Abstract:
STUDY OBJECTIVE:To identify the arterial and mixed venous blood gas changes caused by different ventilatory strategies during resuscitation from ventricular fibrillation in a pig model of closed-chest cardiac compression. METHODS:A prospective randomized animal study was performed using 27 domestic pigs (body weight, 30 to 35 kg). Pentobarbital-anesthetized pigs were assigned to receive one of three treatments: (1) chest compression without assisted ventilation (n = 8), (2) assisted ventilation with room air (n = 8), and (3) assisted ventilation with 100% oxygen (n = 8). A fourth group, with the airway completely blocked, was added at the end of the experiment (n = 3). After instrumentation, the ventricles were fibrillated, and chest compression was begun 30 seconds after fibrillation with the use of the Thumper Mechanical CPR system (Michigan Instruments). Arterial and mixed venous blood gas samples were collected at 1, 3, 10, and 20 minutes of resuscitation. Defibrillation was attempted after the 20-minute sample was taken. RESULTS:Fibrillation followed by chest compression alone caused a significant drop in arterial and mixed venous partial pressure of oxygen (PO2) and a significant increase in arterial and mixed venous partial pressure of carbon dioxide (PCO2). Compared with the chest compression only, ventilation with room air significantly increased arterial and mixed venous PO2 and decreased arterial and mixed venous PCO2. Ventilation with 100% oxygen further increased arterial and mixed venous PO2 but did not affect PCO2, when compared with room air ventilation. The only successful defibrillations (3 animals) occurred in the group receiving 100% oxygen. CONCLUSION:This study indicates that passive air movement during chest compression does not allow physiologically significant pulmonary gas exchange and that room air ventilation alone is not sufficient to maintain mixed venous PO2.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Whitehurst ME,Blount AD,Austin PE,Carroll RGdoi
10.1016/s0196-0644(98)70203-3subject
Has Abstractpub_date
1998-05-01 00:00:00pages
568-74issue
5eissn
0196-0644issn
1097-6760pii
S0196064498001309journal_volume
31pub_type
杂志文章abstract:STUDY OBJECTIVE:We assess the utility of the peripheral blood WBC count as a screen for lumbar puncture among young infants evaluated for serious bacterial infections. METHODS:We performed logistic regression modeling and receiver operating characteristic curve analysis of peripheral blood WBC count and cerebrospinal ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2003.9
更新日期:2003-02-01 00:00:00
abstract::Ketamine produces rapid and consistent pediatric sedation with a predictable onset and recovery time. A wide margin of safety is afforded without the respiratory and cardiovascular depression commonly seen with alternative agents. The efficacy of ketamine is well established in anesthesia and dentistry and has extensi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(05)82569-7
更新日期:1990-09-01 00:00:00
abstract::A study was undertaken to compare warm gastric (Group 1) and closed thoracic cavity (Group 2) lavage for rewarming severely hypothermic dogs. Adult mongrel dogs were monitored by intra-arterial catheter, central venous catheter, and ECG, and by central venous, esophageal, and rectal temperature probes. Animals were ex...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80227-5
更新日期:1987-11-01 00:00:00
abstract:STUDY OBJECTIVE:Patient-centered medical homes are primary care practices that focus on coordinating acute and preventive care. Such practices can obtain patient-centered medical home recognition from the National Committee for Quality Assurance. We compare growth rates for emergency department (ED) use and costs of ED...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.01.002
更新日期:2015-06-01 00:00:00
abstract:STUDY OBJECTIVE:News media are used for community education and notification in exception from informed consent clinical trials, yet their effectiveness as an added safeguard in such research remains unknown. We assessed the number of callers requesting opt-out bracelets after each local media report and described the ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2009.05.028
更新日期:2010-01-01 00:00:00
abstract::Blunt abdominal trauma is a common presentation to the emergency department. Ischemic colitis is a rare complication of this and its possible sequelae are important for an emergency physician to recognize. A 21-year-old man presented to the emergency department with abdominal pain and hourly episodes of bright red blo...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.01.014
更新日期:2011-08-01 00:00:00
abstract:STUDY OBJECTIVE:We describe the characteristics and outcomes of enrollee-health plan disputes over insurance coverage for emergency department (ED) services at 2 large health maintenance organizations (HMOs) that apply the prudent layperson standard. METHODS:We abstracted information from a stratified random sample of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(03)00637-1
更新日期:2004-02-01 00:00:00
abstract:STUDY OBJECTIVE:The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. METHODS:We used Ohio's prescription drug monitoring pr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2017.03.057
更新日期:2017-12-01 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: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:We sought to evaluate the methods and accuracy of mortality data collection and summarize the injury mortality rate in one sector of the State of Olancho, Honduras, with the intent to establish a baseline of injury mortality that will identify potential areas of intervention and serve as a comparison af...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2000.109444
