Emergency Treatment Pubmed Results

CONCLUSIONS: Sedation practices in ICU are shaped by complex interactions between clinical framing, cultural norms, education and training and organisational pressures. Optimising sedation and implementing innovation require prioritisation of sedation as an active, goal-directed treatment, supported by structured education and leadership engagement.

CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: Reciprocal trust between families, nurses and the respiratory team could and should be established swiftly after admission with a discussion of each party's immediate responsibilities and back-up roles.

CONCLUSIONS: It was determined that CP techniques had an effect on DBP, heart rate, respiratory rate and SpO2 in patients under MV support, but had no effect on other parameters.

CONCLUSIONS: US-PDT is a more efficient, safer, and less invasive alternative to ST for ARF patients, resulting in better clinical outcomes, reduced inflammation, fewer complications, and improved survival rates.

CONCLUSIONS AND RELEVANCE: In this cohort study of community-dwelling dual-eligible enrollees, regular Medicaid home visits prior to heat events were not associated with changes in ED visits during extreme heat. This finding suggests that while regular home visits may not have reduced ED visits during heat events, they could have helped facilitate timely care-seeking when heat-related symptoms arose.

CONCLUSIONS: Despite advanced notification, PSPS events are associated with negative health consequences. Older adults are particularly vulnerable to the unintended adverse health effects of PSPS and should be prioritized in mitigation efforts.

Ingestion of button batteries poses an acute life-threatening injury risk, particularly for small children. The Canadian Surveillance System for Poison Information reported 1021 single-substance button-battery ingestion cases from 2020 to 2023, and the British Columbia Drug and Poison Information Centre (DPIC) managed 548 unintentional ingestion cases from 2013 to 2023. Nearly all the DPIC cases required hospital admission for X-ray imaging, and seven patients required surgical removal of the...

BACKGROUND Ceftriaxone is a cephalosporin antibiotic administered by injection, and although it is widely used, there have been rare reports of anaphylaxis and cardiac arrest, with some fatal outcomes. This report describes the case of a 61-year-old woman with anaphylaxis and cardiac arrest on initial intravenous administration of ceftriaxone who recovered following cardiopulmonary resuscitation. CASE REPORT A 61-year-old woman with a 3-day history of cough and dizziness presented to the...

A healthy young woman sustained severe hyperbaric injury after scuba diving, despite having done previous dives. She had an asystolic cardiac arrest immediately after ascent and was resuscitated for 90 minutes before return of spontaneous circulation (ROSC). After ROSC, she remained profoundly unstable, on multiple vasopressors, with refractory hypothermia and hypoxemia. She was diagnosed with arterial gas emboli (AGE) leading to arrest. The only treatment for AGE is rapid hyperbaric oxygen...

CONCLUSION: This study highlighted that interagency simulations are a valuable exercise when multiple health service providers are involved in the management of individual patients who are critically unwell. The significant effort to organize and coordinate to create high-fidelity scenarios by facilitators is rewarded with significant benefit found by the participants in their ability to be prepared for the real-life scenario. Such findings have important implications for ongoing interagency...

CONCLUSION: In our experience, simulation training scenarios involving critically ill patients with radioactive contamination in nuclear facilities enhance the competencies of both flight personnel and HEMS medical staff. These scenarios also support smoother implementation of HEMS responses to incidents within nuclear facilities and provide a basis for ongoing refinement and improvement of operational procedures.

CONCLUSION: During the study period, neonatal intubation success on transport did not differ when comparing NNP with CCT. This result supports staffing neonatal transport teams based on staffing availability.

CONCLUSION: The Ornge arm circumference and width-based model offers a reliable method for predicting patient weight in air ambulance settings. Implementing this tool could improve the efficiency and safety of patient transfers by reducing delays caused by inaccurate weight estimations, thereby expediting access to critical care. Further research is recommended to validate these findings in larger and more diverse populations.

CONCLUSIONS: Patient engagement is a key challenge for digital tools in mental health, but previous studies in digital decision support tools have focussed on clinician feedback. In this study we ascertained the views of lived experience participants in mental healthcare triage and referral in difficult to treat depression. Participants identified delays, errors and confusion in the referral process and expressed positive views on the ability of the CHRONOSIG tool to help to improve waiting...

CONCLUSIONS: Reintubation after HLT significantly increases morbidity and mortality. Identified predictors provide actionable targets for enhanced perioperative airway management.

CONCLUSION: The findings revealed 12 facilitators and eight barriers influencing resilience among CCTPs in the fixed-wing air ambulance environment in South Africa.

CONCLUSION: Obesity status was associated with an increase in modifiable duration of emergent air ambulance interfacility transfers in Ontario.

