Emergency Treatment Pubmed Results

CONCLUSION: The WPMV pedagogical module significantly improves theoretical knowledge and applied clinical reasoning among CICU nurses. However, conclusions are limited to educational outcomes, and further research is required to evaluate its impact on clinical practice and patient outcomes.

BACKGROUND Ventilator-associated pneumonia (VAP) is a severe complication in mechanically ventilated patients. Understanding the knowledge, attitudes, and practices (KAP) of healthcare providers is crucial for prevention. This study aimed to assess the KAP regarding VAP among doctors and nurses in intensive care units (ICU) and respiratory departments across 9 hospitals in China. MATERIAL AND METHODS This multicenter cross-sectional study was conducted from April to June 2024 in 9 hospitals in...

CONCLUSIONS: IOR decision-making in ICUs is dynamic, context-dependent and morally complex, requiring nurses to continuously negotiate competing expectations under uncertainty.

Improving stroke recognition and promoting immediate action are critical to enhancing prehospital stroke care. For two decades, the FAST (Face, Arm, Speech, Time) mnemonic has been widely taught, yet it fails to capture many posterior circulation strokes. To address these limitations, BE FAST (adding Balance and Eye symptoms) was introduced but showed reduced recall for more common symptoms represented by FAST, likely due to common symptoms being placed after less common ones, thus weakening...

CONCLUSION: This study developed a simple, reliable, and clinically applicable nomogram for predicting IMV weaning success in COPD patients with respiratory failure. The nomogram might assist clinicians in implementing early risk stratification, optimizing weaning strategies, and improving clinical outcomes.

CONCLUSIONS AND RELEVANCE: In this diagnostic study of 2 ED eTrigger cohorts, model performance varied by cohort, with LLMs showing similar discrimination but different binary thresholds. These findings suggest that evaluation within the review workflow is needed before implementation and that reviewer-like concordance captures a distinct dimension of model behavior from discrimination.

CONCLUSION: Among five circulating biomarkers of bronchoalveolar injury, sRAGE showed the most favorable kinetic profile, rapidly increasing in MV patients. The early measurement of sRAGE and SpO2/FIO2 upon hospital admission may effectively identify COVID-19 patients at high risk of requiring MV and prolonged oxygen support.

An accurate assessment of inspiratory effort in mechanically ventilated children is essential for optimizing ventilator support and avoiding lung- and diaphragmatic injury. Over-assistance leads to diaphragmatic disuse and atrophy, whereas under-assistance may result in fatigue, diaphragm weakness and patient self-inflicted lung injury (P-SILI). This manuscript demonstrates validated bedside techniques to quantify inspiratory effort. We describe the reference standard for respiratory muscle...

INTRODUCTION: Opioid use continues to cause harm and fatalities worldwide, despite ongoing preventive efforts. Early administration of the antidote naloxone can reverse potentially fatal opioid overdoses. Naloxone distribution programmes have increased survival across regions; however, additional efforts are needed to reduce opioid overdose mortality. One approach is to expand naloxone availability within communities.

CONCLUSION: LVBCs are prevalent among adult ED patients yet inconsistently defined. Addressing the issue will require standardised criteria, interventions targeting root causes, and research focused on patient-centred and economic consequences to optimise BC ordering practices.

This study aimed to analyze the effect of a modified emergency nursing pathway based on the shared decision-making model during alteplase thrombolysis for acute ischemic stroke and provide a reference for establishing a nursing system in the emergency department. Eighty patients with acute ischemic stroke treated with alteplase thrombolysis in our hospital from October 2023 to August 2024 were selected as the study subjects. They were divided into a control group (receiving conventional...

The current study was planned to discuss the importance of endotracheal intubation in airway management, focusing on the less explored concept of physiologically difficult airways in patients with unstable physiological states. Addressing three key physiological challenges is central to successful airway management. These are: refractory hypoxia, refractory hypotension, and metabolic acidosis. Refractory hypoxia occurs when individuals are unable to sustain sufficient oxygen saturation levels...