更新日期:2000-10-01 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::Systemic toxicity after significant dermal exposure to hydrofluoric acid includes rapid development of hypocalcemia and hyperkalemia, leading to ventricular fibrillation. Similar dysrhythmias have occurred in patients after ingestion of sodium fluoride-containing compounds. Ingestion of hydrofluoric acid could induce ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81910-9
更新日期:1992-11-01 00:00:00
abstract::In a traditional clinical trial, a fixed number of patients are evaluated before the data are analyzed. This has the disadvantage that more patients may be enrolled than are necessary to achieve a statistically significant result. Sequential statistical techniques provide a method for the analysis of clinical trials s...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82570-3
更新日期:1990-09-01 00:00:00
abstract::Experimental ischemia by the classic frostbite rabbit ear model clearly defined the role of thromboxane as a mediator of progressive dermal ischemia in frostbite injuries. The therapeutic groups consisted of the antiprostanoids, methylprednisolone, and aspirin combined with anti-thromboxane agents Aloe vera and methim...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80758-8
更新日期:1987-09-01 00:00:00
abstract:STUDY OBJECTIVE:We determine the accuracy of an age-adjusted D-dimer threshold to detect pulmonary embolism in emergency department (ED) patients older than 50 years and describe current ED practices when evaluating possible pulmonary embolism. METHODS:This was a retrospective study of ED encounters for suspected pulm...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.07.026
更新日期:2016-02-01 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 OBJECTIVE:We seek to examine the efficacy and safety of prereperfusion emergency medical services (EMS)-administered intravenous metoprolol in anterior ST-segment elevation myocardial infarction patients undergoing eventual primary angioplasty. METHODS:This is a prespecified subgroup analysis of the Effect of Me...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.annemergmed.2014.07.010
更新日期:2015-03-01 00:00:00
abstract::This report describes a case of acquired eventration of a hemidiaphragm after insertion of a chest tube for treatment of an iatrogenic pneumothorax. Partial withdrawal of the chest tube resulted in immediate return of the hemidiaphragm to its original position. This is believed to be the first report of the resolution...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(95)70275-x
更新日期:1995-04-01 00:00:00
abstract:STUDY OBJECTIVES:To assess the timing of key decisions and clinical events in the treatment of acute myocardial infarction with thrombolytic therapy. DESIGN:Prospective study of emergency department patients. SETTING:EDs in 11 urban and two rural hospitals. TYPES OF PARTICIPANTS:Patients with presumed acute myocardi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/s0196-0644(05)81749-4
更新日期:1992-10-01 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: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::The American College of Emergency Physicians algorithm project was a pilot study designed to identify a method for evaluating algorithms by peer review and field test. The intent of the pilot project was to make recommendations which would permit a more extensive evaluation of the logic, usefulness, and safety of vari...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80195-8
更新日期:1980-10-01 00:00:00
abstract::Antiarrhythmic agents have been used to treat malignant ventricular arrhythmias in the setting of acute myocardial ischemia with proven efficacy for many years. Thus, it has been presumed that these agents would be efficacious for the treatment of cardiac arrest. Unfortunately, hard data supporting this contention are...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:10.1016/s0196-0644(05)80461-5
更新日期:1993-02-01 00:00:00
abstract:STUDY OBJECTIVE:Intraosseous access is widely used in pediatric and adult resuscitations when vascular access cannot be promptly established. Confirmation of intraosseous needle placement has traditionally relied on the ability to aspirate blood or marrow or infuse crystalloid easily. This study's aim is to determine t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2006.11.009
更新日期:2007-04-01 00:00:00
abstract::Emergency thoracotomy has become a mainstay in the resuscitation of patients with major thoracic injuries. It also is occasionally useful in several other life-threatening conditions. The specific indications for emergency thoracotomy are reviewed, and expeditious thoracotomy in the emergency department, when necessar...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80057-1
更新日期:1981-05-01 00:00:00
abstract:STUDY OBJECTIVE:We assessed the independent relationship between age and the quality of medical care provided to patients presenting to the emergency department (ED) with acute myocardial infarction. METHODS:We conducted a 2-year retrospective cohort study of 2,216 acute myocardial infarction patients presenting urgen...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.12.012
更新日期:2005-07-01 00:00:00
abstract:STUDY OBJECTIVE:Video imaging of intubation as seen by the laryngoscopist has not been a part of traditional instruction methods, and its potential impact on novice intubation success rates has not been evaluated. METHODS:We prospectively tracked the success rates of novice intubators in paramedic classes who were req...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2001.111516
更新日期:2001-01-01 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:STUDY OBJECTIVE:The antivenom currently available for treatment of systemic black widow envenomation (latrodectism) is composed of equine whole immunoglobin. Although considered effective, it has been associated with anaphylaxis and 2 reported fatalities. We test the efficacy and safety of new equine antivenom composed...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.annemergmed.2019.02.007
更新日期:2019-09-01 00:00:00