Transitioning from fire-based emergency medical services to the world of critical care flight medicine represents a dramatic professional evolution. This shift demands not only new clinical competencies but also a profound transformation in mindset, autonomy, and operational readiness. Fixed-wing critical care flight paramedics must master complex equipment, medications, and physiology under unique constraints, including altitude and international operations. This subject review explores the...

CONCLUSION: Over 40 years, Duke LifeFlight has exemplified resilience, clinical excellence, and leadership in critical care transport. As it enters a new era, the program remains dedicated to advancing prehospital medicine and continuing its mission of delivering lifesaving care when seconds matter most.

On July 30, 2025, at approximately 08:25, a magnitude 8.7 earthquake occurred near the Kamchatka Peninsula. Although the earthquake itself caused no direct damage in eastern Shizuoka Prefecture, a tsunami was predicted to reach Japan, prompting the issuance of a tsunami warning. In response to the forecast-predicting tsunami heights of up to 3 m in eastern Shizuoka-operations of the physician-staffed helicopter were relocated to an inland landing site, away from the coastal area, to ensure the...

CONCLUSIONS: Musculoskeletal conditions remain a blind spot for people designing, implementing, and evaluating digital health for triage: few tools were specifically designed for musculoskeletal conditions, and most existing tools performed poorly when applied to musculoskeletal populations. We recommend health systems and clinicians use a multimodal approach, integrating both digital health tools and clinical decision-making to safely triage and diagnose until a more robust tool for...

CONCLUSION: Research is required to identify the unique needs of the air medical setting and develop effective and feasible methods to address learning outcomes, the impact of which must be evaluated. Simulation should be embedded into air medical training programs, and educators should be supported with the resources, materials, and learning facilities needed to develop effective simulation programs.

CONCLUSION: Requirement of IMV at 72 h is an important early post-transplant outcome associated with post-transplant survival. This appears driven by those with severe PGD.

CONCLUSION: The first 2 phases of this study have demonstrated that transport team members can use handheld US technology to obtain timely and sufficient quality cardiac images to allow for identifying and triaging of CHD in infants. This novel, resource-conscious application has the potential to streamline the care of hypoxemic newborns after undergoing protocol efficiency refinement, independent proficiency testing, and study of remote application.

CONCLUSION: The air medical transport of patients with an EVD is a low-frequency transfer. Therefore, the use of clinical practice guidelines will enable best practice assessment and management.

CONCLUSIONS: This novel POC hs-cTn assay achieves high sensitivity and NPV when used alongside the T-MACS decision aid, but efficiency may be greater at a 5 ng/L threshold without requiring any decision aid.

CONCLUSION: Invasive mechanical ventilation, central venous catheterization, and elevated D-dimer levels are associated with VTE risk, supported by relatively high-quality evidence. These findings may help identify ICU patients at higher risk of VTE, inform the development of risk assessment models for patient stratification, and ultimately contribute to improved prognosis through optimal screening and management strategies.

CONCLUSION: Older patient age, higher BMI, and ISS are independent predictors of post-traumatic thromboembolism. Crucially, the administration of TXA and erythrocyte concentrates, essential for acute hemorrhage control, was not associated with an increased thromboembolic risk in the obese cohort. These findings support aggressive hemostatic resuscitation in high-risk obese patients.

CONCLUSION: Significant differences exist between Sweden and the Northeastern U.S. in prehospital WB transfusion demographics and practices. These findings highlight that one should not assume similar patient profiles or transfusion strategies across different countries' EMS WB programs.

CONCLUSION: Very early VTEp (≤ 24 h) was associated with a reduction of 3.7 ventilator days in low-risk and 2.8 days in moderate-risk TBI patients, while high-risk patients demonstrated increased mortality (21.3%). These findings underscore the importance of personalized, risk-stratified prophylaxis strategies. However, given the retrospective design and absence of radiologic progression or cause-specific mortality data, prospective validation is required before implementing practice...

CONCLUSIONS AND RELEVANCE: In this cohort study of patients successfully resuscitated from IHCA, American Indian or Alaska Native, Black, and Hispanic patients were less likely to have early DNAR orders than White patients. There were no differences in survival among patients with early DNAR orders placed.

CONCLUSIONS AND RELEVANCE: This qualitative study identified 3 strategies, informed by the perspectives of multiple stakeholders, to manage law enforcement presence in the ED. Optimization of hospital environments through these 3 strategies may support SOV rights and recovery, mitigate adverse interactions between law enforcement and SOVs, and improve information sharing and job effectiveness for different stakeholders in the ED.

