Emergency Treatment Pubmed Results

CONCLUSION: Documented adherence to selected prehospital ACS process indicators differed between the two providers. MD1 showed higher documented rates for several process measures, but the retrospective design, heterogeneous documentation formats, limited case-mix adjustment, and the possibility of reverse causation for dwell time preclude causal inference or conclusions about patient benefit. The findings are hypothesis-generating and primarily relevant for local quality assurance and...

CONCLUSIONS: In situations where intravenous catheters are difficult to secure or at high risk of dislodgement either clingfilm or cohesive dressing should be used. Simple elastic bandages should not be used in any setting for securement of PIVC.

CONCLUSIONS: This study identified a range of barriers and facilitators influencing the quality of emergency obstetric and newborn care services, encompassing factors related to healthcare facilities, healthcare providers, as well as clients and the whole community. Therefore, all health care facilities and the regional health bureau need to improve the identified barriers and strengthen all facilitators of quality emergency obstetric and newborn care services.

CONCLUSION: Antibiotic prescribing in the emergency department was notably high, accompanied by critically low rates of microbiological investigation. The findings demonstrate a persistent reliance on empirical therapy. Enhancing diagnostic support, promoting culture-guided treatment, and incorporating routine antimicrobial de-escalation strategies may help strengthen rational antibiotic use and warrant further evaluation.

BACKGROUND: Patients undergoing radiation therapy (RT) for head and neck cancer frequently require escalation of care, leading to emergency department (ED) visits and hospital admissions. An outpatient urgent care clinic (OncoSTAT) may reduce ED visits.

Mechanical ventilation is lifesaving yet harmful when paired with deep sedation and immobility. The ABCDEF, or intensive care unit liberation bundle (assessment and treatment of pain, spontaneous awakening and breathing trials, judicious choice of analgesia/sedation, delirium prevention/management, early mobility, and family engagement) mitigates these risks, improving survival, reducing delirium and coma, shortening time receiving ventilation, and promoting recovery. This article synthesizes...

CONCLUSION: The interdepartmental care model expedited critical care for boarding emergency department patients, increased intensive care unit length of stay, and slightly reduced short-stay admissions.

CONCLUSIONS: Acute specialist contacts declined over time, while the proportion and incidence rate of those following a primary care contact increased, particularly following out-of-hours services. The consistent trend across demographic groups suggests that changes in healthcare organisation and service use, rather than population changes, are contributing to the observed trend.

Vascular Interventional Radiologists (VIRs) frequently perform procedures to treat active hemorrhage and are consulted for assistance in management of active hemorrhage. Many such patients are critically ill with hemorrhagic shock, and may require complex urgent and medical management by the treating VIR. VIRs should understand the pathophysiology of hemorrhage and guidelines for management. Here, we discuss the assessment of acute hemorrhage, physiology of acute traumatic coagulopathy, and how...

CONCLUSION: LISA and INSURE are equally effective modalities for surfactant administration in neonates with no significant differences.

The recent implementation of preventive strategies against Respiratory Syncytial Virus (RSV) in infants has raised questions about potential changes in RSV seasonality and the circulation of other respiratory viruses. This study aimed to compare respiratory virus activity among paediatric patients presenting to the Bambino Gesù Children's Hospital (Rome, Italy), with respiratory symptoms and available BioFire Respiratory Panel 2.1 plus results during September-December 2024 (N = 670) and 2025 (N...

The study aimed to evaluate delays in emergency department (ED) arrival among stroke patients and to identify demographic factors that contribute to these delays. It was a cross-sectional study conducted at the Department of Neurology, Liaquat National Hospital, Karachi, Pakistan, from January to July 2024. A total of 174 patients attending the ED for acute stroke were interviewed. There were 112 men and 62 women, with a mean age of 60.54 ± 12.74 years. One hundred and twenty-six (72.4%) of...

CONCLUSIONS: There are significant differences in the behavior of EMS and HEMS physicians. Future studies are worth considering to understand the correlation between the performance of these procedures by EMS physicians before hospitalization.

