Abstract：
STUDY OBJECTIVE:Scorpion envenomation is a common life-threatening hazard in tropical and subtropical countries. Standard treatment is not clearly defined. Many therapies, such as steroids, are prescribed without experimental justification. We sought to assess the efficacy of systematic administration of intravenous hydrocortisone hemisuccinate (50 mg/kg) in scorpion envenomation. METHODS:Six hundred consecutive envenomated patients older than 10 years who presented to the ED of a nonteaching secondary hospital in an area of Tunisia endemic for scorpion envenomation were randomly assigned to receive hydrocortisone hemisuccinate 50 mg/kg (n = 305) or placebo (n = 295) in addition to standard medical care. Patients in the two groups had similar clinical characteristics on initial clinical evaluation. Each was categorized as grade 1 (absence of systemic symptoms) or grade 2 (systemic symptoms of scorpion envenomation). Patients were treated in the ED for up to 4 hours or in the ICU, depending on clinical severity. Steroid and placebo groups were compared according to mortality rate, change of severity grade 4 hours after presentation and treatment, and duration of hospital stay. RESULTS:Distribution of patients with respect to severity grade was similar in the two groups at the 4-hour clinical evaluation. We detected no significant difference at the time of discharge between steroid-and placebo-treated patients with respect to mortality (one patient in each group) or duration of hospital stay. Extra costs incurred through steroid administration totaled US $989,000. CONCLUSION:Our findings do not support the use of intravenous high-dose steroids in scorpion-envenomated patients. The discontinuation of this practice would reduce costs substantially.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Abroug F,Nouira S,Haguiga H,Elatrous S,Belghith M,Boujdaria R,Touzi N,Bouchoucha Sdoi
10.1016/s0196-0644(97)70105-7subject
Has Abstractpub_date
1997-07-01 00:00:00pages
23-7issue
1eissn
0196-0644issn
1097-6760pii
S0196-0644(97)70105-7journal_volume
30pub_type
临床试验,杂志文章,随机对照试验abstract：:The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine-sponsored residency and fellowship programs, as well as the residents and fellows training in those programs. We present the 2018 annual report on the status of US emergency medicine training programs. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2018.03.037
更新日期：2018-05-01 00:00:00
abstract：:During the evaluation of a victim of a motor vehicle accident, routine radiographs of the patient's cervical spine, chest, and pelvis revealed multiple radiopaque foreign bodies along his posterior neck, chest, abdomen, and pelvis. Repeat examination of the patient disclosed no evidence of foreign bodies. Further ques...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82986-5
更新日期：1991-09-01 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：:As administrators evaluate potential approaches to improve cost, quality, and throughput efficiencies in the emergency department (ED), "front-end" operations become an important area of focus. Interventions such as immediate bedding, bedside registration, advanced triage (triage-based care) protocols, physician/pract...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/j.annemergmed.2009.05.021
更新日期：2010-02-01 00:00:00
abstract：:The ingestion of iron-containing products is a potential toxicologic emergency. The total iron binding capacity (TIBC) has been used widely as a predictor of end-organ toxicity and a guide to the need for deferoxamine therapy. When the TIBC is greater than the serum iron concentration (SIC), it is held that no free ir...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(99)70420-8
更新日期：1999-01-01 00:00:00
abstract：:In 1976 an independent department was established for the emergency treatment of patients in the county hospital in Szolnok, Hungary. The new system changed the traditional structure of patient flow and the work plan of other departments, and it influenced the curing and nursing activities of the departments. The reor...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80113-2
更新日期：1980-07-01 00:00:00
abstract：STUDY OBJECTIVE:To develop management guidelines for the treatment of anaphylactoid reactions to intravenous N-acetylcysteine (NAC) and to assess the safety of restarting the infusion after a reaction. METHODS:In phased 1, we used a 6-year retrospective case series of hospitalized patients and a review of the literatu...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(98)70229-x
更新日期：1998-06-01 00:00:00
abstract：:A patient with a 70% hydrofluoric acid burn developed systemic dissemination of fluoride ion from a 9% to 10% body surface area exposure on the lower extremities. Severe hypocalcemia and intractable ventricular arrhythmias resulted. This case is the second documented occurrence of hypocalcemia from hydrofluoric acid b...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)81078-7
更新日期：1985-02-01 00:00:00
abstract：STUDY OBJECTIVE:Influenza has been linked to emergency department (ED) crowding, yet few studies have examined this association. We describe the relationship between ED crowding and influenza outbreaks. METHODS:A retrospective time series analysis was conducted in Toronto from January 1996 to April 1999 (n=170 weeks)....
