therapies in acutely lowering ventricular rates in patients with newly recognized atrial fibrillation. DESIGN:A randomized, double-blinded, placebo-controlled clinical ...

    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(94)70163-6

    authors: Hays JV,Gilman JK,Rubal BJ

    更新日期:1994-07-01 00:00:00

  • Insurance Status and Access to Urgent Primary Care Follow-up After an Emergency Department Visit in 2016.

    abstract:STUDY OBJECTIVE:We examine the availability of follow-up appointments for emergency department (ED) patients without established primary care by insurance and clinical condition. METHODS:We used "secret shopper" methodology, employing 2 black men to telephone all 53 primary care practices in greater New Haven, posing ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2017.08.045

    authors: Chou SC,Deng Y,Smart J,Parwani V,Bernstein SL,Venkatesh AK

    更新日期:2018-04-01 00:00:00

  • Emergency department thoracotomy.

    abstract::Emergency thoracotomy has become a mainstay in the resuscitation of patients with major thoracic injuries. It also is occasionally useful in several other life-threatening conditions. The specific indications for emergency thoracotomy are reviewed, and expeditious thoracotomy in the emergency department, when necessar...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(81)80057-1

    authors: Hoffman JR

    更新日期:1981-05-01 00:00:00

  • The use of antiarrhythmics in advanced cardiac life support.

    abstract::Antiarrhythmic agents have been used to treat malignant ventricular arrhythmias in the setting of acute myocardial ischemia with proven efficacy for many years. Thus, it has been presumed that these agents would be efficacious for the treatment of cardiac arrest. Unfortunately, hard data supporting this contention are...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:10.1016/s0196-0644(05)80461-5

    authors: Jaffe AS

    更新日期:1993-02-01 00:00:00

  • Prospective, randomized trial of epinephrine, metaproterenol, and both in the prehospital treatment of asthma in the adult patient.

    abstract:STUDY OBJECTIVE:To compare the effectiveness and incidence of adverse reactions with three treatment regimens for asthma in adults in the prehospital setting. DESIGN:Prospective, randomized clinical study. SETTING:Inner-city emergency medical service system providing basic and advanced life support and transport to 1...

    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(95)70116-8

    authors: Quadrel M,Lavery RF,Jaker M,Atkin S,Tortella BJ,Cody RP

    更新日期:1995-10-01 00:00:00

  • Rapid endovascular warming for profound hypothermia.

    abstract::Profound hypothermia is associated with high mortality and morbidity. Optimal outcomes have been reported with invasive extracorporeal warming techniques not readily available in most hospitals. Endovascular warming devices may provide a less invasive alternative. A 68-year-old woman developed profound hypothermia aft...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2007.05.020

    authors: Laniewicz M,Lyn-Kew K,Silbergleit R

    更新日期:2008-02-01 00:00:00

  • Massive, fatal, intracardiac thrombosis associated with prothrombin complex concentrate.

    abstract::Prothrombin complex concentrates are frequently used to rapidly reverse anticoagulation with vitamin K antagonists associated with life-threatening bleeding. We report a patient receiving warfarin who presented to the emergency department with an international normalization ratio greater than 12.8 in cardiac tamponade...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2008.12.027

    authors: Warren O,Simon B

    更新日期:2009-06-01 00:00:00

  • Ultrasonographic confirmation of intraosseous needle placement in an adult unembalmed cadaver model.

    abstract:STUDY OBJECTIVE:Intraosseous access is widely used in pediatric and adult resuscitations when vascular access cannot be promptly established. Confirmation of intraosseous needle placement has traditionally relied on the ability to aspirate blood or marrow or infuse crystalloid easily. This study's aim is to determine t...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2006.11.009

    authors: Stone MB,Teismann NA,Wang R

    更新日期:2007-04-01 00:00:00

  • Predicting Progression to Septic Shock in the Emergency Department Using an Externally Generalizable Machine-Learning Algorithm.

    abstract:STUDY OBJECTIVE:Machine-learning algorithms allow improved prediction of sepsis syndromes in the emergency department (ED), using data from electronic medical records. Transfer learning, a new subfield of machine learning, allows generalizability of an algorithm across clinical sites. We aim to validate the Artificial ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2020.11.007

    authors: Wardi G,Carlile M,Holder A,Shashikumar S,Hayden SR,Nemati S

    更新日期:2021-01-15 00:00:00

  • Does screening in the emergency department hurt or help victims of intimate partner violence?