CONCLUSIONS: Diaphragm atrophy is a significant and early complication in pediatric cardiac surgery patients. While atrophy alone did not predict weaning outcomes in this cohort, a higher dTF was independently associated with extubation success, suggesting that dTF may serve as a functional marker of weaning readiness in this population.

CONCLUSION: Adolescent suicide attempts show a sex- and method-specific profile, with the pandemic period associated with increased psychiatric burden. Family history of suicide and prior psychiatric diagnosis should remain central to risk assessment.

Atopic dermatitis, the most common inflammatory skin disease of childhood, affects up to 20% of US children and frequently prompts emergency department (ED) visits. Clinicians must distinguish uncomplicated flares from secondary infections or treatment complications and initiate appropriate acute interventions. Evidence supports the judicious use of topical corticosteroids, with systemic therapy reserved for severe or refractory cases. The therapeutic landscape has expanded to include biological...

CONCLUSION: ED providers recognize the potential value of nonpharmacological pain treatment strategies. However, both broad healthcare and ED-specific barriers to implementation may limit routine use in the ED. Future efforts for improving pain management in the ED should identify strategies to address implementation barriers of evidence-based nonpharmacological interventions.

Medicare beneficiaries frequently visit the emergency department (ED) at the end of life, but little is known about the epidemiology of patients admitted to hospice from the ED. We used 100 percent Medicare fee-for-service claims from the period 2018-20 to describe the frequency of direct ED-to-hospice enrollments, associated patient and hospice agency characteristics, and patient outcomes. In this sample, 4.3 percent of initial enrollments in hospice originated from the ED. ED-to-hospice...

Racial and ethnic disparities in health care, including surgery, are well-documented and linked to worse outcomes for minority groups. Social determinants of health-such as living environment, access to care, and prehospital factors-play a significant role in shaping surgical risk and recovery. Neighborhood socioeconomic status, built environment, pollution, and health literacy all contribute to disparities, with disadvantaged communities facing higher rates of advanced disease, complications,...

Neuroleptic malignant syndrome (NMS) is a rare, life-threatening hypermetabolic reaction to dopamine-antagonist drugs that may progress to profound rhabdomyolysis, extreme hyperkalemia, and cardiac arrest (CA). Evidence guiding extracorporeal cardiopulmonary resuscitation (ECPR) for metabolic or toxic etiologies is scarce, and its use in NMS has not yet been described. We report the case of a 23 year old woman who presented with hyperthermia, severe muscular rigidity and laboratory evidence of...

CONCLUSIONS: Paramedic transport decisions for RACF residents were strongly associated with acute illness severity, but crew skill set was also independently associated with transport. Attendances managed by extended care paramedics had lower adjusted probabilities of hospital transport. These findings suggest that extended-scope paramedic models warrant prospective evaluation in this setting.

CONCLUSION: There is strong professional and public support for improving care delivery, including potential hot zone working, to minimise the therapeutic vacuum in active terrorist attacks. Better risk communication and better shared mental models are necessary to balance responder risk with care delivery to maximise lives saved as safely as possible.

CONCLUSION: The clinical effect of prehospital non-invasive ventilation could not be determined due to early termination. This trial highlights important challenges relevant to future clinical trials in the prehospital setting, including patient selection, diagnostic requirements and implementation of complex interventions.

CONCLUSION: Using quantitative pupillometry to assess pupil function during cardiac arrest is feasible when performed by nurses. This report may facilitate pupil assessment during cardiac arrest and provide new insights into cerebral perfusion as a biomarker of recovery.

CONCLUSION: The ED syphilis screening program for Aboriginal and Torres Strait Islander peoples was not cost-effective with the current background rate of syphilis. However, similar screening programs in settings with a higher burden of syphilis may be cost-effective, and further refining the target population based on additional risk factors could help reduce costs.

