Abstract:
STUDY OBJECTIVE:To determine the accuracy of four methods of endotracheal tube size selection in the pediatric population. STUDY DESIGN:Prospective, blinded comparison. SETTING:The Children's Hospital of Philadelphia. PARTICIPANTS:Two hundred thirty-seven children aged 1 month to 9 years old undergoing elective surgery requiring endotracheal intubation. SELECTION PROCEDURES:Consecutive sample. INTERVENTIONS:Four methods of determining proper endotracheal tube size in children were compared. These methods included direct comparison with the width of the fifth finger, direct comparison with the diameter of the fifth finger using a ring-sizing device, direct comparison with the width of the fifth fingernail, and estimation using a formula ([age in years + 16]/4). In infants, a 3.0-mm (internal diameter) endotracheal tube was predicted for those 3 months of age and younger, and a 3.5-mm endotracheal tube was predicted for those from 3 to 9 months of age. The size of the endotracheal tube used in the operating room was recorded, as was the "air leak" around the tube. An appropriately sized endotracheal tube was determined by an air leak with ventilation pressures between 5 and 40 cm of water. MAIN RESULTS:Direct comparison using the width and the diameter of the fifth finger predicted an endotracheal tube between 1 mm smaller and 0.5 mm larger than that used by the anesthesiologists in 11% and 14% of patients, respectively. The age-based formula predicted an endotracheal tube size in this range in 97.5% of patients, and direct comparison with the width of the fifth fingernail predicted an endotracheal tube in this same range in 91% of patients. These findings were consistent within all age groups studied. CONCLUSION:Neither fifth finger width nor fifth finger diameter accurately predicts proper endotracheal tube size in most children. A more accurate estimation can be made using the age-based formula, but when the child's age is unknown or when calculation is awkward or impossible, an accurate estimate can be made using the width of the fifth fingernail.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
King BR,Baker MD,Braitman LE,Seidl-Friedman J,Schreiner MSdoi
10.1016/s0196-0644(05)81937-7subject
Has Abstractpub_date
1993-03-01 00:00:00pages
530-4issue
3eissn
0196-0644issn
1097-6760pii
S0196-0644(05)81937-7journal_volume
22pub_type
杂志文章abstract:STUDY OBJECTIVE:Hospital-based emergency departments (EDs) are the gateway to hospital admissions for many Americans. Approximately half of all US hospital admissions originate from EDs, and more than 3 in 4 are among Medicare beneficiaries. Recent literature has demonstrated nearly 2-fold variation in both physician- ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2016.03.019
更新日期:2016-10-01 00:00:00
abstract:STUDY OBJECTIVES:To develop a practical procedure for producing a nomogram describing the relationship between the osmolality gap and serum ethanol concentrations that is appropriate for the formulas and analytical methodologies in use at any laboratory. DESIGN:Retrospective review of serum sodium, glucose, urea nitro...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81899-2
更新日期:1992-11-01 00:00:00
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...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81253-3
更新日期:1993-10-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to develop and validate standardized clinical criteria to identify patients presenting to the emergency department whose care may be safely deferred to a later date in a nonemergency setting. METHODS:Using a modified Delphi process, a 17-member multidisciplinary physician panel developed expl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2000.107003
更新日期:2000-07-01 00:00:00
abstract::Patients evaluated by paramedics but not transported to the hospital account for 50% to 90% of emergency medical services lawsuits. We reviewed 2,698 consecutive paramedic run reports to examine documentation in these cases. Documentation criteria for prehospital patient release were history, physical examination, vit...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82187-0
更新日期:1990-05-01 00:00:00
abstract:STUDY OBJECTIVE:To be able to adhere to discharge instructions after a visit to the emergency department (ED), patients should understand both the care that they received and their discharge instructions. The objective of this study is to assess, at discharge, patients' comprehension of their ED care and instructions a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.05.016
更新日期:2009-04-01 00:00:00
abstract::Twenty cases of shaken baby syndrome are reviewed to determine important signs, symptoms, physical findings, laboratory parameters, and prognosis. The signs and symptoms of this form of head trauma are nonspecific. The findings may mimic infection, intoxication, or metabolic abnormalities. Diagnosis depends on a high ...
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
abstract:STUDY OBJECTIVE:We seek to describe the medical history and clinical findings of patients attending the emergency department (ED) with suspected coronavirus disease 2019 (COVID-19) and estimate the diagnostic accuracy of patients' characteristics for predicting COVID-19. METHODS:We prospectively enrolled all patients ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.05.022
更新日期:2020-10-01 00:00:00
abstract:STUDY OBJECTIVE:In patients presenting to the emergency department (ED) with an initial diagnostic impression of noncardiac chest pain, we determine the 30-day incidence of adverse cardiac events and characteristics associated with those events. METHODS:The multicenter, prospectively collected Internet Tracking Regist...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.03.021
更新日期:2004-12-01 00:00:00
abstract:STUDY OBJECTIVE:Ultrasonographically guided intravenous peripheral catheters have dismal dwell time, with most intravenous lines failing before completion of therapy. Catheter length in the vein is directly related to catheter longevity. We investigate the survival of an ultralong ultrasonographically guided intravenou...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2019.11.013
更新日期:2020-08-01 00:00:00
abstract::A prospective, randomized study of 500 consecutive emergency department patients with traumatic lacerations requiring sutures was performed comparing use of topical 1% povidone-iodine (Betadine) and scrubbing with wound management by irrigation with normal saline without scrubbing. A 60-second wound irrigation and scr...