Cardiac arrest (CA) is a leading cause of death globally. Exosomes derived from mesenchymal stem cells exhibit favourable production, storage, and safety characteristics, making them a promising alternative for post-CA resuscitation. We assessed the safety, biodistribution, and protective effects of human embryonic stem cell-derived immunity-and-matrix regulatory cells (hESC-IMRC-Exo) for post-CA resuscitation cardiac/cerebral injuries, and preliminarily explored its underlying molecular...

Background and Objectives: Postoperative pulmonary complications (PPCs) remain an important cause of morbidity after cardiac surgery. Driving pressure (DP), defined as the difference between plateau pressure and positive end-expiratory pressure, has been proposed as a bedside marker of respiratory system mechanics during lung-protective ventilation. However, its relationship with PPCs in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) remains uncertain. This study aimed to...

Background and Objectives: The SARS-CoV-2 pandemic disrupted oral and maxillofacial surgery (OMS) services worldwide because of the high aerosol-generating nature of head-and-neck procedures, restricted access to elective dental care, and systemic reallocation of hospital resources. Continuous longitudinal multi-year data covering both the pandemic and the post-pandemic phases from regional Romanian (and more broadly central and southeastern European) emergency centers remain scarce. We aimed to...

Background and Objectives: Healthcare-associated infections (HAIs) remain a major challenge in emergency hospital settings, where high patient turnover and empirical antibiotic use may contribute to the emergence and spread of multidrug-resistant organisms. Monitoring antibiotic consumption is essential for antimicrobial stewardship and infection prevention. This study evaluated antibiotic consumption patterns across multiple hospital units and explored their ecological relationship with HAI...

Background and Objectives: Tracheostomy is frequently performed in critically ill patients requiring prolonged invasive mechanical ventilation; however, factors associated with intermediate-term mortality after tracheostomy remain poorly characterized. This study aimed to identify clinical and procedural factors associated with 90-day all-cause mortality after tracheostomy in ICU patients. Materials and Methods: This retrospective multicenter cohort study included 292 adult patients who...

Few studies have examined the impact of community-acquired respiratory viruses (CRVs) on emergency department visits and outcomes in adults. This study aimed to characterize the epidemiology of CRV infections and assess associations between virus types and clinical outcomes. We retrospectively reviewed adult patients with respiratory symptoms who underwent rapid influenza testing at a community hospital emergency department in Okinawa, Japan, from February 2020 to January 2021. Residual samples...

Neonatal mortality remains a critical public health issue, particularly in resource-limited settings. Simulation-based programs such as Helping Babies Breathe (HBB) have proven effective in strengthening midwives' knowledge and skills in neonatal resuscitation, yet no study has evaluated their impact among practicing Moroccan midwives. The objective of this study was to assess the effectiveness of HBB training on satisfaction, self-efficacy, theoretical knowledge, one-year knowledge retention,...

CONCLUSIONS: Graded intra-hospital transport implementation remains inconsistent across ICUs in southwestern China and is associated with hospital characteristics and staffing resources. Comprehensive implementation may support better transport preparation, communication, documentation and adverse event reporting.

CONCLUSION: After the COVID-19 containment period, ED visits significantly increased, especially in the pediatric age group, while adult volumes recovered more slowly with distinct diagnostic shifts. These patterns in ED visits during the pandemic highlight the need for continuous ED surveillance and flexible, adaptive healthcare strategies that can rapidly scale services and adjust staffing to meet the evolving demands of both pediatric and adult populations during and after public health...

CONCLUSION: The availability of BEmOC and CEmOC services and the related readiness of HFs were low. This study reveals critical gaps in selected LLMICs, including where facilities perform caesarean deliveries without having blood transfusion services. If not addressed, these gaps will limit the contribution of EmOC to reducing maternal mortality in LLMICs.

Background: Traumatic brain injury (TBI) and substance use disorder (SUD) frequently co-occur due to shared risk factors and a potentially bidirectional relationship. However, epidemiological patterns in rural populations remain understudied despite known disparities in access and outcomes. This study aimed to characterize the relationship between TBI and SUD in a rural Southwestern population, including demographic and clinical patterns of diagnostic sequencing. Methods: A retrospective...

