Abstract：
:Acid-base changes occurring during cardiac arrest and subsequent CPR are related to a complex low-perfusion state characterized clinically by venous and tissue hypercarbic and metabolic (lactic) acidosis. This low-flow state is a dynamic process dependent on the time intervals between onset of arrest, initiation of CPR, and restoration of adequate spontaneous circulation. Increased release of CO2 from ischemic tissues and reduced CO2 transport from the tissues to the lungs result in profound tissue acidosis. However, recent experimental data suggest that even very low pH is compatible with neurologically intact survival. Thus, the clinical use of buffer agents, and especially of sodium bicarbonate, is currently controversial. Because results of controlled clinical studies are not available, a careful review of well-performed experimental studies is necessary. So far, the use of either CO2-generating or CO2-consuming buffers has not been proved conclusively to increase neurologically intact long-term survival after CPR. More importantly, adequate ventilation and effective chest compressions must be quickly established after cardiac arrest. This will counterbalance the hypercarbic and metabolic acidemia of cardiac arrest by creating concurrent hypocarbic arterial alkalemia during at least the early phase of CPR. Thus, the treatment of the complex acid-base changes associated with CPR is based primarily on the classical maneuvers of A and B (airway and breathing = adequate oxygenation and ventilation), C (chest compressions), and D (early defibrillation for rapid restoration of spontaneous circulation). In cases of prolonged cardiac arrest or preexisting metabolic acidemia, buffer therapy may be indicated.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
von Planta M,Bar-Joseph G,Wiklund L,Bircher NG,Falk JL,Abramson NSdoi
10.1016/s0196-0644(05)80471-8subject
Has Abstractpub_date
1993-02-01 00:00:00pages
404-10issue
2 Pt 2eissn
0196-0644issn
1097-6760journal_volume
22pub_type
杂志文章,评审abstract：:Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy that can be mistaken for a normal intrauterine pregnancy on ultrasonography, leading to catastrophic results. Increasingly, emergency physicians are using ultrasonography to diagnose intrauterine pregnancy. Emergency physicians should be aware of...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.125426
更新日期：2002-07-01 00:00:00
abstract：:Axial (in-line) traction is recommended as a stabilizing maneuver during orotracheal intubation of a trauma victim with a potential cervical spine injury. There are no published data demonstrating the safety of this technique in trauma patients with an unstable cervical spine. In our study, 17 victims of blunt traumat...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80498-0
更新日期：1988-01-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the timeliness of response of consultants called to evaluate patients in the emergency department of a community hospital. METHODS:Consultation requests from an ED located in a medium-sized community hospital were studied for a 1-month period. Data collected included name and specialty of ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70035-6
更新日期：1998-11-01 00:00:00
abstract：:Traumatic dislocation of the hip joint is relatively uncommon in children. The trauma required to produce a dislocation can vary from minimal to severe, high-energy force. We report a case of posterior hip dislocation in a 9-year-old boy who received relatively minor trauma to his leg but who did not seek medical atte...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80298-6
更新日期：1987-01-01 00:00:00
abstract：:Barium is a divalent alkaline earth metal used as the insoluble sulfate salt in contrast radiography and soluble acid salts in industry. Barium poisoning results from ingestion or inhalation of the acid salts; the most common poisoning occurs after ingestion of the rodenticide barium carbonate (BaCO3). We report seven...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(05)81393-9
更新日期：1991-10-01 00:00:00
abstract：:We present the case of a 27-year-old man who sustained a minor head injury and presented with complaints of headache and vomiting. The diagnosis of vertex epidural hematoma is discussed. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70145-8
更新日期：1994-08-01 00:00:00
abstract：STUDY OBJECTIVE:Emergency department (ED) patients with atrial fibrillation or flutter are at risk of stroke, and guidelines recommend anticoagulation for patients with increased cardiovascular risk. Emergency physicians have a unique opportunity to provide appropriate anticoagulation for such patients, and we wished t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.04.004
更新日期：2013-12-01 00:00:00
abstract：STUDY OBJECTIVE:The study was designed to determine if open peritoneal lavage is superior to closed peritoneal lavage. DESIGN AND PARTICIPANTS:Patients who were admitted to a trauma center and needed peritoneal lavage were assigned to alternate trauma teams. Team 1 performed only open lavages one month and then switch...
