Abstract：
STUDY OBJECTIVE:To determine compliance with advanced cardiac life support (ACLS) guidelines among ACLS-certified and non-ACLS-certified physicians. DESIGN:Retrospective review of consecutive cardiac arrests between July 1989 and June 1990, including assessment of the resuscitation leaders' ACLS certification. SETTING AND PARTICIPANTS:All nontraumatic prehospital and hospital cardiac arrests in a rural university hospital. RESULTS:Two hundred seven arrests were studied for a total of 436 rhythms with a maximum of 4 rhythms per arrest. There were 78 resuscitations (36.3%) with return of spontaneous circulation. A total of 2,038 interventions were recorded for all rhythms, with 1,320 (64.8%) compliant with ACLS guidelines compared with 718 (35.2%) deviations. Synchronized cardioversion, calcium chloride and sodium bicarbonate were used with significantly higher noncompliance. Ventricular fibrillation had significantly higher mean rhythm deviation scores, whereas scores were significantly lower for sinus rhythm and stable bradycardia (P < .003). Resuscitations led by ACLS-certified and non-ACLS-certified physicians were compared for mean number of deviations per resuscitation attempt, and no differences were found. Resuscitations with return of spontaneous circulation were compared with unsuccessful resuscitations, and there was no difference between groups in controlled deviation scores. No differences could be found between ACLS-certified and non-ACLS-certified physicians for return of spontaneous circulation and survival-to-discharge rates. CONCLUSION:Despite biannual ACLS training of all medical residents and ICU nurses, noncompliance with ACLS guidelines was noted in 35.2% of treatments. We found no correlation between ACLS certification and ACLS guideline compliance.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Cline DM,Welch KJ,Cline LS,Brown CKdoi
10.1016/s0196-0644(95)70355-1subject
Has Abstractpub_date
1995-01-01 00:00:00pages
52-7issue
1eissn
0196-0644issn
1097-6760pii
S0196-0644(95)70355-1journal_volume
25pub_type
杂志文章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：STUDY OBJECTIVE:To evaluate the ability of emergency medical technician-paramedic (EMT-P) units to become and remain proficient in the performance of the intraosseous infusion procedure. DESIGN AND SETTING:Descriptive nonrandomized trial open to all patients meeting protocol criteria over a five-year period; prehospit...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80975-8
更新日期：1993-07-01 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：:Drinking increases motor vehicle crash likelihood starting at blood alcohol levels as low as .02 mmol/L. Clinical experience tells us that drunken drivers "cycle through" the system many times, presenting opportunities for intervention. We describe the drunken driver's risk of occurrence at each juncture in the cycle ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(95)70148-6
更新日期：1995-08-01 00:00:00
abstract：:The foundation of safe care for patients with confirmed or suspected Ebola virus disease is effective infection control practice, which requires implementation of appropriate administrative policies, work practices, and environmental controls, accompanied by focused education, training, and supervision. In 2002, Emory...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2015.04.008
更新日期：2015-09-01 00:00:00
abstract：:Survival after out-of-hospital cardiac arrest is intimately related to the time from cardiovascular collapse to the initiation of CPR, or downtime. Furthermore, the reperfusion technique that optimizes coronary and cerebral blood flow after cardiac arrest may also be dependent on downtime. Peak blood lactate levels ha...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80408-0
更新日期：1987-12-01 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：: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：:The insurance market is evolving, with increased emphasis on plans with high deductibles and a large degree of coinsurance. This article serves as an introduction to the defining characteristics of consumer-driven health care plans and their associated health savings accounts. We discuss the most recent evidence on th...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2005.05.013
更新日期：2005-12-01 00:00:00
abstract：:Acoustic otoscopy detects middle ear pathology by measuring the ability of the tympanic membrane to reflect sound. Fluid or thickening of the tympanic membrane increases sound reflection. We conducted a study to compare acoustic otoscopy with pneumatic otoscopy in identifying middle ear pathology in 80 children (160 e...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/s0196-0644(89)80578-5
更新日期：1989-04-01 00:00:00
abstract：STUDY OBJECTIVE:The accurate diagnosis of influenza remains a diagnostic dilemma. We examine the performance of various strategies for diagnosing influenza infection in an unselected sample of adults during influenza season. METHODS:Consecutive adults presenting to a university emergency department or urgent care clin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2005.05.020
更新日期：2005-11-01 00:00:00
abstract：:A method is presented for reviewing the taped radio-telemetry records of paramedic calls managed by hospital-based emergency medicine residents. All paramedic calls to the LAC/USC base station are reviewed by an emergency medicine resident using a special tape review form which focuses on communication skills, initial...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80458-1
更新日期：1981-01-01 00:00:00
