Abstract：
STUDY OBJECTIVE:To compare the efficacy of a novel antidote, insulin, with standard treatments, glucagon and epinephrine, in a canine model of acute beta-blocker toxicity. METHODS:Anesthetized dogs were fitted with instruments by means of thoracotomy and vascular cutdown for multiple cardiodynamic, hemodynamic, metabolic, and electrical measures. After basal measurements were taken, animals received intravenous propranolol (.25 mg/kg/minute) continuously for the remainder of the experiment. Toxicity was defined as a 25% decrease in the product of heart rate times mean blood pressure. Thirty minutes after the development of toxicity, toxic measures were taken (treatment 0 minutes), and then the animals (n = 6 each group) received either sham (saline solution), insulin (4 IU/minute with glucose clamped), glucagon (50 micrograms/kg bolus, then 150 micrograms/kg/hour infusion), or epinephrine (1 microgram/kg/minute). Animals were monitored until death or for 240 minutes. RESULTS:Propranolol decreased contractility, left ventricular pressure, and systemic blood pressure, and resulted in death of all sham-treated animals by 150 minutes. Six of six insulin-treated, four of six glucagon-treated, and one of six epinephrine-treated animals survived. Survival was greater for insulin-treated animals, compared with either glucagon-treated (P < .05) or epinephrine-treated animals (P < .02) by the log-rank test. Insulin-treated animals were characterized by improved cardiodynamics and hemodynamics, increased myocardial glucose uptake, and decreased serum potassium. CONCLUSION:Insulin is a superior antidote compared with glucagon or epinephrine in an anesthetized canine model of acute beta-blocker toxicity.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Kerns W 2nd,Schroeder D,Williams C,Tomaszewski C,Raymond Rdoi
10.1016/s0196-0644(97)70196-3subject
Has Abstractpub_date
1997-06-01 00:00:00pages
748-57issue
6eissn
0196-0644issn
1097-6760journal_volume
29pub_type
杂志文章abstract：:Epiglottitis in adults, while uncommon, is certainly not rare. Despite the increasing reports of the disorder in the literature, it continues to be misdiagnosed in emergency departments. The first step in the diagnosis of acute epiglottitis is for the emergency physician to think of it. The literature concerning the e...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80463-5
更新日期：1981-01-01 00:00:00
abstract：:Inconsistency in contacting the families of acutely ill patients can negatively affect relatives and induce stress in emergency department staff. Role clarification and performance guidelines are discussed in the context of a telephone notification of relatives checklist, with staff advised in six specific interventio...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(82)80204-7
更新日期：1982-11-01 00:00:00
abstract：:Paliperidone, or 9-hydroxy risperidone, is the newest atypical antipsychotic agent to be approved for use by the Food and Drug Administration. Despite being the primary active metabolite of risperidone, paliperidone differs in several ways from risperidone. The most notable difference is that paliperidone is formulate...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2010.10.015
更新日期：2011-07-01 00:00:00
abstract：:This article provides information supporting the need for new outcome measures in emergency care. It also addresses the use of outcome measures in emergency care, the impact of emergency care, identification of at-risk groups, new approaches to measuring patient satisfaction, quality of life and cost-effectiveness, an...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：
更新日期：1998-02-01 00:00:00
abstract：:To study factors that cause or prevent injuries, it can be efficient to use a case-control study design and select both cases and controls from patients seen in the ED. Bias in case ascertainment can be reduced by studying exposures that, aside from their influence on the risk of injury, are unrelated to the use of em...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(98)70289-6
更新日期：1998-01-01 00:00:00
abstract：:We followed serial plasma baclofen concentrations in a woman who ingested more than 2 g of baclofen in a suicide attempt, the largest ingestion of baclofen reported to date. The plasma clearance of baclofen was characterized by first-order elimination kinetics with a half-life of 8.6 hours. The persistent central nerv...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80388-2
更新日期：1986-07-01 00:00:00
abstract：:We conducted a retrospective chart review to determine whether the treatment of uncomplicated convulsions in emergency department patients with a history of epilepsy complied with a clinical standard and whether the degree of compliance with the standard was related to the treating physician's specialty or postgraduat...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82336-4
更新日期：1990-04-01 00:00:00
abstract：STUDY OBJECTIVE:Urinary catheters are often placed in the emergency department (ED) and are associated with an increased safety risk for hospitalized patients. We evaluate the effect of an intervention to reduce unnecessary placement of urinary catheters in the ED. METHODS:Eighteen EDs from 1 health system underwent t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2014.02.013
更新日期：2014-06-01 00:00:00
abstract：STUDY OBJECTIVE:We assess the prognostic role of initial glucose levels in patients with a first acute myocardial infarction in the emergency department (ED). METHODS:We conducted a 3-year retrospective cohort study. Patients with a first acute myocardial infarction were recruited from the ED of a tertiary hospital fr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2006.10.023