CONCLUSION: The ICU Liberation Bundle has been shown to improve patient outcomes. Future initiatives should focus on sustaining a comprehensive approach to reducing ventilator-associated events.

This study aimed to evaluate the effects of an integrated nursing model on systemic inflammation, oxygenation, and clinical outcomes in children with severe respiratory failure. Children with severe respiratory failure requiring invasive mechanical ventilation for ≥72 hours were consecutively enrolled. Participants were allocated according to admission period into a routine nursing group (2023) and an integrated nursing group (2024-2025). The integrated nursing model involved multidisciplinary...

CONCLUSION: Recent studies suggest that monitoring techniques may enhance spontaneous circulation recovery rates, although evidence from multicenter randomized controlled trials is lacking. Further research is needed to address this gap.

CONCLUSION: Pediatric emergencies in the prehospital setting are uncommon yet challenging, revealing gaps between training expectations, clinical exposure, and perceived competencies. Strengthened pediatric emergency training-particularly simulation-based practice and EPA-based curricular elements-may enhance preparedness, standardize entrustment decisions, and improve patient safety. Future work should operationalize nested pediatric EPAs and evaluate competency outcomes prospectively.

CONCLUSION: Among the acute poisoning cases collected in this study, drug poisoning was the main type and showed an upward trend. The high-risk groups were the aged 10-20 and ≥60 years groups, and females, with the highest incidence in winter and no significant difference in regional distribution. Therefore, we should strengthen public education activities, enhance prevention and control for key populations, promote rational drug use, strengthen problem-solving strategies for proper drug...

CONCLUSIONS: Provision of expanded supplemental benefits may reduce acute care utilization for certain enrollees. As spending on MA supplemental benefits rises, continued efforts are needed to assess impacts of those benefits.

CONCLUSIONS: The co-designed care pathway prioritises education and awareness to help healthcare professionals recognise and respond to potential trafficking victims in EDs. The care process can be initiated using 'Code Orange', supporting coordinated, interprofessional and comprehensive interventions. Using a person-centred, trauma-informed approach, the care pathway emphasises safety, security and compassion for both victims and healthcare professionals.

BACKGROUND: Current neonatal resuscitation program standards recommend the use of real-time documentation completed by a designated scribe. Accurate documentation of resuscitation interventions after delivery is an important component of future care for the newborn.

CONCLUSIONS: The XGBoost model demonstrated excellent predictive performance with high interpretability for 30-day ED revisit predictions. The implementation of this model could enable risk-stratified interventions and more efficient resource allocation in medically underserved settings, potentially reducing unnecessary revisits and improving patient outcomes. This formative study establishes feasibility and provides a foundation for future multicenter validation studies in similar medically...

For the past few years, pharmaceutical logistics has undergone significant changes, especially in the period referred to as the post-pandemic era, which brought major transformations to healthcare systems around the world. This research provides a novel model to enhance pharmaceutical supply chain services by routing, locating, and allocating urgent and non-urgent patients to home delivery services or automated medicine lockers. Two scenarios are proposed, with one scenario considering two types...

CONCLUSIONS: Unplanned extubations in PICU are influenced by both clinical factors and organizational aspects of care. Notably, most predictors identified (e.g., sedation practices, nurse staffing) are modifiable, indicating the potential for targeted interventions to reduce this adverse event.

CONCLUSION: Inhalation injury was associated with a higher likelihood of lower respiratory tract positivity for potentially pathogenic microorganisms and with increased in-hospital mortality in mechanically ventilated patients.

CONCLUSIONS: Failed extubation affects over one-third of contemporary LT recipients and is strongly associated with morbidity and mortality, highlighting the need for risk-stratified perioperative management and optimized donor-recipient matching.

Survival for out-of-hospital cardiac arrest can be significantly improved through volunteer efforts. To shorten the time to good-quality cardiopulmonary resuscitation, some emergency call centers use mobile phone technology to rapidly locate and alert nearby trained volunteers. Some such community first responder systems use phased alerts: notifying increasingly many volunteers with built-in time delays. The policy that defines the phasing of alerts affects both response times, which have a...

