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 emergency department personnel their wish not to be the recipient of advanced life support procedures. Prehospital advance directives (PHAD) offer that opportunity. Arizona is only the fourth state to pass a PHAD statute and the first to simplify the law so it is interpreted easily by both providers and patients. PHAD laws need not be complex, either in their language or in their implementation requirements. Simple and easily understood statues and their resulting directives increase the likelihood that those most likely to need and use this directive will be able to comply with its provisions. Arizona's law addresses several controversial areas yet to be worked out by other states. Placing the PHAD in statute ensures that a statewide attempt will be made to comply with its provisions, and as a law it should be more permanent than advance directive protocols based on administrative fiat. Physicians in other states may want to follow Arizona's lead and employ a joint effort by their state's bar association, hospital association, and medical association to smooth the passage of similar legislation. All parties involved, however, must not seek a perfect statute. Arizona's experience suggests that legislators will need to strike a balance between the needs of the citizens and the fears of lawyers wary of any potential liability for the state or the emergency medical services system.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Iserson KVdoi
10.1016/s0196-0644(05)81309-5subject
Has Abstractpub_date
1993-11-01 00:00:00pages
1703-10issue
11eissn
0196-0644issn
1097-6760pii
S0196-0644(05)81309-5journal_volume
22pub_type
杂志文章abstract：:Intravenous (IV) fibrinolytic therapy, a recent area of research, has a great deal of applicability in emergency medicine. We report our experience with 30 patients treated with this method. Thirty consecutive patients in the early stages of acute evolving myocardial infarction (AMI) were assigned to receive high-dose...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80283-3
更新日期：1985-05-01 00:00:00
abstract：STUDY OBJECTIVE:Cost concerns may inhibit emergency medical services (EMS) use. Novel tax-based and subscription prepayment programs indemnify patients against the cost of EMS treatment and transport. We determine whether the presence of (or enrollment in) prepayment plans increase EMS use among patients with acute che...
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：
更新日期：2000-06-01 00:00:00
abstract：:The cases of three patients with spinal cord compression who presented with acute urinary retention are discussed. Two patients had previously diagnosed carcinoma; in one, acute urinary retention was the first sign of metastatic renal cell carcinoma. Two patients had a history compatible with prostatic hypertrophy. Al...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80876-9
更新日期：1986-10-01 00:00:00
abstract：:Hyperkalemia is a life-threatening electrolyte disturbance. The clinical presentation is most commonly related to its effects on cardiac conductivity and contractility, although weakness and respiratory compromise may occur. We describe what we believe to be the first reported case of life-threatening hyperkalemia pre...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70107-6
更新日期：1998-07-01 00:00:00
abstract：:Recent investigations suggest that increased intrathoracic pressure causing compression of the heart and great vessels in the thorax plays an important role in providing blood flow during cardiopulmonary resuscitation. This communication reports the case of a four-year-old asphyxiated girl found to have a small amount...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80474-4
更新日期：1980-12-01 00:00:00
abstract：:A survey completed by 265 emergency medical technicians (EMTs) who provide emergency prehospital care in a rural area included a stress inventory for health professionals and a job satisfaction scale. Logistic regression indicated that the 118 paid EMTs were more likely to be dissatisfied with the freedom they have on...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80070-7
更新日期：1987-06-01 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：:Descriptive statistics include measures of central tendency and variability. Measures of central tendency include mean, median, and mode. The mean is the arithmetic average of data from interval or ratio scales. The median reflects the 50th percentile score. The mode is the most frequently occurring value of a data di...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82052-9
更新日期：1990-03-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the relative importance of variables correlated with patient satisfaction with emergency department care and service. DESIGN:Retrospective telephone survey targeting all patients who visited the Panorama City Kaiser Permanente ED from April 4 to April 17, 1991. Patients were contacted with...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81947-x
更新日期：1993-03-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether N-acetylcysteine (NAC reduces methemoglobin. METHODS:We carried out an in vitro laboratory experiment in which five healthy adult volunteers donated blood. Each sample was divided equally among three test tubes. Tube 1 served as a negative control. Sodium nitrite .18 mol/L with dex...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(96)70112-9
更新日期：1996-11-01 00:00:00
abstract：:In 2013 and 2014, more than 700 deaths were attributed to fentanyl and fentanyl analogues in the United States. Of recent concern is the cluster of unintentional fentanyl overdoses because of tablets thought to be "Norco" purchased on the street in Northern California. U-47700 (trans-3,4-dichloro-N-[2-(dimethyl-amino)...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.06.014
更新日期：2017-01-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the efficacy of a 4-day "burst" course of prednisone added to standard treatment with H1 antihistamines for the management of acute urticaria in outpatients. DESIGN:Prospective, randomized, double-blinded, clinical trial. SETTING:Emergency department of an urban tertiary care teaching hosp...
