Emergency Treatment Pubmed Results

CONCLUSION: A significant proportion of patients with acute pericarditis experience long-term complications. Sub-optimal adherence to guideline-recommended doses of anti-inflammatory drugs was commonly observed, suggesting an area for improvement in the management of these patients.

CONCLUSIONS: Multi-factorial and multi-component fall prevention interventions initiated from the ED did not decrease falls or recurrent healthcare use. These interventions may improve functional status in older adults at fall risk. Comparisons are limited by the heterogeneity in types of interventions, intervention compliance, and timing of outcomes.

BACKGROUND: Telephone triage services are widely used in many countries, reflecting a broader shift towards remote patient consultations. Acknowledging this trend, we introduced a programme that placed medical students within a telephone triage service. We present this novel teaching intervention alongside an evaluation of student experiences.

CONCLUSION: Use of preemptive anticoagulation for patients with suspected PE was low. Most physicians were unaware of guidelines supporting its use and do not have institutional protocols to guide use of preemptive anticoagulation. Implementation and use of institutional protocols may increase guideline-directed preemptive anticoagulation in select patients.

CONCLUSION: This study indicates that newly qualified nurses in emergency and critical care settings demonstrate a moderate level of emergency response competence, which may be associated by years of work experience and environmental factors. The findings highlight that strengthening perceived organizational support and self-efficacy represents a key intervention strategy for improving emergency response competence, particularly among new nurses in emergency and critical care units who...

CONCLUSIONS: Three clinically distinct STEMI phenotypes were identified with markedly different mortality risks and treatment requirements during prehospital care. Phenotypes derived from readily available prehospital parameters may facilitate early risk stratification, optimize triage decisions, and guide individualized therapeutic strategies.

Background/Objectives: Positive end-expiratory pressure (PEEP) is a standardized component of the invasive mechanical ventilation (IMV) settings to improve oxygenation; however, its physiological effects in patients with no documented prior lung disease remain poorly defined. This study evaluated the impact of moderate PEEP variations on macrohemodynamic parameters, gas exchange, and driving pressure (ΔP). Methods: This single-arm, non-randomized, crossover study included adult intensive care...

CONCLUSION: The findings highlight ethnic disparities in primary healthcare utilization, showing higher use of emergency medical care in Sami compared to non-Sami. Further research should explore the underlying and probably multifaceted factors driving the observed differences.

Loss of speech due to mechanical ventilation is common among patients admitted to intensive care. This condition, often referred to as voicelessness, can generate negative emotions such as frustration and anger. Augmentative and Alternative Communication (AAC) techniques are useful for facilitating communication, but their use can be complex in patients with extensive burns. This case study describes the use of a high-tech AAC system based on a motion sensor in an adolescent with second- and...

CONCLUSION: Prehospital administration of high opioid doses to older patients was associated with increased rates of altered responsiveness and delirium. These findings highlight how out-of-hospital care can impact a patient's ED and hospital course.

CONCLUSION: We identified opportunities to improve sedation and ventilation in the three study settings in Vietnam. The barriers to delivering the care processes we studied echoed those reported in high-income countries, but were exacerbated by local contextual factors such as staffing shortages and differences in professional roles. We developed recommendations for future improvement projects: implementing setting-adapted protocols, standardising terminology to improve documentation, engaging...

Fever in the returning international traveler presents a diagnostic challenge in the emergency department due to the wide range of potential infectious diseases that may be encountered abroad, many of which may manifest with nonspecific presentations. Malaria remains the most common and life-threatening tropical cause of fever and must be ruled out in all febrile patients returning from malaria-endemic regions. Other key infections to consider in returning travelers include dengue, enteric...

Sentinel injuries are often found incidentally on infants presenting with medical concerns or minor trauma as the chief complaint. Failure to recognize these findings as a potential indicator of child physical abuse may result in devastating outcomes, including disability and death. This issue reviews the most common sentinel injuries, including bruises, subconjunctival hemorrhages, oral injuries, and burns. Evidenced-based strategies are provided for evaluation and management of infants...

