Abstract：
STUDY OBJECTIVE:To determine if there is a significant prevalence of drug or alcohol use among adolescents evaluated for significant acute trauma. DESIGN:A prospective, age-matched controlled study over a 20-month period. SETTING:Urban pediatric emergency department in a Level I pediatric trauma center. PARTICIPANTS:Patients between 13 and 19 years of age requiring admission to the trauma service following evaluation in a pediatric ED and an age-matched control group of asthmatic patients. RESULTS:A total of 134 patients (mean age, 14.8 years) were admitted for trauma-related injuries, and 22 of 65 (34%) were positive for alcohol or drugs of abuse. The mean age of patients with a positive toxicology screen was 15.4 years. Most commonly detected drugs were alcohol (eight), benzodiazepines (eight), cocaine (five), and cannabinoids (four). The number of positive screens in the trauma group (22 of 65) was significantly higher than controls (one of 49) (P < .001). This remained statistically significant even when those trauma patients not screened were assumed to have a negative toxicology screen (22 of 134 versus one of 49) (P < .01). There was also a significantly higher number of positive toxicology screens among adolescents with an intentional versus unintentional mechanism of injury (21 of 71 versus one of 63) (P < .001). CONCLUSION:A significant number of adolescents admitted to the hospital for trauma-related injuries have a toxicology screen positive for alcohol or drugs of abuse. A toxicology screen should be a standard laboratory test in adolescents involved in significant trauma, especially if the mechanism was intentional.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Loiselle JM,Baker MD,Templeton JM Jr,Schwartz G,Drott Hdoi
10.1016/s0196-0644(05)81253-3subject
Has Abstractpub_date
1993-10-01 00:00:00pages
1530-4issue
10eissn
0196-0644issn
1097-6760pii
S0196-0644(05)81253-3journal_volume
22pub_type
杂志文章abstract：STUDY OBJECTIVE:Recent studies have demonstrated that a single episode of acute kidney injury from a number of causes can increase the risk of severe long-term outcomes, including major cardiovascular events and death. We tested the hypothesis that patients who develop acute kidney injury consistent with contrast-induc...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2015.04.028
更新日期：2015-09-01 00:00:00
abstract：:The Prehospital Index (PHI) is a triage-oriented trauma severity scoring system comprising four components: systolic blood pressure, pulse, respiratory status, and level of consciousness, each scored 0 to 5. The PHI was developed after analysis of 313 cases to provide an objective prehospital scoring system for distin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80016-6
更新日期：1986-02-01 00:00:00
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
更新日期：1992-04-01 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：STUDY OBJECTIVE:Medication history is an essential part of patient assessment in emergency care. Patient-reported medication history can be incomplete. We study whether an electronic pharmacy-sourced prescription record can supplement the patient-reported history. METHODS:In a community hospital, we compared the patie...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.04.014
更新日期：2013-09-01 00:00:00
abstract：:Reported are two cases of metallic constricting devices presenting to our emergency department. A 40-year-old man was unable to remove a steel ring from his engorged penile shaft after autostimulation, and a 22-year-old man riveted a metallic nut onto his right index finger proximal to his distal interphalangeal joint...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(82)80368-5
更新日期：1982-07-01 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
abstract：STUDY OBJECTIVES:To compare diagnostic strategies for the emergency assessment of patients with suspected acute thoracic aortic dissection and to measure the effect of delays related to the availability of these tests on the selection of the most appropriate one. METHODS:We carried out a decision analysis representing...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(96)70026-4
更新日期：1996-09-01 00:00:00
abstract：:We describe a case series of emergency department (ED) visits for intoxication related to the use of the caffeinated alcoholic beverage Four Loko. Medical records from the 4-month period July to November 2010 were hand searched for key words such as "intoxicated," "caffeinated," "Four Loko," "alcohol," and "EtOH." Pat...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.06.015
更新日期：2012-01-01 00:00:00
abstract：:The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in red...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.10.018
更新日期：2012-07-01 00:00:00
abstract：STUDY OBJECTIVE:Previous studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a...