CONCLUSIONS: Pharmacy-led services improved clinical outcomes, however there was lack of studies showing the economic and humanistic outcomes of these services. The need for standardized protocols and further research to establish their broader impacts should be considered. The findings support the continued integration and expansion of pharmacist roles in emergency care, which could influence global policy and practice in healthcare systems.

CONCLUSION: In this study, poisoning-related cardiac arrest was associated with a high survival rate, even in cases with non-shockable rhythms. Hypoxia and direct cardiac toxicity were identified as the primary aetiologies in many patients.

BACKGROUND: Outcome from large vessel occlusion stroke can be significantly improved by time-critical thrombectomy but treatment is only available in regional comprehensive stroke centres (CSCs). Many patients are first admitted to a local primary stroke centre (PSC) and require transfer to a CSC, which delays treatment and decreases the chance of a good outcome. Access to thrombectomy might be improved if eligible patients could be identified in the prehospital setting and selectively...

CONCLUSIONS: This long-term study of ED presentations highlighted the stable demand for ED services associated with a dramatic decrease in ETP and an increase in DNW cases suggesting a health system operating at critical levels of capacity. Addressing these challenges requires a multifaceted approach, and our study may assist in providing a foundation for future research and policy development aimed at improving ED efficiency and patient outcomes.

CONCLUSION: The findings of this research present a knowledge framework that can help exercise planners in prehospital settings in designing scientifically sound and standardized exercises aimed at enhancing disaster response processes. Furthermore, the implementation and evaluation of both discussion-based and operation-based disaster exercises informed by these identified quality indicators can foster the development of knowledge and promote behavioral change among prehospital staff, and...

CONCLUSIONS: Survey respondents largely supported the Pedi-PART trial. Respondents who were parents or who had higher education were more likely to support the trial.

CONCLUSIONS: Observational deployment of a heart rate variability-based clinical decision support tool within the emergency department is feasible and perceived to have the potential to improve care.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, most patients with OHCA received ETI as the first advanced airway procedure, despite higher SGA first-pass success. Among patients whose initial attempt failed, most continued with the same device. However, switching from ETI to SGA had a higher final success rates. These findings highlight the importance of airway device sequence in prehospital care and may inform training and protocols for airway management.

CONCLUSION: We identified three triage models that had different roles related to access to unscheduled care. Telephone triage is used frequently to fit demand to available resources.

CONCLUSION: This study clarifies the effect of vitamin D in controlling all clinical manifestation of severe traumatic lung contusion, controlling all clinical manifestation of VAP, controlling all clinical manifestation of sepsis, accelerate weaning from ventilation, shorten the duration of ICU stay and decreasing the mortality rate of those patients who had sever traumatic lung contusion and ventilated for ten days, then complicated by VAP and sepsis as complications from prolonged...

CONCLUSIONS: Our findings highlight the increasing role of the potent unregulated drug supply in opioid toxicities across Canada, as well as important differences in the role of prescription opioids in harms across demographic groups, geography, and opioid indication.

When given a sample of 100 emergency department discharge instructions, Claude Sonnet, a large language model, produced accurate Spanish translations as evaluated by Spanish-speaking physicians and medical interpreters.

CONCLUSIONS: To improve the engagement of older adults in falls prevention interventions following a fall, the establishment of a central point of contact could be considered. Individual tailored interventions, including psychological support as well as specific fall training, are needed.

CONCLUSIONS: Patients transported in CPA experienced fewer EOL discussions, showed socioeconomic disparities, and had distinct perceptions of the quality of death. These findings emphasize the need to enhance advanced care planning communication and emergency preparedness in EOL cancer care.

As a result of the ageing of the population, emergency departments are receiving more and more elderly people, some of whom visit several times a year (frequent users). Sometimes, these visits are inappropriate or avoidable. This study, which focuses on elderly people who are frequent users of emergency departments, is based on an analysis of a complex and authentic story and interviews with the professionals involved. It highlights the main risks of disruption in the care pathway for these...

CONCLUSION: Our VOG-based machine learning model for differentiating dangerous from benign vertigo demonstrated good accuracy and showed potential for use across different equipment, testing methods, and institutional protocols.

RATIONALE: In computed tomography angiography (CTA), the phenomenon of contrast agent separation (CAS) is one of the key imaging features for diagnosing arterial dissection. This case highlights that the "contrast agent separation" (CAS) sign in CTA after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may result from retrograde perfusion exceeding native cardiac output, causing uneven contrast mixing and potential misdiagnosis as Type A aortic dissection (AD). CTA combined with...

BACKGROUND: The COVID-19 pandemic highlighted a global shortage of, and inequity of access to, medical oxygen. Understanding patient outcomes and the capacities of health facilities to provide respiratory support including oxygen is key to matching need and demand. We report results from a global study including 23 low-income and middle-income countries.