    abstract:STUDY OBJECTIVE:Recent systematic reviews have noted a lack of evidence that screening for intimate partner violence does more good than harm. We assess whether patients screened for intimate partner violence on a computer kiosk in the emergency department (ED) experienced any adverse events during or subsequent to the...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2007.11.019

    authors: Houry D,Kaslow NJ,Kemball RS,McNutt LA,Cerulli C,Straus H,Rosenberg E,Lu C,Rhodes KV

    更新日期:2008-04-01 00:00:00

  • A comprehensive view of parental satisfaction with pediatric emergency department visits.

    abstract:STUDY OBJECTIVE:We develop a comprehensive view of aspects of care associated with parental satisfaction with pediatric emergency department (ED) visits, using both quantitative and qualitative data. METHODS:This was a retrospective observational study using data from an institution-wide system to measure patient sati...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2013.04.025

    authors: Byczkowski TL,Fitzgerald M,Kennebeck S,Vaughn L,Myers K,Kachelmeyer A,Timm N

    更新日期:2013-10-01 00:00:00

  • Emergency medicine and police collaboration to prevent community violence.

    abstract::An important responsibility of emergency departments is the management of injuries sustained in assaults. Most assaults, including many causing serious injury, are not reported and not recorded by the police. This is important because police investigation and the conviction of offenders has a substantial deterrent eff...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1067/mem.2001.114317

    authors: Shepherd JP

    更新日期:2001-10-01 00:00:00

  • Two separate unintentional fatalities with the same revolver.

    abstract::We report 2 deaths and 1 injury that resulted from 2 separate unintentional discharges of the same Ruger Blackhawk revolver. One discharge was a consequence of careless firearm handling combined with a slip during a decocking procedure unique to certain hammer-action firearms. The second discharge occurred when the fi...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2001.112251

    authors: Lee C,Nolte KB

    更新日期:2001-03-01 00:00:00

  • Abdominal compressions increase vital organ perfusion during CPR in dogs: relation with efficacy of thoracic compressions.

    abstract:STUDY OBJECTIVE:Abdominal compressions can be interposed between the thoracic compressions of standard CPR (SCPR). The resulting interposed abdominal compression CPR (IAC-CPR) may increase blood pressures and patient survival, particularly if applied as a primary technique after in-hospital cardiac arrest. We used a pr...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(95)70298-9

    authors: Hoekstra OS,van Lambalgen AA,Groeneveld AB,van den Bos GC,Thijs LG

    更新日期:1995-03-01 00:00:00

  • Elevated Toxoplasma IgG antibody in patients tested for infectious mononucleosis in an urban emergency department.

    abstract::There are many infectious causes of fatigue, sore throat, and fever, including mononucleosis and toxoplasmosis. Toxoplasma antibody testing is rarely performed in most emergency departments; as a result, toxoplasmosis is diagnosed infrequently. We obtained Toxoplasma IgG IFA titers on ED patients who had mononucleosis...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(89)80575-x

    authors: Sayre MR,Jehle D

    更新日期:1989-04-01 00:00:00

  • A randomized trial of intravenous ketorolac versus intravenous metoclopramide plus diphenhydramine for tension-type and all nonmigraine, noncluster recurrent headaches.

    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

    authors: Friedman BW,Adewunmi V,Campbell C,Solorzano C,Esses D,Bijur PE,Gallagher EJ

    更新日期:2013-10-01 00:00:00

  • Medical counterbioterrorism: the response to provide anthrax prophylaxis to New York City US Postal Service employees.