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：: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
更新日期：1989-04-01 00:00:00
abstract：STUDY OBJECTIVES:To survey faculty attrition in emergency medicine and compare it with faculty attrition in the specialties of orthopedic surgery and cardiology. DESIGN:Chairmen of the three departments were surveyed regarding faculty attrition, work hours, and motivation for leaving. Those emergency physicians having...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81110-2
更新日期：1991-01-01 00:00:00
abstract：:During the evaluation of a victim of a motor vehicle accident, routine radiographs of the patient's cervical spine, chest, and pelvis revealed multiple radiopaque foreign bodies along his posterior neck, chest, abdomen, and pelvis. Repeat examination of the patient disclosed no evidence of foreign bodies. Further ques...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82986-5
更新日期：1991-09-01 00:00:00
abstract：:While advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) courses have become accepted standards for physicians who care for the critically ill and injured patient, only recently have pediatric advanced life support (PALS) courses been developed. The American Academy of Pediatrics has shown re...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80067-0
更新日期：1984-11-01 00:00:00
abstract：:The use of the emergency IV contrast-enhanced abdominal computed tomography (CT) scanning was evaluated in 90 pediatric patients sustaining blunt abdominal trauma. Medical records, CT scans, and operative and postmortem reports, when applicable, were reviewed retrospectively. By identifying the organs of injury, CT sc...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80611-5
更新日期：1988-07-01 00:00:00
abstract：STUDY OBJECTIVE:Studies of travel-related mortality and morbidity have been limited to nonfatal events. Causes of travel-related mortality may differ significantly from morbidity and thus have different prevention strategies. DESIGN:We examined the overseas fatalities of US citizen travelers for the years 1975 and 198...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82379-0
更新日期：1991-06-01 00:00:00
abstract：STUDY OBJECTIVE:Although adjunctive intravenous bicarbonate therapy is commonly recommended for children with severe diabetic ketoacidosis (DKA), no studies assessing clinical outcome with this therapy have ever been performed. Our objective was to determine whether bicarbonate therapy influenced outcome for pediatric ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(98)70279-3
更新日期：1998-01-01 00:00:00
abstract：:We examined the hemodynamic effects of congesting cuffs (rotating tourniquets) in 12 patients with first acute myocardial infarction and new onset of congestive heart failure 24 to 48 hours after admission. Congesting cuffs were applied for two periods of 15 minutes each, 15 minutes apart, and inflated to 30 mm Hg and...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80570-x
更新日期：1987-07-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether a one-time dose of triamcinolone diacetate, 40 mg intramuscular (i.m.), given to adult patients treated in the emergency department for mild to moderate exacerbation of asthma would decrease the rate of relapse during the following week, compared with a nontapering course of oral pr...
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(98)70343-9
更新日期：1998-03-01 00:00:00
abstract：:We examined the performance of a hospital-based mobile coronary care unit staffed by emergency physicians, coronary care nurses, and ambulance personnel in a metropolitan setting (Brisbane, Australia). Our unit attended 2,260 calls during 18 months of operation. Standard dispatched ambulances arrived first to 78% of t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80462-7
更新日期：1989-09-01 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
doi：10.1016/s0196-0644(86)80120-2
更新日期：1986-09-01 00:00:00
abstract：STUDY OBJECTIVE:The antivenom currently available for treatment of systemic black widow envenomation (latrodectism) is composed of equine whole immunoglobin. Although considered effective, it has been associated with anaphylaxis and 2 reported fatalities. We test the efficacy and safety of new equine antivenom composed...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.annemergmed.2019.02.007
更新日期：2019-09-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the public health impact of a hurricane on an inland area. DESIGN:Descriptive study. SETTING:Seven hospital emergency departments. PARTICIPANTS:Patients who were treated from September 22 to October 6, 1989, for an injury or illness related to Hurricane Hugo. INTERVENTION:None. MEASUREM...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70307-8
更新日期：1994-04-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the feasibility of managing patients with acute pyelonephritis as outpatients after initial treatment with IV antibiotics in an emergency department observation unit. DESIGN:Prospective and uncontrolled. SETTING:ED observation unit. TYPE OF PARTICIPANTS:Nonpregnant female patients 14 yea...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80935-7
更新日期：1991-03-01 00:00:00
abstract：STUDY OBJECTIVE:We evaluated a strategy to increase use of the test (Dix-Hallpike's test [DHT]) and treatment (canalith repositioning maneuver [CRM]) for benign paroxysmal positional vertigo in emergency department (ED) dizziness visits. METHODS:We conducted a stepped-wedge randomized trial in 6 EDs. The population wa...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.annemergmed.2019.09.017
更新日期：2020-04-01 00:00:00
abstract：:As we mark the 25th anniversary of the clinical application of closed-chest cardiopulmonary resuscitation (SCPR), it is time to look back and analyze the progress we have made in the resuscitation of sudden death syndrome. Recent studies of SCPR's effectiveness have yielded mixed results, in comparison to early studie...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80052-4
更新日期：1985-08-01 00:00:00
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
更新日期：2017-12-01 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：STUDY OBJECTIVES:To determine the sensitivity, specificity, and predictive values of a new rapid creatine kinase-MB (R-CK-MB) assay compared with a standard CK-MB (S-CK-MB) assay and to determine its potential use in the evaluation of emergency department patients with possible myocardial infarction. DESIGN:Retrospect...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82971-3
更新日期：1991-09-01 00:00:00