CONCLUSION: Dynamic parameters within 72 h of ICU admission are predictors of extubation failure and 28-day mortality in severe pneumonia-induced ARDS, offering a tool for early risk stratification. Extubation failure was also strongly associated with increased short-term mortality, underscoring its clinical significance as an adverse outcome during the disease course.

CONCLUSION: The study found that patients with ESKD experienced an increase in ED visits during the COVID-19 pandemic, along with a higher risk of hospitalization and mortality; however, the distribution of patients across hospital service levels improved during the outbreak. These findings can inform preparedness strategies for future public health emergencies.

Mechanical thrombectomy in acute ischemic stroke is highly effective and results in less disability compared to standard care. The treatment is time-sensitive, and delays lead to worse outcomes. Delivering mechanical thrombectomy in sparsely populated rural areas, such as Northern Sweden, is challenging due to long and resource-demanding transports. An alternative to the traditional approach of transporting the patient to the thrombectomy center is to instead transport the thrombectomist to the...

BACKGROUND: Ambulance clinicians use pre-alert calls to emergency departments to enable them to prepare for the arrival of a patient. This can lead to improved time-critical treatment. However, pre-alerts should be used judiciously, as over-alerting may add pressures on busy emergency departments, while under-alerting may lead to delays in time-critical patient care. We undertook a mixed-methods study to explore how pre-alerts are used and their impact on patients, ambulance and emergency...

CONCLUSIONS: Conservative fluid management and active deresuscitation were not associated with worsening tissue perfusion or acute kidney injury. A reduction in vascular injury markers was not observed. Given the modest sample size and resultant imprecision, clinically important effects cannot be excluded.

CONCLUSION: After adjusting for comorbidities and hs-cTn results, older adults had higher rates of death or MI and hospitalization at 30 days.

RATIONALE: Fluid therapy is one of the main interventions provided for critically ill patients, although there is no consensus regarding the type of solution that should be used. There are two main types: colloid and crystalloid. The most commonly administered crystalloid solution is 0.9% saline. Buffered solutions may offer some theoretical advantages (e.g. less metabolic acidosis, less electrolyte disturbance), but the clinical relevance of these remains unknown. This is an update of a review...

CONCLUSION: sPG offers a rapid, cost-effective tool to identify functional dizziness in the emergency setting, complementing standard clinical assessment. It facilitates early recognition of functional dizziness and may reduce underdiagnosis and prolonged symptom chronification.

CONCLUSION: Outborn infants continue to require more invasive respiratory support and experience worse outcomes.

CONCLUSION: The time-to-event analysis found that callers to NHS 111 who do not wait to be triaged are slower to attend ED with a non-avoidable cause than those who are triaged, and are more likely to attend ED with an avoidable cause than triaged callers. This suggests that, for patients with a serious health problem that would be considered non-avoidable at ED, triaging by NHS 111 was associated with a reduced time to ED attendance.

CONCLUSION: Mechanically ventilated patients at Jimma Medical Center experience a high mortality rate. Key determinants of mortality were re‑intubation, comorbidities, complications, MODS, and delayed intubation. Improving ICU protocols, early identification of high‑risk patients, proper monitoring, and prevention of unplanned extubation may improve survival outcomes.

INTRODUCTION: Nearly half of patients who receive invasive mechanical ventilation for acute respiratory failure require over 4 days of ventilator support, each day of which is associated with increased morbidity, mortality and cost. Many of these patients develop expiratory muscle atrophy and weakness, which are linked to failed extubation and weaning. We seek to test the hypothesis that exhalation synchronised abdominal functional electrical stimulation reduces mechanical ventilation duration.

BACKGROUND Cardiopulmonary resuscitation (CPR) is a life-saving intervention. Effective, early CPR can greatly increase survival and improve post-cardiac arrest quality of life. Therefore, all healthcare professionals, including medical students, should acquire CPR skills. This study aimed to evaluate knowledge, attitudes, and practices of CPR in 110 undergraduates in radiological sciences at Jazan University between February 1 and May 25, 2022. MATERIAL AND METHODS A cross-sectional study was...