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(87)80008-2
更新日期:1987-02-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the experience of croup at Princess Margaret Hospital for Children (PMH), the only tertiary pediatric hospital in Western Australia, from 1980 through 1995 with reference to the introduction of routine steroid treatment in the ICU in 1989, in the general hospital wards from 1989 through 1993...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70084-7
更新日期:1996-12-01 00:00:00
abstract::The traditional use of the throat culture to guide treatment of potential streptococcal pharyngitis recently has been questioned because of the following facts: antibiotic therapy within the first 48 hours of illness reduces the severity and symptoms of streptococcal pharyngitis; more rapid treatment of streptococcal ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80573-x
更新日期:1986-03-01 00:00:00
abstract::Recent developments, such as the bombings of the World Trade Center in 1993 and the Alfred P. Murrah Federal Building in Oklahoma City in 1995, the sarin attacks in Tokyo and Matsumoto, Japan, and US Embassy bombings in Kenya and Tanzania in 1998, have heightened fears of terrorist attacks. Future terrorist activities...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70228-3
更新日期:1999-08-01 00:00:00
abstract::Abruptio placentae is a complication of pregnancy associated with significant morbidity and mortality for both fetus and mother. The presence of uterine pain and tenderness traditionally has been considered a useful criterion for distinguishing abruptio placentae from other causes of bleeding in pregnancy. We report t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81040-6
更新日期:1992-07-01 00:00:00
abstract:STUDY OBJECTIVE:Aeromedical crews offer an advanced level of practice and rapid transport to definitive care; however, their efficacy remains unproven. Previous studies have used relatively small sample sizes or have been unable to adequately control for the effect of other potentially influential variables. Here we ex...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.01.024
更新日期:2005-08-01 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 Trauma Score (TS) is a physiologic measure of injury severity that correlates with patient outcome. Application of the TS has shown that it is useful for patient triage, for predicting patient outcome, and as a means of normalizing for case mix when comparing prehospital care and transport modalities. Our study ex...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80917-3
更新日期:1985-11-01 00:00:00
abstract::Early experience with the use of tissue plasminogen activator (tPA) in acute myocardial infarction is reviewed, including comparisons with other thrombolytic agents, a summary of hemorrhagic complications associated with its use, and the rationale for adjunctive therapeutic strategies. The use of tPA has been associat...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,评审
doi:10.1016/s0196-0644(88)80064-7
更新日期:1988-11-01 00:00:00
abstract::This report describes a case of near-fatal intoxication following accidental exposure to 1, 1, 1-trichloroethane in a child. This solvent, generally safe, is widely used to 1, 1, 1-trichloroethane in a child. This solvent, generally safe, is widely used in industrial and domestic preparations. Exposure to high levels ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80011-x
更新日期:1981-10-01 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::Randomized clinical trials, which aim to determine the efficacy and safety of drugs and medical devices, are a complex enterprise with myriad challenges, stakeholders, and traditions. Although the primary goal is scientific discovery, clinical trials must also fulfill regulatory, clinical, and ethical requirements. In...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2012.01.020
更新日期:2012-10-01 00:00:00
abstract::This is a report of a patient who survived a large propranolol overdose, as documented by toxic blood levels. The signs and symptoms were those of profound inotropic and moderate chronotropic cardiotoxicity which failed to respond to parasympatholytics or catecholamines, but subsequently reversed coincident with the a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80436-7
更新日期:1980-01-01 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:STUDY OBJECTIVE:To analyze the emergency medicine system in a developing country and identify areas of need and potential collaboration. DESIGN:Convenience sample surveys of all emergency visits over a 2-week period, hospital admission and health department statistics, and interviews with government officials, health ...
journal_title:Annals of emergency medicine
pub_type: 评论,杂志文章
doi:10.1016/s0196-0644(95)70087-0
更新日期:1995-09-01 00:00:00
abstract::The rapid expansion of cost-consciousness and managed care into the medical marketplace has challenged the autonomy of physicians and patients. These challenges have taken a variety of forms, including limitations on reimbursement and restrictions on the amount and type of emergency care patients may receive. Challeng...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70094-x
更新日期:1996-12-01 00:00:00
abstract::To help establish a rational approach to the initial management of Clinitest tablet ingestion, we investigated the effect of number of tablets, volume of diluent, and type of diluent on dissolution time (TD), temperature generation (delta T), and pH. Dissolution time was independent of the number of tablets and the vo...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80008-7
更新日期:1986-02-01 00:00:00
abstract::Prothrombin complex concentrates are frequently used to rapidly reverse anticoagulation with vitamin K antagonists associated with life-threatening bleeding. We report a patient receiving warfarin who presented to the emergency department with an international normalization ratio greater than 12.8 in cardiac tamponade...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.12.027
更新日期:2009-06-01 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:STUDY OBJECTIVE:We describe and analyze a recent rapid deployment of disaster medical assistance teams and other government agencies to provide medical screening and anthrax prophylaxis to New York City US Postal Service employees potentially exposed to letters contaminated with anthrax spores. METHODS:A description o...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2003.105
更新日期:2003-04-01 00:00:00