Showing papers in "Annals of Emergency Medicine in 1992"

TL;DR: Highly sensitive decision rules have been developed and will now be validated; these may permit clinicians to confidently reduce the number of radiographs ordered in patients with ankle injuries.

TL;DR: Since the introduction of immediate ED two-dimensional echocardiography, the time to diagnosis of penetrating cardiac injury has decreased and both the survival rate and neurologic outcome of survivors has improved.

TL;DR: Cervical-spine radiology may not be necessary in patients without spinous tenderness in the neck, intoxication, altered level of alertness, or other severely painful injury.

TL;DR: Prehospital medications improve survival in congestive heart failure, especially in critical patients, and early treatment is associated with improved survival, but these medications appear to increase mortality in patients misdiagnosed in the field.

TL;DR: Resource use and charges associated with emergency care are higher for the elderly than for younger patients, and increases in emergency resources and personnel or improvement in efficiency will be needed to maintain emergency care at present levels as the US population continues to grow and age.

TL;DR: In light of recent threats of chemical warfare and the possibilities of chemical acts of terrorism, North American physicians should be knowledgeable of the effects of these agents and the care of exposure victims.

TL;DR: There is a high incidence of agonal activity associated with out-of-hospital cardiac arrest, and presence of Agonal respirations is associated with increased survival.

TL;DR: With the rapid growth of the size of the elderly population, it is important that the emergency medical resources needed to care for the geriatric population are assessed.

TL;DR: In this paper, the hypothesis that serial CK-MB sampling in the emergency department can identify acute myocardial infarction (AMI) in patients presenting to the ED with chest pain and nondiagnostic ECGs was tested.

TL;DR: Most spontaneous pneumomediastinum cases occur in the setting of inhalational drug use, with 82% presenting with either dyspnea or chest pain, and most will present with either subcutaneous emphysema or a Hamman's crunch on examination.

TL;DR: Practical emergency physicians are uncomfortable with elderly patients, and this may reflect the inadequacies of training, research, and continuing education in geriatric emergency medicine.

TL;DR: Although calcium gluconate usually has been considered the first-line treatment of severe envenomations by black widow spiders, it was found to be ineffective for pain relief compared with a combination of IV opioids and benzodiazepines.

TL;DR: In light of recent threats of chemical warfare and the possibilities of chemical acts of terrorism, North American physicians should be knowledgeable of its effects and the care of its victims.

TL;DR: In equal IM doses (5 mg), droperidol results in more rapid control of agitated patients than haloperidol, without any increase in undesirable side effects.

TL;DR: Continuous, semiquantitative end-tidal carbon dioxide monitoring in the prehospital and emergency department setting for confirming proper endotracheal tube placement and assessing prognosis and blood flow during CPR found the colorimetric ETCO2 device is highly accurate for confirming endotrachal tube position in nonarrest patients.

TL;DR: In this model of uncontrolled hemorrhage, immediate IV administration of hypertonic saline/dextran significantly increased hemorrhage volume and mortality and reduction in survival were not as great as that produced by the standard practice of attempting to replace the lost blood with three times that volume of lactated Ringer's.

TL;DR: Although the elderly are the fastest-growing segment of the population, little or no planning is ongoing to meet the emergency health care needs of the elderly in the future, and the task force has provided specific recommendations for addressing these problems.

TL;DR: A physical and evidentiary examination is warranted in all cases of female sexual assault presenting within 36 hours of the assault and institutions dealing with victims from a transient, lower socioeconomic population should offer prophylactic treatment for sexually transmitted disease and pregnancy rather than rely on compliance with follow-up schedules.

TL;DR: A randomized, double-blind, multicenter clinical trial of placebo versus nimodipine was conducted to test the hypothesis that nimmodipine would reduce the frequency of death and of worsening by 30% compared with placebo as mentioned in this paper.

TL;DR: Routine early administration of IV magnesium in acute asthma does not alter treatment outcome and changes in peak expiratory flow were not statistically different.

TL;DR: There is clinically significant overlap in the erythrocyte sedimentation rate, temperature, and WBC count in children with septic arthritis of the hip versus transient synovitis of the Hip in an urban regional children's hospital.

TL;DR: Acute intoxication appears to alter the initial assessment of injury severity, resulting in an increased use of invasive diagnostic and therapeutic procedures.

TL;DR: In this paper, the authors used a specialized tape to select the appropriate size of a pediatric ET tube for elective surgery in a group of children undergoing elective surgey, and the tape was validated by using it to select ET tube size in another group of 203 children undergoing surgey.

TL;DR: Elderly patients fail to manifest identifiable clinical features indicative of bloodstream infection, and the sensitivity and specificity of the best statistical model for identifying bacteremic elderly patients suggest that clinical indicators alone are unreliable predictors of b acteremia in the geriatric ED population studied.

TL;DR: The detector accurately identifies ETT position in children with spontaneous circulation who weigh more than 2 kg and during CPR, a positive test correctly indicates that the ETT is in the airway, but a negative result (suggesting esophageal placement) requires an alternate means of confirmingETT position.

TL;DR: The number of individuals planning to leave appeared to be greater than the number that will be replaced through residency training, and a disproportionate number reported high levels of stress and depression and plan on leaving the specialty of emergency medicine.

TL;DR: Hyperglycemia and restoration of blood flow to ischemic territories were strong risk factors for hemorrhagic infarct conversion and concomitant tissue metabolic changes suggest that marked tissue energy depletion accompanied by acidosis damages brain vessels and renders them penetrable for edema fluid and, ultimately, red blood cell extravasation.

TL;DR: Serial changes in ECGs during a three- to four-hour interval were associated with the diagnosis of myocardial infarction but were infrequent and less accurate than serial CK-MB levels obtained for the same interval.

TL;DR: Capnography by nasal cannula appears to be a useful modality in monitoring during conscious sedation, but further research and clinical experience are required before routine use can be recommended.