Abstract:
STUDY OBJECTIVE:To assess the need for cranial computed tomography (CT) in the emergency department evaluation of children with Glasgow Coma Scale (GCS) score of 15 after mild head injury with loss of consciousness. DESIGN:Retrospective case series of children aged 2 to 17 years with documented loss of consciousness after head injury from January 1, 1988, to July 31, 1992. All had a GCS score of 15 on initial ED evaluation and were further categorized according to physical examination findings, neurologic status, and whether the head injury was isolated or nonisolated. Recursive partitioning was used to identify variables predictive of the presence and absence of intracranial hemorrhage. SETTING:ED in two settings: a regional tertiary care trauma center and a community children's hospital. RESULTS:Of the 185 patients who met study criteria, 17 had evidence of depressed or basilar skull fractures on physical examination or had a ventriculoperitoneal shunt in place before head injury. In the remaining 168 patients, recursive partitioning identified two variables (neurologic status and head injury type) associated with intracranial hemorrhage. Overall, 12 of 168 patients (7%) had intracranial bleeding. However, none of the 49 neurologically normal children with isolated head injury had intracranial hemorrhage (95% confidence interval, 0.0 to 6.0). CONCLUSION:The prevalence of intracranial hemorrhage in children with mild closed-head injury appears to vary with the presence of neurologic abnormalities and other noncranial injuries. After isolated head injury with loss of consciousness, children older than 2 years who are neurologically normal and without signs of depressed or basilar skull fracture may be discharged home from the ED without a cranial CT scan after careful physical examination alone.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Davis RL,Mullen N,Makela M,Taylor JA,Cohen W,Rivara FPdoi
10.1016/s0196-0644(94)70273-xsubject
Has Abstractpub_date
1994-10-01 00:00:00pages
640-5issue
4eissn
0196-0644issn
1097-6760pii
S019606449400185Xjournal_volume
24pub_type
杂志文章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 This problem can be addressed in part through searching clinical trials registries to identify unpublished studies.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
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doi:10.1016/j.annemergmed.2014.10.001
更新日期:2015-10-01 00:00:00
abstract::Ethanol disrupts the physical structure of cell membranes. The most fluid membranes, including those that are low in cholesterol, are the most easily disordered by ethanol. Although the membrane-disordering effect is small, there is pharmacological, temporal, and genetic evidence that it is important. Animals that are...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
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更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:We examine the central venous catheter placement rate during the implementation of an ultrasound-guided peripheral intravenous access program. METHODS:We conducted a time-series analysis of the monthly central venous catheter rate among adult emergency department (ED) patients in an academic urban ED b...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2012.09.016
更新日期:2013-02-01 00:00:00
abstract::We have developed a new method of implementing a transcribed emergency record at minimum cost. Dictated emergency records are typed immediately by a transcriber located in the emergency department. This member of the medical record transcriber pool is given other non-urgent medical record material to type when there a...
journal_title:Annals of emergency medicine
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更新日期:1983-09-01 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
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doi:10.1067/s0196-0644(03)00388-3
更新日期:2003-10-01 00:00:00
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journal_title:Annals of emergency medicine
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doi:10.1016/j.annemergmed.2007.08.003
更新日期:2007-11-01 00:00:00
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doi:10.1016/j.annemergmed.2008.05.007
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journal_title:Annals of emergency medicine
pub_type: 评论,杂志文章
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更新日期:2009-11-01 00:00:00
abstract::The resuscitation of a patient with failure of a permanent artificial pacemaker is described. A mechanically inactive heart showed a variety of ineffective rhythms, and dissociation could not be overcome by drug therapy. The urgent need for artificial pacing presented problems that eventually were overcome. The time r...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)81036-2
更新日期:1985-12-01 00:00:00
abstract:STUDY OBJECTIVE:It is often taught that acetaminophen-induced liver dysfunction occurs only after a latent period of 24 to 48 hours. This study was designed to evaluate the temporal profile of transaminase levels in patients with acetaminophen-induced hepatotoxicity. DESIGN:Prospective data collection using standard p...
journal_title:Annals of emergency medicine
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doi:10.1016/s0196-0644(95)70237-7
更新日期:1995-07-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2018.02.022
更新日期:2018-07-01 00:00:00
abstract::Spontaneous rupture of utero-ovarian vessels during pregnancy is a rare cause of maternal and fetal loss. We report the case of a 30-year-old woman who presented to the emergency department in her third trimester with frank maternal shock. The prompt recognition of shock, correction of hypovolemia, and rapid surgical ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70052-4
更新日期:1994-02-01 00:00:00
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doi:10.1016/j.annemergmed.2020.06.048
更新日期:2020-08-14 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.annemergmed.2012.01.020
更新日期:2012-10-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80464-8
更新日期:1983-06-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate the importance of hospital bed occupancy for 30-day mortality, inhospital mortality, readmission for inpatient care within 30 days, and revisits to the emergency department (ED) within 7 days among all adult patients visiting the ED. METHODS:This was an observational cohort study including ...
journal_title:Annals of emergency medicine
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doi:10.1016/j.annemergmed.2019.11.009
更新日期:2020-08-01 00:00:00
abstract::A major earthquake devastated the Armenian Republic of the Soviet Union on December 7, 1988, resulting in thousands of deaths and injuries. In a postearthquake investigation of three towns seriously affected by the earthquake, we studied earthquake-related injury patterns, made observations on rescue and medical effor...
journal_title:Annals of emergency medicine
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更新日期:1990-08-01 00:00:00
abstract:STUDY OBJECTIVE:We assess the utility of the peripheral blood WBC count as a screen for lumbar puncture among young infants evaluated for serious bacterial infections. METHODS:We performed logistic regression modeling and receiver operating characteristic curve analysis of peripheral blood WBC count and cerebrospinal ...
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pub_type: 杂志文章
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journal_title:Annals of emergency medicine
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更新日期:2006-06-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
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更新日期:1994-09-01 00:00:00
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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
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.04.019
更新日期:2015-01-01 00:00:00
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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::Injury severity determination serves multiple purposes in trauma care systems by aiding prehospital triage, assisting clinical management, and facilitating outcome evaluation. Numerous authors have described methods for quantifying injury severity, most of which use physiologic status or anatomic injury. For prehospit...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(86)80936-2
更新日期:1986-12-01 00:00:00
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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
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.08.025
更新日期:2006-01-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80571-5
更新日期:1984-02-01 00:00:00