更新日期：2007-05-01 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: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 OBJECTIVE:We estimate the test characteristics of nasogastric aspiration to diagnose upper gastrointestinal tract hemorrhage in patients without hematemesis. METHODS:In this retrospective cohort study, medical records from patients admitted to 2 urban hospitals between 1997 and 2002 for gastrointestinal tract bl...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2003.09.002
更新日期：2004-04-01 00:00:00
abstract：STUDY OBJECTIVE:We determine whether children with immediate posttraumatic seizures require hospitalization for observation of possible neurologic complications. METHODS:This was a prospective observational cohort study of children younger than 18 years with blunt head trauma resulting in immediate posttraumatic seizu...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/S0196064403012071
更新日期：2004-06-01 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：: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: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：STUDY OBJECTIVE:To examine community changes in self-reported CPR training and use from 1980-82 to 1985-87 using data obtained from the Minnesota Heart Survey. A comparative investigation of CPR training among blacks and whites in 1985-86 also was completed. DESIGN:Data were obtained in 1980-81, 1981-82, 1985-86, and ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82782-9
更新日期：1992-06-01 00:00:00
abstract：:We present the case of a 21-year-old man who presented to the emergency department with an episode of profound weakness due to thyrotoxic periodic paralysis, a syndrome of muscular weakness occurring in patients with hyperthyroidism. Prior to the diagnosis, the patient was treated with a parenteral tranquilizer. When ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80568-7
更新日期：1988-08-01 00:00:00
abstract：STUDY OBJECTIVE:Buffered lidocaine was compared with plain lidocaine as a local anesthetic for simple lacerations. DESIGN:Randomized, double-blind, prospective clinical trial. SETTING:Urban emergency department. TYPE OF PARTICIPANTS:Ninety-one adult patients with simple linear lacerations were enrolled. Patients wit...
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)82603-4
更新日期：1990-12-01 00:00:00
abstract：:This study was designed to investigate the efficacy of a decongestant-antihistamine preparation in combination with antibiotic treatment of acute otitis media. The effectiveness of a new Dimetapp (DIM) preparation was assessed in comparison with each of its components (brompheniramine maleate [BPM] and phenylephrine h...
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(83)80125-5
更新日期：1983-01-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the potential usefulness of external cardiac pacing for the termination of sustained ventricular tachycardia in the emergency department setting. TYPE OF PARTICIPANTS:Five men and one woman (mean age, 57 years) who presented to the ED with a wide-complex, hemodynamically stable tachycardia...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80160-x
更新日期：1992-02-01 00:00:00
abstract：STUDY OBJECTIVE:To investigate whether the addition of a single aerosolized dose of glycopyrrolate leads to a greater improvement in pulmonary function than treatment with albuterol alone for patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). DESIGN:Prospective, randomized, blinded, cont...
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)70260-1
更新日期：1995-04-01 00:00:00
abstract：STUDY OBJECTIVE:Serum markers of smooth muscle destruction have been shown to be elevated in ectopic pregnancy, but they remain of questionable clinical utility. Our goal was to determine the clinical utility of 3 markers of smooth muscle destruction: creatine phosphokinase (CPK), smooth muscle heavy-chain myosin (SMHC...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.119851
更新日期：2001-12-01 00:00:00
abstract：STUDY OBJECTIVE:To describe the development of an emergency department-based injury surveillance system, to describe the problems encountered, and to briefly describe the data output and potential applications. METHODS:Within our university-based hospital system and Level I trauma center register, injury data currentl...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(96)70298-6
更新日期：1996-01-01 00:00:00
abstract：STUDY OBJECTIVE:Prediction rules for pulmonary embolism use variables explicitly shown to estimate the probability of pulmonary embolism. However, clinicians often use variables that have not been similarly validated, yet are implicitly believed to modify probability of pulmonary embolism. The objective of this study i...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.annemergmed.2009.11.010
更新日期：2010-04-01 00:00:00
abstract：:WHAT IS ALREADY KNOWN ON THIS TOPIC: Procalcitonin is a biomarker that appears to correlate with bacterial infection. WHAT QUESTION THIS STUDY ADDRESSED: Does a procalcitonin level add prognostic information for pneumonia patients in conjunction with scoring systems such as the Pneumonia Severity Index or CURB-65? WHA...
journal_title：Annals of emergency medicine
pub_type： 评论,杂志文章
doi：10.1016/j.annemergmed.2008.05.033
更新日期：2008-07-01 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: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：:Emergency clinicians often care for patients with terminal illness who are receiving hospice care and many more patients who may be in need of such care. Hospice care has been shown to successfully address the multidimensional aspects of the end-of-life concerns of terminally ill patients: dying with dignity, dying wi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2010.06.569
更新日期：2011-03-01 00:00:00
abstract：STUDY OBJECTIVE:We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. METHODS:We studied a retrospective cohort of injured patients aged 16 years or old...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2014.04.019
更新日期：2015-01-01 00:00:00