Pediatric respiratory infections remain among the leading causes of emergency department visits, hospitalization and pediatric intensive care unit (PICU) admission. Although most acute respiratory infections in children are viral, clinical manifestations overlap substantially among viral, bacterial and atypical pathogens, creating diagnostic uncertainty and promoting empirical antimicrobial use. Rapid antigen tests, nucleic acid amplification tests, multiplex respiratory panels and metagenomic...

CONCLUSIONS: Although pediatric drug poisoning generally has a favorable prognosis, it remains a significant public health issue. These findings highlight the need for targeted preventive strategies, including caregiver education, safe medication storage at home, and increased awareness and training programs for both families and healthcare professionals.

CONCLUSIONS: The findings indicate that AI has significant potential to enhance emergency triage by streamlining service flows and providing robust clinical decision support. However, the current evidence remains heterogeneous and largely exploratory. Key challenges include variability in model performance, a lack of external validation, and studies often limited to specific populations. Consequently, many current tools still lack the necessary reliability for safe, large-scale clinical...

Suicide is a substantial public health problem. In 2024, approximately 49,000 persons died by suicide in the United States, and an estimated 2.9 million persons aged ≥12 years reported having attempted suicide. Emergency department (ED) visits for suspected suicide attempts among adolescents increased during 2020-2021, then decreased in 2022; reports based on more recent data, including ED visits for suicide attempts among older age groups, are lacking. National Syndromic Surveillance Program...

CONCLUSIONS: Maintenance of ALS competence appears to require coordinated educational and organisational supports; longitudinal evaluations with explicit definitions and validated outcomes are needed.

Background: Although disparities in food allergy (FA) related emergency department (ED) use exist, social context factors are understudied and may play an important role. Objective: We sought to evaluate the role of food security and community resources in explaining disparities in FA-related ED usage. Methods: Electronic medical record data from Hasbro Children's Hospital's FA clinic were extracted from January 1, 2016, to December 31, 2021, for children ages < 18 years. Diagnostic...

CONCLUSIONS: By relieving pressure on inpatient services, the GT integration into ED workflows represents a scalable strategy for health systems facing demographic shifts and rising demand for age-sensitive care.

CONCLUSIONS: The EI allows characterization of the heterogeneity of the ED population. The organizational model of Hospital de la Santa Creu i Sant Pau, oriented toward geriatric and network-based care, facilitates referral of complex patients to more appropriate resources, reducing admissions to high-technology hospitals. Incorporating comorbidity analysis may improve ED planning and funding.

BACKGROUND: Intensive care following resuscitation from out-of-hospital cardiac arrest (OHCA) is based on a set of interventions, all of which are intended to reduce anoxic brain injury and improve outcomes, including sedation, mechanical ventilation, circulatory optimization, and temperature control protocols. The backrest position impacts intracranial pressure and cerebral blood flow in traumatic brain injury, and the optimal position for improving outcomes after OHCA is unknown; guidelines...

CONCLUSIONS: This study will provide the first robust evidence on the impact of climate change-related weather conditions on ED usage and morbidity in Germany. The findings aim to support early detection, preparedness, and targeted protection strategies for vulnerable populations and inform clinical and public health decision-making.

BACKGROUND: Nearly half of all 4.8 million annual paediatric deaths worldwide are caused by acute illnesses, which are preventable with timely triage, emergency care and prehospital transport. We assessed the feasibility of using telemedicine to connect emergency medical technicians (EMTs) in ambulances with paediatric telemedicine physicians (TMPs) to improve patient care in a low-resource setting.

CONCLUSION: Despite self-reported generally strong positive attitudes towards RA for hip fractures, it remains underused. Insufficient skills and training were the most common self-reported barriers. Future research could be aimed at assessing the impact of standardised training and departmental protocols on clinical practice.

CONCLUSIONS: The interpretable machine learning model demonstrates moderate predictive performance in both the internal and external validation cohorts and can be used for early risk assessment of invasive MV in patients with acute pancreatitis. The key predictive variables primarily reflect multi-organ dysfunction consistent with the underlying pathophysiological mechanisms of acute pancreatitis.