This article explores the mutual relationship between emergency nursing and ski patrol, highlighting their complementary roles in providing prehospital and hospital-based trauma and medical care. Ski patrols, acting as a crucial first line of medical response personnel in remote, dynamic, and environmentally challenging alpine settings, stabilize patients and manage extrications under the protocols of the National Ski Patrol's Outdoor Emergency Care program. Emergency nurses, in turn, leverage...

CONCLUSIONS: IOTA-ADNEX implementation in OSC offers high same-day discharge rates and reduction in surgical rates compared with RMI triage. To ensure success, implementation should be supported by adequate infrastructure, training and clear pathways. It requires leadership, comprehensive staff training and robust communication strategies. These findings provide practical guidance for healthcare systems for wider implementation of IOTA-ADNEX.

CONCLUSION: Simulation-based training significantly enhances students' competence and confidence in performing BLS. These findings support its integration into medical curricula to foster critical life-saving skills.

CONCLUSION: In adults with sepsis, the NEWS2 score showed higher sensitivity and marginally better prognostic accuracy than qSOFA for predicting short-term mortality and hospital stay. NEWS2 may therefore serve as a more reliable bedside tool for early identification of high-risk patients in emergency and ICU settings.

CONCLUSION: This scoping review highlights the need to define clinicians' roles in managing gynaecological CPP exacerbations in acute, non-specialist settings. It identifies gaps in best-practice pain assessment, management and clinician education, with guidelines and recommendations often of poor quality. Effective CPP management requires a multidisciplinary and biopsychosocial approach and, despite limitations, clinicians can enhance knowledge and practice scope to improve patient outcomes.

CONCLUSIONS: Reducing GRV monitoring to once daily did not increase the incidence of feeding intolerance.

CONCLUSIONS: SHERS acceptance is primarily associated with perceived accessibility, while skepticism may act as a barrier. Developers should prioritize seamless integration with existing ecosystems, clear feedback mechanisms to prevent false alarms, and strong data protection.

Without a personalized first-aid kit, your vacation can quickly turn into a nightmare. Almost every first-aid kit should contain basic supplies for pain, fever, and typical gastrointestinal problems, as well as bandages, disinfectants, and sufficient sunscreen. In addition, you should also consider any necessary long-term medication, insect repellent, and contraception.

INTRODUCTION: Domestic sex trafficking is a major health and human rights concern associated with profound social, physical and psychological harms, including complex trauma. People who are being/have been sex trafficked often present to emergency departments (EDs) with unmet health needs and in contexts shaped by coercion, control and fear of authority. ED encounters represent an important setting for identifying sex trafficking, building trust, making referrals to specialised resources and...

Abdominopelvic CT scans are widely used in pediatric emergency departments (PEDs) but are frequently overused, often resulting in a high proportion of normal findings. To evaluate the diagnostic utility of abdominopelvic CT in acute pediatric emergencies and to identify patterns of use and potential overuse, particularly in relation to presenting symptoms and clinical context. This retrospective study of 399 children (56.6% male, mean age 6.54 ± 4.0 years) at a tertiary center in Tehran, Iran...

CONCLUSION: With the implementation of the statutory changes proposed in this article, all persons in the United States would be guaranteed a statutory right to emergency medical care during direct contact with law enforcement officers. Further, complete data could be collected regarding the prevalence, nature and handling of medical emergencies among persons held in custody, as well as among persons experiencing medical crises during interactions with law enforcement officers in the field.

CONCLUSION: his XGBoost model, incorporating four objective variables, demonstrates good predictive performance for radiographic pneumonia in pediatric outpatient and emergency settings. Its high negative predictive value supports its use as a screening tool to reliably exclude pneumonia and reduce unnecessary chest X‑rays. The model has been deployed as a web-based tool for clinical use.

