Abstract：
STUDY OBJECTIVE:To determine whether abdominal ultrasound can be used routinely as the primary screening test to identify the need for laparotomy in trauma patients. METHODS:Ultrasound was used at a Level II trauma center as a primary screening test for evaluation of intraabdominal injury. We reviewed the charts of all patients from trauma codes presenting between January 1, 1991, and December 31, 1993, to determine the results of abdominal ultrasound evaluation and to learn whether laparotomy was required. RESULTS:A total of 2,013 trauma patients presented during the study interval. Ultrasound was performed in 1,631 patients as the primary screening test for abdominal injury (mean time after arrival, 22.9 minutes), abdominal computed tomography (CT) was performed as the primary screen on 8 (mean time, 68.6 minutes), and 93 patients underwent both ultrasound and CT of the abdomen. Of 86 patients requiring laparotomy who were screened by ultrasound, 80 had positive diagnostic findings, for a sensitivity of 93.0%. Of the 1,545 ultrasound-screened patients who did not require laparotomy, 1,390 had negative findings, for a specificity of 90.0%. None of the patients with negative ultrasound results died or sustained identifiable mortality as a consequence of their negative scans. CONCLUSION:Ultrasound is a sensitive and specific test with which to evaluate trauma patients for abdominal injury requiring surgery. Routine abdominal ultrasound can be performed at the bedside in the emergency department as a timely, noninvasive diagnostic test. This use of a screening abdominal ultrasound examination can improve clinical decision-making for the use of emergency laparotomy. Ultrasound may be a better alternative to CT or diagnostic peritoneal lavage for the initial screening evaluation of abdominal trauma.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Porter RS,Nester BA,Dalsey WC,O'Mara M,Gleeson T,Pennell R,Beyer FCdoi
10.1016/s0196-0644(97)70343-3subject
Has Abstractpub_date
1997-03-01 00:00:00pages
323-30issue
3eissn
0196-0644issn
1097-6760pii
S0196064497000899journal_volume
29pub_type
杂志文章abstract：:A comparison of several maneuvers that are believed to increase vagal tone was made by measuring the carotid sinus with an ultrasound device. For 20 healthy volunteers the mean carotid sinus diameter was 5.7 mm supine, 6.1 mm in the Trendelenberg position, 6.5 mm after supine medical antishock trousers (MAST) inflatio...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80921-5
更新日期：1985-11-01 00:00:00
abstract：STUDY OBJECTIVE:To derive a highly sensitive decision rule for the selective use of radiography in acute knee injuries. DESIGN:Prospectively administered survey. SETTING:Emergency departments of two university hospitals. PARTICIPANTS:Convenience sample of 1,047 adults with acute knee injuries. RESULTS:Attending eme...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(95)70106-0
更新日期：1995-10-01 00:00:00
abstract：:Despite 3 decades of scientific progress, rates of survival from out-of-hospital cardiac arrest remain low. The Cardiac Arrest Registry to Enhance Survival (CARES) was created to provide communities with a means to identify cases of out-of-hospital cardiac arrest, measure how well emergency medical services (EMS) perf...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2009.03.018
更新日期：2009-11-01 00:00:00
abstract：:We report 2 deaths and 1 injury that resulted from 2 separate unintentional discharges of the same Ruger Blackhawk revolver. One discharge was a consequence of careless firearm handling combined with a slip during a decocking procedure unique to certain hammer-action firearms. The second discharge occurred when the fi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.112251
更新日期：2001-03-01 00:00:00
abstract：:Verapamil is considered by many investigators to be the drug of choice for the acute management of uncomplicated PSVT. Several clinical investigators have demonstrated termination of PSVT in more than 90% of their patients within minutes following IV drug administration. The incidence of reported severe adverse reacti...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(81)80013-3
更新日期：1981-10-01 00:00:00
abstract：STUDY OBJECTIVE:We describe patient perceptions of computed tomography (CT) and their understanding of radiation exposure and risk. METHODS:This was a cross-sectional study of acute abdominal pain patients aged 18 years or older. Confidence in medical evaluations with increasing levels of laboratory testing and imagin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2010.10.018
更新日期：2011-07-01 00:00:00
abstract：STUDY OBJECTIVE:We evaluated the influence of home visiting on the risk for medically attended unintentional injury during home visiting (0 to 3 years) and subsequent to home visiting (3 to 5 years). METHODS:A retrospective, quasi-experimental study was conducted in a cohort of mother-child pairs in Hamilton County, O...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2017.01.029
更新日期：2017-09-01 00:00:00
abstract：:Elevated intracranial pressure commonly is associated with severe head injury. Emergency airway management technique in the patient who has sustained severe head injury must optimize conditions for intubation, minimize the adverse effects of intubation, and permit rapid and effective management of the elevated intracr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(05)82743-x
更新日期：1993-06-01 00:00:00
abstract：STUDY PURPOSE:To evaluate the efficacy of adenosine in the treatment of emergency department patients with spontaneous paroxysmal supraventricular tachycardia (PSVT). DESIGN:An eight-month prospective outcome study. POPULATION:Patients 16 or more years old with PSVT by surface ECG criteria. Patients were excluded if ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80829-7
更新日期：1991-07-01 00:00:00
abstract：STUDY OBJECTIVES:To determine whether music significantly reduces the pain and anxiety associated with laceration repair in the emergency department. PARTICIPANTS AND SETTING:Adult patients presenting to the ED at an urban teaching hospital for laceration repair. Exclusion criteria included patients less than 18 years...