CONCLUSIONS: SE management requires rapid sequential treatment with benzodiazepines followed by second-line antiseizure drugs. Comparable efficacy among second-line options allows individualized treatment. The Spanish RACESUR and ADAN scales are validated tools that facilitate risk stratification in emergency settings.

CONCLUSIONS: This study demonstrates that major infrastructure failures significantly affect ambulance transport times and destination patterns, highlighting the need to understand infrastructure vulnerability in emergency planning.

CONCLUSIONS: CCSV is associated with better PaO2/FiO2 at 24 hours vs other ventilation strategies. There was no higher incidence rate of pneumothorax with CCSV, and no significant differences were found in the development of radiological infiltrates.

CONCLUSIONS: A fully automated ED SMS communication program was technically feasible and was viewed favorably by survey respondents. Future work should evaluate strategies to increase enrollment and engagement, assess implementation in other settings, and examine the impact of automated messaging on patient experience.

CONCLUSIONS: The study demonstrates the feasibility and effectiveness of transforming emergency care toward integrated, value-based practices centered on frailty using 3D/3D+ multidimensional assessment.

CONCLUSION: Our analysis shows that social media can increase the visibility of long-term invasive mechanical ventilation and reach diverse audiences. Although visibility does not equate to awareness, these findings highlight the potential of social media to support broader communication about long-term IMV and weaning within the medical community and society. Trial registration number: The PRiVENT study is registered at ClinicalTrials.gov (NCT05260853) on 02/03/2022.

CONCLUSION: Incorporating spatial and demographic variations in EMS risk substantially enhances the accuracy of accessibility measurement and optimization outcomes. The results underscore the importance of prioritizing high-risk older adults populations, strengthening EMS capacity in urban cores, and improving coverage in underserved suburbs. This framework offers a transferable tool for developing more efficient and equitable EMS systems in rapidly urbanizing and aging regions.

CONCLUSION: According to the review of quantitative research, non-resuscitative TAFA remains an under-explored area of prehospital medicine. Considering the paucity and the inconclusiveness of available evidence, significantly more research is required to better understand its effects and practical implications. The evidence map generated by this scoping review may assist the professional community in advancing the development of non-resuscitative TAFA.

CONCLUSIONS: The integrated model is associated with shorter treatment times, better neurological recovery, reduced anxiety and depression and higher satisfaction in AIS patients, providing preliminary evidence for a patientcentred comprehensive emergency care model.

CONCLUSION: Initiating HMV at home yields substantial budget savings for payers and society in the Netherlands without compromising previously demonstrated clinical outcomes. These findings support broader implementation of home-based HMV initiation and may inform reimbursement reform and wider adoption of home-based HMV initiation.

Background: Anaphylaxis is a life-threatening allergic reaction that requires prompt epinephrine and post-treatment management. Guidelines recommend prescribing epinephrine at discharge from the emergency department (ED), yet results of studies show lower-than-recommended prescribing rates and variable ED lengths of stay (LOS). Large-scale analyses of adult anaphylaxis care in U.S. EDs remain limited. Objective: The objective was to estimate the proportion of adults discharged from U.S. EDs with...

CONCLUSIONS: DNACPR recommendations for people with a learning disability are at risk of not being followed as intended in emergency contexts due to challenges in communication and documentation. These issues create uncertainty and may contribute to a default to attempt resuscitation. Improvements are needed in how DNACPR decisions are documented, shared and accessed across care settings, alongside training to support staff in interpreting and applying recommendations in complex situations,...

CONCLUSION: The CPC-UI training allowed nurses to practice critical skills needed in the first few minutes of a patient arrest. This training may be especially important in non-critical care areas where nurses typically have less frequent exposure to patient arrest situations and consequently stand to benefit most from structured preparation. Overall, the CPC-UI training presents a valuable model for enhancing nurse preparedness in resuscitation scenarios, warranting broader implementation and...

CONCLUSION: Our Random Survival Forest model for competing risk could not accurately predict cardiac arrest in individual patients newly diagnosed with heart failure, because the event death without attempted resuscitation was treated as a competing event. The lack of information on transitions to palliative care and Do-Not-Attempt-CPR-orders limits the clinical relevance of any cardiac arrest prediction model.