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)70002-1
更新日期：1995-11-01 00:00:00
abstract：:A 24-year-old man was assaulted and sustained a stab wound to the left lower neck. When he arrived at the emergency department, he was hemodynamically stable. Although the wound had penetrated the platysma, on initial evaluation the patient did not appear to have sustained significant injury. Closer examination of the...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82619-8
更新日期：1990-12-01 00:00:00
abstract：:Ketamine produces rapid and consistent pediatric sedation with a predictable onset and recovery time. A wide margin of safety is afforded without the respiratory and cardiovascular depression commonly seen with alternative agents. The efficacy of ketamine is well established in anesthesia and dentistry and has extensi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(05)82569-7
更新日期：1990-09-01 00:00:00
abstract：STUDY OBJECTIVE:Measurement of interval data is important in the accurate recording of events that occur in an emergency medical services system. Measurement of intervals should be a simple task. However, when two separate clocks are needed to record the beginning and end of an interval, accurate measurement may be dif...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70222-1
更新日期：1997-04-01 00:00:00
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
更新日期：1994-05-01 00:00:00
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
更新日期：2001-10-01 00:00:00
abstract：STUDY OBJECTIVE:The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. METHODS:We used Ohio's prescription drug monitoring pr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2017.03.057
更新日期：2017-12-01 00:00:00
abstract：:We present the cases of three patients with skin blisters following carbon monoxide (CO) poisoning. Their blisters appeared to be related to the severity of the poisoning (HbCO levels of more than 40%). Two of the three patients died despite aggressive initial 100% surface oxygen followed by hyperbaric oxygen therapy....
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80792-7
更新日期：1985-06-01 00:00:00
abstract：STUDY OBJECTIVE:Factors associated with intraosseous (IO) catheterization are not well described. Our objective is to identify factors associated with the attempt and timing of IO catheterization in a pediatric emergency department (ED) resuscitation setting. METHODS:We completed a video-based, case-control study (1:3...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2019.09.005
更新日期：2020-06-01 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：:Glyburide, a second-generation sulfonylurea hypoglycemic agent, is metabolized by the P-450 hepatic enzyme system. Ciprofloxacin, a widely used quinolone antibiotic, is a recognized P-450 enzyme inhibitor. Conflicting data exist in the medical literature on the ability of quinolone antibiotics to inhibit glyburide hep...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2000.108617
更新日期：2000-08-01 00:00:00
abstract：STUDY OBJECTIVES:We determine whether the addition of heat to topical eutectic mixture of local anesthetic (EMLA) cream shortens the onset time to effective analgesia. We hypothesized that applying EMLA cream for 20 minutes with an external heat pack would be as effective as the standard 60-minute application time. ME...
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.2003.228
更新日期：2003-07-01 00:00:00
abstract：STUDY OBJECTIVE:To gather preliminary data on the safety and efficacy of IV magnesium in a rat model of hydrofluoric acid burns. MODEL:Forty-seven anesthetized male rats (200 to 300 g) received a standardized burn with 52% hydrofluoric acid. INTERVENTIONS:Animals were anesthetized with 30 to 50 mg/kg ketamine IM and ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70064-8
更新日期：1994-03-01 00:00:00
abstract：STUDY OBJECTIVE:We assessed the independent relationship between age and the quality of medical care provided to patients presenting to the emergency department (ED) with acute myocardial infarction. METHODS:We conducted a 2-year retrospective cohort study of 2,216 acute myocardial infarction patients presenting urgen...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2004.12.012
更新日期：2005-07-01 00:00:00
abstract：STUDY OBJECTIVE:Physicians often prescribe antibiotics to patients even when there is no clear indication for their use. Previous studies examining antibiotic use in acute bronchitis and upper respiratory infections have been conducted in primary care settings. We evaluate the factors that physicians in the emergency d...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.annemergmed.2007.03.026
更新日期：2007-09-01 00:00:00
abstract：:Thrombolytic therapy offers the promise of major therapeutic intervention in many areas as well as in the treatment of patients with acute myocardial infarction who present to the emergency department. Infusion of tissue-type plasminogen activator (tPA) during field transport has been proven safe, but optimal methods ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(89)80271-9
更新日期：1989-12-01 00:00:00
abstract：:Communication at discharge is an important part of high-quality emergency department (ED) care. This review describes the existing literature on patient understanding and implementation of discharge instructions, discusses previous interventions aimed at improving the discharge process, and recommends best practices a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2011.10.023
更新日期：2012-08-01 00:00:00
abstract：:A technique of direct mechanical ventricular assistance (DMVA) has been available since 1966. Ventricular assistance is provided by a glass cup lined with a Silastic diaphragm. It is held on the cardiac ventricles by suction. Alternating positive and negative pressure in the space between the cup and the diaphragm pro...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80247-9
更新日期：1983-12-01 00:00:00
abstract：STUDY OBJECTIVE:Video capsule endoscopy has been used to diagnose gastrointestinal hemorrhage and other small bowel diseases but has not been tested in an emergency department (ED) setting. The objectives in this pilot study are to demonstrate the ability of emergency physicians to detect blood in the upper gastrointes...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1016/j.annemergmed.2012.11.008
更新日期：2013-04-01 00:00:00