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)81067-4
更新日期：1991-12-01 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：:Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), is a propionic acid derivative that possesses analgesic and antipyretic properties through inhibition of prostaglandin synthesis. The propionic acids have been considered the least toxic of the NSAIDs, and one, ibuprofen, is currently available as an over-the-co...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80939-4
更新日期：1989-10-01 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 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：:A fatal case of ascending tonic-clonic seizure (ATCS) syndrome resulted from the inadvertent, unrecognized use of a hyperosmolar ionic contrast agent during myelography. The patient presented with lower-extremity myoclonic jerking, agitation, hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation. Em...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70045-9
更新日期：1998-11-01 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：STUDY OBJECTIVES:We assessed the validity and completeness of data in the past medical history (PMH) obtained electronically from parents and examined effects of the human-computer interface and sociodemographic variables on electronic parental report. METHODS:We compared parents' electronic report of PMH data with a ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(00)70052-7
更新日期：2000-04-01 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：:Myocardial rupture is a catastrophic complication of acute myocardial infarction that usually results in sudden death. If diagnosed quickly, patients with myocardial rupture may be salvaged. This report describes the application of emergency department two-dimensional echocardiography in the diagnosis of six cases of ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70361-2
更新日期：1994-06-01 00:00:00
abstract：STUDY OBJECTIVE:We hypothesize that emergency department (ED) volume and increased patient complexity are associated with lower quality of care, as measured by time to antibiotics for patients being admitted with community-acquired pneumonia. METHODS:This was a cross-sectional study at a university tertiary care hospi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2007.08.003
更新日期：2007-11-01 00:00:00
abstract：STUDY OBJECTIVE:Emergency departments (EDs) frequently refer patients for needed outpatient specialty care, but little is known about the dynamics of these referrals when patients are publicly insured. Hence, we explored factors, including the role of ED referrals, associated with specialists' willingness to accept pat...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2012.10.030
更新日期：2013-04-01 00:00:00
abstract：:A research project was developed to study the process of professional socialization in graduate medical education by describing and analyzing the development of emergency medicine residencies in comparison to those of surgery and internal medicine. Based on the assumption that residency programs have a profound impact...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80332-5
更新日期：1980-02-01 00:00:00
abstract：STUDY OBJECTIVE:Annually, 38 million people are evaluated for trauma, the leading cause of death in persons younger than 45 years. The primary objective is to assess whether using a protocol inclusive of point-of-care, limited ultrasonography (PLUS), compared to usual care (control), among patients presenting to the em...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2006.01.008
更新日期：2006-09-01 00:00:00
abstract：STUDY OBJECTIVE:Previous studies have suggested that serum markers of smooth muscle destruction have utility in predicting ectopic pregnancy. Our goal was to determine whether a novel marker of muscle destruction, smooth muscle heavy-chain myosin (SMHC), is elevated in the serum of patients with ectopic pregnancy. MET...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章
doi：10.1067/mem.2000.109104
更新日期：2000-08-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the efficacy of IM ketorolac versus that of oral ibuprofen in acute musculoskeletal pain. DESIGN:Randomized, prospective, double-blind clinical trial. SETTING:Urban teaching emergency department with an annual census of 43,000. PARTICIPANTS:Convenience sample of 82 patients aged 18 to 70 ...
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)70138-9
更新日期：1995-08-01 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：:The sudden emergence of 2009 H1N1 influenza in the spring of that year sparked a surge in visits to emergency departments in New York City and other communities. A larger, second wave of cases was anticipated the following autumn. To reduce a potential surge of health system utilization without denying needed care, we...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2010.04.005
更新日期：2010-09-01 00:00:00
abstract：STUDY OBJECTIVE:The Utstein guidelines recommend that emergency medical services (EMS)-witnessed cardiac arrests be considered separately from other out-of-hospital cardiac arrest cases. The objective of this study was to assess EMS-witnessed cardiac arrest and to determine predictors of survival in this group. METHOD...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/S0196-0644(00)70133-8
更新日期：2000-02-01 00:00:00
abstract：:Sodium dichloroacetate (DCA) has been shown to lower elevated serum lactate levels produced by hypoxia, exercise, and phenformin. We conducted a study to investigate the effect of DCA treatment on lactic acidosis following resuscitation from asphyxial cardiac arrest. Conditioned dogs were anesthetized with pentobarbit...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80239-7
更新日期：1988-05-01 00:00:00
abstract：:A team of missionary doctors from Ecuador recently described striking success in the treatment of venomous snakebites with a series of brief, high-voltage, low-current electric shocks applied to the bit site. We designed a randomized, controlled, blinded test of their methods in laboratory rats. Venom of the fer-de-la...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80118-5
更新日期：1988-03-01 00:00:00
abstract：STUDY OBJECTIVE:We describe the demographics, characteristics, treatment, and clinical course of methamphetamine body stuffers. We also determine the clinical characteristics of methamphetamine body stuffers who have severe outcomes. METHODS:A 6.5-year descriptive nonconcurrent observational case series evaluated meth...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2009.08.005
更新日期：2010-02-01 00:00:00
abstract：STUDY OBJECTIVE:The objective was to quantify the analgesic effect of a dose of intravenous morphine, 0.1 mg/kg, to emergency department (ED) patients presenting in acute, severe pain. METHODS:This was a prospective convenience cohort of patients aged 21 to 65 years and presenting to an academic urban ED with acute, s...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2005.03.010
更新日期：2005-10-01 00:00:00