CONCLUSION: Given the vast size and sparse population of WA, rural and remote patients with open fractures face delays to crucial interventions when compared to similar patients presenting to a metropolitan trauma hospital. Enhancing early antibiotic administration protocols and education within the aeromedical retrieval service and rural/remote sites could improve the timeliness and consistency of care for patients requiring long-distance retrieval to tertiary care.

Preventing the progression of coronavirus disease 2019 (COVID-19) is a critical issue, particularly in patients with comorbidities such as asthma. However, real-world data on the effectiveness of oral antivirals in patients with asthma and non-severe COVID-19 are limited. This study was conducted to evaluate the effectiveness of 2 oral antivirals, nirmatrelvir/ritonavir (NMV-r) and molnupiravir, in reducing adverse outcomes in asthmatic patients with non-severe COVID-19. This retrospective...

CONCLUSION: A structured pre-triage protocol is feasible, acceptable, and potentially effective in enhancing triage efficiency, particularly for visually assessable conditions like skin and eye presentations. By enabling earlier access to essential information, such protocols may reduce unnecessary consultations, improve workflow, and support clinician confidence.

BACKGROUND: Acute poisoning requires the swift and accurate identification of toxicants to enable timely and effective medical interventions. Conventional specimen transportation by automobile can often be delayed due to urban traffic, geographic barriers, and unpredictable road conditions, which can postpone critical toxicant analysis. The exploration of advanced technology such as the unmanned aircraft system (UAS) and ambient ionization mass spectrometry (AIMS) addresses these challenges by...

CONCLUSION: Our study showed that ED admission rates, particularly among older adults, increased from 2008 to 2019. This highlights the growing care needs of older patients and underscore the importance of geriatric-friendly EDs and evidence-based programmes to ensure high-quality care.

In addition to a migration journey often marked by multiple traumatic events, adolescents and young adults (AYA) seeking asylum and living on emergency assistance find themselves in an extremely precarious situation in terms of legal status and living conditions, with a significant impact on their health, during a crucial developmental period. This article aims to explore the specific issues affecting AYA receiving emergency assistance, in terms of physical and mental health, as well as the...

CONCLUSION: Despite being assigned to higher acuity, older adults had longer EDLOS and higher admission rates than younger adults within the same triage category. This highlights a mismatch between triage allocation and care needs, requiring enhanced geriatric-specific risk-stratification approaches.

CONCLUSIONS: In this multi-language evaluation of real-world ED discharge instructions, Google Translate and ChatGPT-4o were non-inferior to professional interpreters for most domains of translation accuracy.

CONCLUSIONS: Trauma care capacity at HUCSH, as measured by this assessment, improved during 5 years of a multi-institutional international partnership. Opportunities exist for investment in hospital infrastructure, workforce retention, and standardized clinical protocols. This model may guide capacity-building efforts in other low-resource settings, serve as a framework for iterative trauma capacity assessment, and monitor progression toward National Surgical, Obstetric, and Anesthesia Plans.

CONCLUSION: A physiotherapist-integrated orthopaedic consultation model in secondary care is highly accepted by patients, increases service capacity and broadens multidisciplinary decision-making capacity. While a model as such is theoretically positioned to reduce consultation wait times, this was not observed in the present analysis-reflecting a growing unmet need for orthopaedic consultation in secondary care.

CONCLUSIONS: Geriatric co-management at the ED is associated with decreased hospital admissions while 30-day ED readmissions or mortality was not impacted. These preliminary results contribute to the evidence that geriatric co-management may be an effective intervention for older patients with frailty at the ED.

CONCLUSIONS: IFs identified in trauma whole-body CT requiring intervention are prevalent and can lead to substantial medical costs. The widely reported prevalence range suggests variations in radiologist recommendations and reporting in clinical practice and calls for standardisations. IFs requiring urgent intervention are not rare, which leads to a diagnosis of significant diseases including cancers and urgent vascular pathologies. Future studies should report long-term, patient-relevant...