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2003.12.008
更新日期：2004-07-01 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: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:We describe the recidivism characteristics of an adult emergency department (ED) observation unit population and determine whether rates differ according to demographic or clinical features. METHODS:This prospective observational cohort study of a protocol-driven ED observation unit reviewed all discha...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2010.02.012
更新日期：2010-07-01 00:00:00
abstract：:This clinical policy focuses on critical issues in the evaluation and management of patients with acute myocardial infarction or unstable angina. A MEDLINE search for articles published between January 1993 and December 1998 was performed using combinations of the key words chest pain, acute myocardial infarction, uns...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2000.106387
更新日期：2000-05-01 00:00:00
abstract：STUDY OBJECTIVE:We identify, describe, and categorize vulnerabilities in emergency department (ED) to internal medicine patient transfers. METHODS:We surveyed all emergency medicine house staff, emergency physician assistants, internal medicine house staff and hospitalists at an urban, academic medical center. Respond...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2008.05.007
更新日期：2009-06-01 00:00:00
abstract：STUDY OBJECTIVES:The syndrome of rhabdomyolysis associated with cocaine use has been recently described, but the incidence, severity, risk factors, and complications are unknown. This study sought to describe the spectrum of the syndrome and identify clinical features of patients at risk. DESIGN:Retrospective case ser...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)81518-5
更新日期：1990-10-01 00:00:00
abstract：STUDY OBJECTIVE:The use of the International Classification of Diseases system to describe emergency department (ED) case mix has disadvantages. We therefore developed computer algorithms that recognize a combination of words, word fragments, and word patterns to link free-text complaint fields to 20 reason-for-visit c...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(03)00748-0
更新日期：2004-03-01 00:00:00
abstract：:We describe a patient with a long history of rheumatoid arthritis who presented in full cardiopulmonary arrest. He was given intracardiac epinephrine. Fibroptic laryngoscopy determined the cause of the arrest to be upper airway obstruction from cricoarytenoid joint ankylosis, a complication of long-standing rheumatoid...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80893-3
更新日期：1985-07-01 00:00:00
abstract：STUDY OBJECTIVE:Radiology-performed transabdominal pelvic ultrasound, used to evaluate female patients with suspected pelvic pathology in the pediatric emergency department (ED), is often delayed by the need to fill the bladder. We seek to determine whether point-of-care ultrasound assessment of bladder fullness can pr...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2018.04.010
更新日期：2018-11-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the effects of early fluid resuscitation on the rate, volume, and duration of hemorrhage using a sheep model of uncontrolled pulmonary vascular hemorrhage. METHODS:Sixteen adult sheep were anesthetized and fitted with catheters to measure systemic and pulmonary artery pressures. A branch o...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70352-4
更新日期：1997-03-01 00:00:00
abstract：:Olfactory and gustatory hallucinations are not often encountered in the acute care setting but may represent the subtle presenting features of a significant underlying disease process. We describe a patient whose most striking presenting symptoms were of olfactory and gustatory hallucinations and in whom the diagnosis...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2010.02.020
更新日期：2010-10-01 00:00:00
abstract：:We report a case of traumatic arterial hemorrhage from the posterior urethral artery, refractory to traditional hemostatic technique, and successfully managed with intraurethral thrombin hemostatic matrix (FloSeal [Baxter Healthcare Corporation, Deerfield, Illinois, US]). We believe that this demonstrates a safe, effe...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.07.012
更新日期：2016-12-01 00:00:00
abstract：:Neurologic injury is a significant source of morbidity and mortality in pediatric patients. In order to clarify the factors influencing outcome in pediatric patients with severe head injury, we studied 200 consecutive patients with Glasgow Coma Scale (GCS) scores of 8 or less. The following data were collected: age, G...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)81025-8
更新日期：1985-12-01 00:00:00
abstract：:Transthoracic cardiac pacing historically has been relegated to the role of the technique of last resort in treating cardiac arrest. Recent studies have shown that this technique has a high rate of successful electrical capture, but often without mechanical activity. Survival rates have been shown to be dismal when th...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80450-3
更新日期：1984-09-01 00:00:00
abstract：:An important aspect in the effective management of an emergency medical services system is the ability to monitor system performance. To provide this information on a timely basis, a comprehensive data collection system is required. We describe the design, implementation, use, and effect of a comprehensive, computeriz...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80847-9
更新日期：1989-05-01 00:00:00
abstract：STUDY OBJECTIVES:To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN:A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70238-1
更新日期：1994-12-01 00:00:00
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, metabo...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(97)70196-3
更新日期：1997-06-01 00:00:00
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：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：:The application of molecular biology to microbiology has led to a surge of new information about most infectious microorganisms, the pathogenesis of the infections they cause, and the specific microbial antigens involved in the immune response to these infections. The simultaneous application of the same techniques to...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(94)70187-3
更新日期：1994-09-01 00:00:00
abstract：STUDY OBJECTIVE:We characterize the quantity and quality of data tables and figures in reports of randomized controlled trials (RCTs) submitted to the British Medical Journal (BMJ) and published in peer-reviewed journals. We investigate how the peer review process affected table and figure quality. METHODS:We reviewed...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2006.06.017
更新日期：2006-12-01 00:00:00