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)81652-x
更新日期：1991-04-01 00:00:00
abstract：STUDY OBJECTIVE:Anecdotal concerns suggest that health management organization (HMO) membership instructions may deter members from calling 911 or going to an emergency department for a perceived emergency. This study examines such instructions, specifically in regard to their definition of an emergency condition and a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(99)70267-2
更新日期：1999-07-01 00:00:00
abstract：:Activated charcoal is a safe, effective, inexpensive adjunct in the management of most toxic ingestions. It has the ability to adsorb a wide variety of drugs and chemicals, one of which is acetaminophen. N-acetylcysteine (NAC) is the specific antidote available for serious overdoses of acetaminophen. Current managemen...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80781-2
更新日期：1985-06-01 00:00:00
abstract：:When the abdomen is compressed manually in counterpoint to the rhythm of chest compression, in the performance of interposed abdominal compression-CPR, artificial circulation is approximately doubled in animal experiments and in electronic models of the circulatory system. These studies suggest that external manual co...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80245-8
更新日期：1993-01-01 00:00:00
abstract：STUDY OBJECTIVE:We develop a comprehensive view of aspects of care associated with parental satisfaction with pediatric emergency department (ED) visits, using both quantitative and qualitative data. METHODS:This was a retrospective observational study using data from an institution-wide system to measure patient sati...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.04.025
更新日期：2013-10-01 00:00:00
abstract：:Nontraumatic gas gangrene is extremely rare. It usually occurs following ulceration or perforation of an abdominal or pelvic viscus in persons having impaired host immune defenses. A fatal case of nontraumatic Clostridium septicum septicemia and myonecrosis in an elderly diabetic man with a perforated colon carcinoma ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80121-7
更新日期：1981-06-01 00:00:00
abstract：:A treatment protocol for patients with acute bronchospasm was introduced to an adult emergency department in an attempt to decrease treatment time and potentially decrease need for admission. The charts of all patients seen in a control year (before any protocol was in place) and the first three years of the protocol ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80429-2
更新日期：1986-06-01 00:00:00
abstract：STUDY OBJECTIVES:This study measures the effect of meeting emergency department (ED) patients' expectations for diagnostic and therapeutic interventions on patient satisfaction. METHODS:This was a cross-sectional study of consecutive patients during block enrollment periods surveyed at the beginning and end of their E...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2009.01.024
更新日期：2009-09-01 00:00:00
abstract：:[Salomon B: Emergency department fugue. Ann Emerg Med March 1998;31:412-413]. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/S0196-0644(98)70358-0
更新日期：1998-03-01 00:00:00
abstract：:The Institute of Medicine and other national organizations have asserted that current payment policies strongly discourage emergency medical services (EMS) providers from transporting selected patients who call 911 to non-ED settings (eg, primary care clinics, mental health centers, dialysis centers) or from treating ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.09.025
更新日期：2014-05-01 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：STUDY OBJECTIVE:Cancer immunotherapy is evolving rapidly and is transforming cancer care. During the last decade, immune checkpoint therapies have been developed to enhance the immune response; however, specific adverse effects related to autoimmunity are increasingly apparent. This study aims to fill the knowledge gap...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2018.04.019
更新日期：2019-01-01 00:00:00
abstract：STUDY OBJECTIVE:To study the efficacy of intravenous ketorolac, morphine, and both drugs in combination in reducing pain in acute renal colic. METHODS:We conducted a prospective, double-blinded, randomized controlled trial in an urban, teaching emergency department. Patients aged 18 to 55 years and with a clinical dia...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2006.03.013
更新日期：2006-08-01 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：:Presented is a rationale for use of a new class of drugs, the iron chelating agents, in advanced cardiac life support (ACLS) to prevent late deaths and brain damage following successful cardiopulmonary resuscitation. The relevant biochemical hypothesis states that free iron ions, liberated from bound intracellular sto...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(85)80056-1
更新日期：1985-08-01 00:00:00
abstract：STUDY OBJECTIVE:The effect of urgent cares on local emergency department (ED) patient volumes is presently unknown. In this paper, we aimed to assess the change in low-acuity ED utilization at 2 academic medical centers in relation to patient proximity to an affiliated urgent care. METHODS:We created a geospatial data...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2019.06.024
更新日期：2020-03-01 00:00:00
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 eme...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81309-5
更新日期：1993-11-01 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：:To evaluate the effects of acute alcohol intoxication on serum amylase and isoamylase levels, 58 clinically intoxicated patients with blood alcohol levels greater than 100 mg/dL were studied. Comparisons were made to normal control and a sober chronic alcoholic group. Admitting serum isoamylase levels were determined ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80511-3
更新日期：1983-05-01 00:00:00
abstract：:Although all emergency physicians are familiar with catastrophic causes of free intraperitoneal air, we describe the case of a healthy 26-year-old woman who presented to our emergency department (ED) with a nonsurgical and previously unreported cause of pneumoperitoneum. The patient presented to our ED with complaints...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2015.02.011
更新日期：2015-08-01 00:00:00
abstract：:The traditional use of the American ED, one of unrestricted access by patients and payment for services by insurers, is being questioned in this era of health care reform. Both primary care physicians and managed care organizations have questioned the use of the ED by patients without obvious problems of an emergency ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70164-1
更新日期：1997-09-01 00:00:00