    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

    authors: Partridge R,Alexander J,Lawrence T,Suner S

    更新日期:2003-04-01 00:00:00

  • Management of a vaginal foreign body.

    abstract::A case is presented of a vaginal foreign body. A drinking glass was inserted in the vagina of an intoxicated patient by her irate lover. Infection followed. The emergency care is described, including the method of extraction of the object, along with discussion of the principles involved and associated complications. ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(81)80287-9

    authors: Kurzel RB,Chaudhuri G,Hall D

    更新日期:1981-09-01 00:00:00

  • Overwhelming postsplenectomy infection.

    abstract::A characteristic case of overwhelming postsplenectomy infection in a previously healthy, 25-year-old man is presented. The patient progressed from influenza-like symptoms to irreversible septic shock and death within 24 hours. His spleen had been removed nine years earlier because of abdominal trauma. Aggressive thera...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(88)80304-4

    authors: Stryker RM,Orton DW

    更新日期:1988-02-01 00:00:00

  • Adenosine in the treatment of paroxysmal supraventricular tachycardia in children.

    abstract::Intravenous bolus adenosine was given to four pediatric patients aged 1 month to 8 years who had paroxysmal supraventricular tachycardia that had not responded to conventional medical therapy. Adenosine (one to three doses) was successful in converting the arrhythmia to normal sinus rhythm in all four cases, and no si...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)80069-1

    authors: Reyes G,Stanton R,Galvis AG

    更新日期:1992-12-01 00:00:00

  • Comparative Effectiveness of Patient-Controlled Analgesia for Treating Acute Pain in the Emergency Department.

    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

    authors: Bijur PE,Mills AM,Chang AK,White D,Restivo A,Persaud S,Schechter CB,Gallagher EJ,Birnbaum AJ

    更新日期:2017-12-01 00:00:00

  • Identifying children at very low risk of clinically important blunt abdominal injuries.

    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

    authors: Holmes JF,Lillis K,Monroe D,Borgialli D,Kerrey BT,Mahajan P,Adelgais K,Ellison AM,Yen K,Atabaki S,Menaker J,Bonsu B,Quayle KS,Garcia M,Rogers A,Blumberg S,Lee L,Tunik M,Kooistra J,Kwok M,Cook LJ,Dean JM,Sokolo

    更新日期:2013-08-01 00:00:00

  • Resuscitation skills of lay public after recent training.

    abstract:STUDY OBJECTIVE:To investigate the ability of laypeople to apply basic CPR techniques after recent training. DESIGN:Cross-sectional assessment of practical CPR skills. TYPE OF PARTICIPANTS:151 laypeople who were trained twice in the preceding 20 to 24 months. MEASUREMENTS AND MAIN RESULTS:Practical skills were teste...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(94)70094-x

    authors: Berden HJ,Bierens JJ,Willems FF,Hendrick JM,Pijls NH,Knape JT

    更新日期:1994-05-01 00:00:00

  • Adverse Effects of Immune Checkpoint Therapy in Cancer Patients Visiting the Emergency Department of a Comprehensive Cancer Center.

    abstract:STUDY OBJECTIVE:Cancer immunotherapy is evolving rapidly and is transforming cancer care. During the last decade, immune checkpoint therapies have been developed to enhance the immune response; however, specific adverse effects related to autoimmunity are increasingly apparent. This study aims to fill the knowledge gap...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2018.04.019

    authors: El Majzoub I,Qdaisat A,Thein KZ,Win MA,Han MM,Jacobson K,Chaftari PS,Prejean M,Reyes-Gibby C,Yeung SJ

    更新日期:2019-01-01 00:00:00

  • Typing and screening of blood from intraosseous access.

    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

    authors: Brickman KR,Krupp K,Rega P,Alexander J,Guinness M

    更新日期:1992-04-01 00:00:00

  • A simplified prehospital advance directive law: Arizona's approach.

    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

    authors: Iserson KV

    更新日期:1993-11-01 00:00:00

  • Homicide and suicide risks associated with firearms in the home: a national case-control study.

    abstract:STUDY OBJECTIVE:I test the hypothesis that having a gun in the home is a risk factor for adults to be killed (homicide) or to commit suicide. METHODS:Two case-control analyses were based on national samples of subjects 18 years of age or older. Homicide and suicide case subjects were drawn from the 1993 National Morta...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2003.187

    authors: Wiebe DJ

    更新日期:2003-06-01 00:00:00

  • Quick SOFA Scores Predict Mortality in Adult Emergency Department Patients With and Without Suspected Infection.

    abstract:STUDY OBJECTIVE:The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2016.10.007

    authors: Singer AJ,Ng J,Thode HC Jr,Spiegel R,Weingart S

    更新日期:2017-04-01 00:00:00