Recent advances in digital technologies hold both promise and potential pitfalls for mental health triage. In this News and Perspectives article, JMIR Correspondent Beth Rush reports on the issue of bias and the role of digital tools in the mental health context.

CONCLUSIONS: Both proximity and socio-economic vulnerability are independent determinants of non-urgent PED use. Policies focusing only on primary care access risk missing key drivers of PED use, highlighting the need for locally tailored strategies such as community outreach near hospitals or programs to strengthen health literacy among families.

INTRODUCTION: Abdominal pain is a common presentation in emergency departments. Among these cases, small bowel obstruction (SBO) is a common diagnosis. Diagnostic procedure is currently based on CT, an imaging modality associated with radiation exposure. Studies suggest good accuracy of point of care ultrasound (POCUS) for SBO. Through the OCCLUS-POCUS study, we aim to evaluate the POCUS ability to rule out SBO in patients with low to moderate clinical suspicion, thereby avoiding unnecessary CT...

INTRODUCTION: Older people living in care homes are at increased risk of harm during acute hospital admissions. In England, care home residents have more than twice as many emergency department (ED) attendances as people of the same age living at home. Up to 40% of emergency hospital admissions of older care home residents may be avoidable with different models of care within their homes.In 2023, National Health Service England introduced the updated Enhanced Health in Care Homes (EHCH)...

CONCLUSION: Prehospital ECG teletransmission allowed early detection of cardiac abnormalities and was associated with changes in patient management in a subset of cases. Its integration in emergency workflows could enhance triage, optimize cardiology routing, and strengthen coordination between field teams and regulation centers.

CONCLUSION: The findings show that working conditions in ambulance services influence how care for patients with breathlessness is provided and experienced. Care is delivered in contexts marked by urgency, uncertainty, and constrained resources, requiring ACs to navigate patient needs, safety considerations, and organizational expectations. While acceptance of limitations functions as a professional strategy, it carries ethical implications for patients' safety, dignity, and care.

This review highlights extracorporeal cardiopulmonary resuscitation (ECPR), the rapid deployment of veno-arterial extracorporeal membrane oxygenation as salvage therapy for refractory cardiac arrest. The goal is to bridge patients to recovery or advanced therapies, with outcomes dependent on patient selection (witnessed arrest, shockable rhythm, younger age, and limited comorbidities) and minimizing "low flow" time. ECPR is now applied across intraprocedural, critical care, and out-of-hospital...

CONCLUSIONS: Limited hospital and trauma center density remains a significant barrier to high-quality surgical care. Reducing travel times, increasing access in rural areas, and improving urban infrastructure could enhance replantation outcomes by ensuring that more patients reach registered hand trauma centers within the critical time window.

CONCLUSIONS: The RemEDy project addresses key limitations of current triage research, including the lack of standardized evaluation methods. By combining expert and clinician consensus; real-time assessment; and multilevel analysis of patient-, clinician-, and emergency department-level factors, RemEDy is expected to provide a more comprehensive understanding of mis-triage and its causes. RemEDy will establish a novel framework for real-time triage evaluation and inform the development of...

Tracheostomy is frequently performed in critically ill patients to prevent complications associated with prolonged intubation, including prolonged ventilation and extended hospital stays. Despite these benefits, its effect on mortality rates remains uncertain. This study investigates the relationship between tracheostomy timing and patient outcomes in ventilated intensive care unit (ICU) patients. A retrospective cohort study was conducted, including adults who underwent tracheostomy between...

CONCLUSIONS: EMDC stroke dispatch criteria demonstrated low PPV, reflecting substantial overtriage due to stroke mimics at the earliest stage of emergency assessment. FAST-based criteria were associated with improved discrimination for confirmed stroke. Confirmed stroke cases had shorter EMS on-scene times, suggesting more streamlined prehospital management. These findings highlight the operational impact of stroke mimics on emergency services and the need to refine dispatch strategies. Because...