Abstract：
STUDY OBJECTIVE:To analyze the emergency medicine system in a developing country and identify areas of need and potential collaboration. DESIGN:Convenience sample surveys of all emergency visits over a 2-week period, hospital admission and health department statistics, and interviews with government officials, health providers, and EMS managers. SETTING:Port of Spain General Hospital, Trinidad and Tobago. RESULTS:The ED has more than 100,000 visits per year. No records are kept. No physician in this study had emergency medicine training; only one had completed any residency. The survey included 3,710 patients: 40.5% were admitted, and .3% died. Injuries accounted for 41.6% of all visits, asthma 7.8%. The mean time elapsed before a patient was seen was .5 hour; mean time to discharge, 1.9 hours. In only 9% of patients were laboratory tests performed. Prehospital providers had limited equipment and training. CONCLUSION:The ED and prehospital systems provide high-volume and often high-acuteness care. Barriers to improved care include limited specialized training and lack of medical records.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Kirsch TD,Hilwig WK,Holder Y,Smith GS,Pooran S,Edwards Rdoi
10.1016/s0196-0644(95)70087-0subject
Has Abstractpub_date
1995-09-01 00:00:00pages
361-7issue
3eissn
0196-0644issn
1097-6760pii
S0196-0644(95)70087-0journal_volume
26pub_type
评论,杂志文章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
更新日期：2006-08-01 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：:Presented is the case of a motor vehicle accident (MVA) victim with hypotension and evisceration of small intestine. Vigorous resuscitation in the emergency department was required, after which a portion of small bowel was resected at laparotomy. Evisceration secondary to trauma in an MVA is a rare injury. Significant...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80296-6
更新日期：1984-08-01 00:00:00
abstract：STUDY OBJECTIVES:To reappraise Boehler's angle and evaluate factors, including centering of the central beam, sex of subjects, and side of the body, that may affect angle measurement. DESIGN:Retrospective clinical review. SETTING:Emergency department, Level I trauma center. TYPE OF PARTICIPANTS:120 consecutive patie...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81206-5
更新日期：1991-02-01 00:00:00
abstract：:A 36-year-old man developed extreme shortness of breath after injecting "freebase" cocaine intravenously. Clinical and radiographic evaluation confirmed acute pulmonary edema, and blood gas studies substantiated acute respiratory failure. Despite vigorous therapy, the patient died three hours after admission. When coc...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80314-9
更新日期：1981-08-01 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：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
更新日期：1994-07-01 00:00:00
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 evaluate the safety and efficacy of a single dose of hyoscyamine sulfate in combination with ketorolac tromethamine for the reduction of pain in emergency department patients with ureteral colic. METHODS:We conducted a prospective, randomized, double-blind study at 2 EDs with residency programs in e...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1067/mem.2001.113133
更新日期：2001-02-01 00:00:00
abstract：STUDY OBJECTIVE:An increase in prescriptions for opioid pain medications has coincided with increasing opioid overdose deaths. Guidelines designed to optimize opioid prescriptions written in the emergency department have been implemented, with substantial controversy. Little is known about how physicians perceive and a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2014.03.015
更新日期：2014-11-01 00:00:00
abstract：:The use of electronic control devices has expanded worldwide during the last few years, the most widely used model being the Taser. However, the scientific knowledge about electronic control devices remains limited. We reviewed the medical literature to examine the potential implications of electronic devices in terms...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2011.01.023
更新日期：2011-08-01 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：:Situated in the heart of Europe, Switzerland's 7 million inhabitants, including 1 million foreigners, live in an area of 41,000 km2. German, French, Italian, and Rhaeto-Romanic are the official languages. The Swiss health service stands out because of the high quality and efficiency of its ambulatory and hospitalized ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70144-1
更新日期：1998-08-01 00:00:00
abstract：:Presented is a rationale for use of a new class of drugs, the iron chelating agents, in advanced cardiac life support (ACLS) to prevent late deaths and brain damage following successful cardiopulmonary resuscitation. The relevant biochemical hypothesis states that free iron ions, liberated from bound intracellular sto...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(85)80056-1
更新日期：1985-08-01 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：STUDY OBJECTIVE:Dabigatran is a reversible direct thrombin inhibitor recently approved for stroke prevention in patients with atrial fibrillation. An increasing number of patients receiving dabigatran present to the emergency department (ED) with bleeding complications. Unlike vitamin K antagonists, there are no accept...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.02.008
更新日期：2013-04-01 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：STUDY OBJECTIVES:To determine whether music significantly reduces the pain and anxiety associated with laceration repair in the emergency department. PARTICIPANTS AND SETTING:Adult patients presenting to the ED at an urban teaching hospital for laceration repair. Exclusion criteria included patients less than 18 years...
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)81652-x
更新日期：1991-04-01 00:00:00
abstract：:In response to public pressure for greater accountability from the medical profession, a transformation is occurring in the approach to medical education and assessment of physician competency. Over the past 5 years, the Accreditation Council for Graduate Medical Education (ACGME) has implemented the Outcomes and Gene...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/S0196064403013532
更新日期：2004-06-01 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: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：:The Trauma Score (TS) is a physiologic measure of injury severity that correlates with patient outcome. Application of the TS has shown that it is useful for patient triage, for predicting patient outcome, and as a means of normalizing for case mix when comparing prehospital care and transport modalities. Our study ex...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80917-3
更新日期：1985-11-01 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 estimate the occupational fatality rate among emergency medical services (EMS) personnel in the United States. METHODS:We undertook descriptive epidemiology of occupational fatalities among EMS providers. Analysis was conducted by using data from 3 independent fatality databases: the Census of Fatal...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.128681
更新日期：2002-12-01 00:00:00
abstract：:To evaluate the hypothesis that all victims of severe blunt trauma require a pelvic radiograph, we prospectively studied all such patients admitted to the Southern New Jersey Regional Trauma Center during a seven-month period. All patients were classified as unconscious; impaired; awake, alert, and symptomatic; or ale...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80244-0
更新日期：1988-05-01 00:00:00
abstract：STUDY OBJECTIVE:Publication bias compromises the validity of systematic reviews. This problem can be addressed in part through searching clinical trials registries to identify unpublished studies. This study aims to determine how often systematic reviews published in emergency medicine journals include clinical trials ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2014.10.001
更新日期：2015-10-01 00:00:00
abstract：:We present a case of lethal ingestion of pyrimidifen, a new insecticide with an unclear mode of action. The primary manifestations were coma and circulatory shock, leading to irreversible multiorgan failure. Pyrimidifen was detected in the patient's blood, urine, brain tissue, and gastric content samples. Minimal stru...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2003.260
更新日期：2003-08-01 00:00:00
abstract：:OxyContin (oxycodone hydrochloride controlled release) is a long-acting preparation of oxycodone that is used as an opioid analgesic to treat chronic pain conditions. We report a patient who ingested a massive quantity of OxyContin and had altered mental status, noncardiogenic pulmonary edema, and hypoventilation that...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.128143
更新日期：2002-10-01 00:00:00
abstract：STUDY OBJECTIVES:To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN:A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70238-1
更新日期：1994-12-01 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