abstract：STUDY OBJECTIVE:We sought to determine whether working 5 serial night shifts in the emergency department results in a decline in physician performance as measured with an intelligence test. METHODS:This study compared the cognitive functioning of emergency physicians who worked the day shift (7 AM to 5 pm) with those ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.116024
更新日期：2001-08-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the clinical efficacy and safety of IV adenosine administration in the field for the treatment of paroxysmal supraventricular tachycardia (PSVT). DESIGN:Prospective, consecutive case series. SETTING:An urban emergency medical services system. PARTICIPANTS:Thirty-seven adult patients in w...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82650-2
更新日期：1992-04-01 00:00:00
abstract：:This clinical policy from the American College of Emergency Physicians addresses key issues in opioid management in adult patients presenting to the emergency department. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical que...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,实务指引
doi：10.1016/j.annemergmed.2020.06.049
更新日期：2020-09-01 00:00:00
abstract：STUDY OBJECTIVE:Midazolam is widely used for procedural sedation and analgesia. Etomidate has been studied mostly in adults. Our objective is to compare the efficacy of etomidate and midazolam for achieving procedural sedation and analgesia in children. METHODS:A randomized, double-blind, emergency department and orth...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2006.03.004
更新日期：2006-10-01 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：STUDY OBJECTIVES:To confirm the ability of the esophageal detector device (EDD) to indicate positioning of endotracheal tubes (ETTs) in patients intubated under emergency conditions and to compare the performance of the EDD with that of end-tidal carbon dioxide (ETCO2). METHODS:This single-subject study comprising a p...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/s0196-0644(96)70162-2
更新日期：1996-05-01 00:00:00
abstract：:Severe sepsis and septic shock are as common and lethal as other acute life-threatening conditions that emergency physicians routinely confront such as acute myocardial infarction, stroke, and trauma. Recent studies have led to a better understanding of the pathogenic mechanisms and the development of new or newly app...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2006.02.015
更新日期：2006-07-01 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：:Incarcerated rectal prolapse is a potential surgical emergency. We report a case in which a simple but effective technique involving the desiccating effect of granulated sugar (sucrose) was used to aid the manual reduction of prolapsed but viable rectal tissue. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70174-4
更新日期：1997-09-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the potential for cardiovascular toxicity from severe oral phenytoin overdose. STUDY POPULATION:Fifty-seven patients admitted during a two-year period to an inner-city hospital for severe oral phenytoin overdose, which is defined as a peak level of 40 micrograms/mL or more. METHODS:Case re...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81604-x
更新日期：1991-05-01 00:00:00
abstract：STUDY OBJECTIVE:Serum markers of smooth muscle destruction have been shown to be elevated in ectopic pregnancy, but they remain of questionable clinical utility. Our goal was to determine the clinical utility of 3 markers of smooth muscle destruction: creatine phosphokinase (CPK), smooth muscle heavy-chain myosin (SMHC...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.119851
更新日期：2001-12-01 00:00:00
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
更新日期：2003-06-01 00:00:00
abstract：STUDY OBJECTIVE:To identify the arterial and mixed venous blood gas changes caused by different ventilatory strategies during resuscitation from ventricular fibrillation in a pig model of closed-chest cardiac compression. METHODS:A prospective randomized animal study was performed using 27 domestic pigs (body weight, ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70203-3
更新日期：1998-05-01 00:00:00
abstract：STUDY HYPOTHESIS:The clinical features of children treated with oral antibiotics before the diagnosis of bacterial meningitis differ from those who receive no antibiotics. DESIGN:Retrospective case series. SETTING:University medical center. PARTICIPANTS:Two hundred fifty-eight children 24 months old or younger with ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80149-0
更新日期：1992-02-01 00:00:00
abstract：STUDY OBJECTIVE:We sought to evaluate the methods and accuracy of mortality data collection and summarize the injury mortality rate in one sector of the State of Olancho, Honduras, with the intent to establish a baseline of injury mortality that will identify potential areas of intervention and serve as a comparison af...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2000.109444
更新日期：2000-10-01 00:00:00
abstract：STUDY OBJECTIVE:To compare the efficacy of a novel antidote, insulin, with standard treatments, glucagon and epinephrine, in a canine model of acute beta-blocker toxicity. METHODS:Anesthetized dogs were fitted with instruments by means of thoracotomy and vascular cutdown for multiple cardiodynamic, hemodynamic, metabo...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70196-3
更新日期：1997-06-01 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：:A patient with primary axillary vein thrombosis was treated successfully in the emergency department with a single IV bolus of anistrepalase followed by continuous IV heparin. The patient's symptoms resolved quickly, and a repeat venogram 16 hours later showed near-complete resolution of the venous obstruction. We dis...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81863-3
更新日期：1993-04-01 00:00:00
