Emergency Treatment Pubmed Results

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...

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...

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.

Background and Objectives: The COVID-19 pandemic was associated with major disruptions, not only at the environmental, social, and economic levels but also in the public health systems and, therefore, emergency care utilisation. Prior to the pandemic, one of the most significant issues in the ED was overcrowding, with a consequent percentage of people leaving the ED without being seen (LWBS). The aim of this study was to assess the association between the 2020 COVID-19 pandemic and the number of...

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...

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.

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...

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.

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.

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: 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: 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.

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...

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: 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: 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.

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.

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.

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...

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...

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.

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: 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,...

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.

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.

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

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.

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: 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.

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...

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: 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.

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...

CONCLUSIONS: Total REBOA restored cerebral metabolic markers of ischaemia during haemorrhagic shock, as reflected by normalisation of LPR, even in the presence of experimentally elevated ICP. These findings indicate acute metabolic recovery and so suggest that the use of tREBOA in the setting of elevated ICP is not contra indicated and can be a bridge to further treatment. Our findings do not demonstrate absence of tissue injury, or long-term neurological recovery. Further studies incorporating...

CONCLUSIONS: Findings suggest that modest financial incentives may support patient-approved interfacility transfers, ease ED overcrowding, and enhance utilization of underused hospitals while complying with EMTALA. Further study of this model is warranted.

CONCLUSIONS: Findings from this study support the effectiveness of the Italian legislation in promoting preparedness among first aid respondents in the work environment. While the overall competence levels are high, the variations across departments indicate areas for targeted improvement.

Effective hospital capacity management is critical for enhancing patient care quality, operational efficiency, and healthcare system resilience, notably during demand spikes like those seen in the COVID-19 pandemic. However, devising optimal capacity strategies is complicated by fluctuating demand, conflicting objectives, and multifaceted practical constraints. This study presents a data-driven framework to optimize capacity management decisions within hospital systems during surge events. Two...

CONCLUSIONS: CT-assessed sarcopenia, when integrated with laboratory inflammatory markers, provides a robust, mechanistically grounded, and clinically accessible multimodal prognostic framework across critically ill, pulmonary, and geriatric populations.

CONCLUSIONS: The process evaluation highlights the importance of ongoing training and leadership for implementing new interventions within emergency healthcare settings. Furthermore, it emphasized the importance of achieving a comprehensive understanding of the context to improve implementation.

INTRODUCTION: Diaphragm dysfunction is associated with failure to wean from mechanical ventilation. Inspiratory muscle training (IMT) may help improve outcomes for difficult-to-wean patients, yet the optimal approach remains unknown. High load IMT causes a training effect on the extra-diaphragmatic inspiratory muscles, but does not improve weaning success, questioning the utility of frequently cited high intensity IMT loads. Additionally, patients may find IMT unpleasant and distressing due to...

Premedication protocols are common in the Emergency Department (ED) before intravenous contrast-enhanced computed tomography scans to prevent adverse reactions to the contrast media. Such protocols arose due to the complications related to the high-osmolality contrast used 40 years ago, not the modern low-osmolality contrast, which carries a significantly lower risk of adverse reactions. Established regimens call for hours-long premedication protocols, which are often not feasible for emergency...

Epinephrine use in cardiac arrest (CA) is associated with a greater likelihood of return of spontaneous circulation (ROSC) but this early potential benefit does not seem to translate to survival with good neurologic outcomes. Similarly, high-dose epinephrine may yield a small increase in ROSC but does not improve rates of hospital discharge, long-term survival, or improved neurologic outcomes compared to standard-dosed epinephrine. Higher cumulative doses of epinephrine (>3 mg) during CA has...