Emergency Treatment Pubmed Results

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.

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: 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...

CONCLUSIONS AND RELEVANCE: In this cohort study, among patients with suspected OA-OHCA, EMS-administered naloxone was associated with improved survival and neurologic status and sustained ROSC. These findings support the need for a randomized trial to assess the effects of naloxone in opioid-associated cardiac arrest.

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.

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: 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...

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.

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.

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)...

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...

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...

Background and Objectives: Electrolyte abnormalities are frequently observed in hospitalized patients with acute infections and may reflect underlying disease severity. This study aimed to investigate the association between baseline electrolyte disturbances and clinical outcomes in patients with COVID-19, with a particular focus on albumin-corrected calcium levels. Materials and Methods: This retrospective study included 348 hospitalized patients with COVID-19. Primary analyses were restricted...

The COVID-19 pandemic introduced unprecedented societal disruptions that may have altered patterns of acute substance-related harm. Despite extensive research on overdose mortality, there remains limited real-time, population-level evidence based on Emergency Medical Services (EMS) data. This study provides a national, multi-year characterization of temporal trends in alcohol- and drug-related overdose incidents in Israel across thirteen defined pandemic phases. A total of 18,348 overdose cases...

Supplemental oxygen is a cornerstone intervention in modern clinical practice, widely used to correct hypoxemia in emergency, perioperative, and critical care settings. While oxygen therapy is lifesaving, accumulating evidence indicates that excessive oxygen exposure can induce significant pathophysiological disturbances, particularly within the cardiovascular and pulmonary systems. Hyperoxia (PaO(2) > 100 mm Hg) promotes the generation of reactive oxygen species (ROS), leading to oxidative...

Although family presence during resuscitation demonstrates benefits such as facilitating the grieving process through fostering a sense of closeness, providing reassurance that all efforts were made, and offering an opportunity for a final farewell, its integration for adult patients in healthcare facilities remains contested. Drawing on a Foucauldian lens, this paper explores the complex network of power relations that sustain resistance towards family presence during resuscitation. What counts...

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.

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: 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...

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...

Timely access to children's mental health services depends on accurate identification of service urgency; however, triage practices in Ontario, Canada vary widely, contributing to prolonged wait times and inconsistent pathways to care. This study aimed to develop and validate an empirically based decision-support algorithm to support standardized triaging and prioritization in Ontario based children's mental health agencies. Data were drawn from 17,564 children and youth aged 4-18 years assessed...

CONCLUSION: The primary outcome, magnitude of change in stress and anxiety, demonstrated significant reductions in both POCUS and non-POCUS groups. Despite similar findings within each group, families receiving POCUS reported greater perceived importance of imaging and strong support for its use, highlighting its potential to enhance patient-centered care and support further research into its optimal implementation in pediatric emergency care.

CONCLUSIONS: By linking registry data this study will provide a whole-of-population approach to describing the incidence and outcomes of in-hospital CPR in the English kidney replacement therapy population. This will provide patients, their loved ones, and care providers data on the likelihood of in-hospital CPR success which will aid the advanced care planning in this setting.

CONCLUSIONS: Mortality among patients with CAP admitted to ICUs in middle-income countries remains high, especially in older and mechanically ventilated patients. The lack of data from low-income countries is notable.

INTRODUCTION: We designed the Optimising Care in Critically Ill at the UCHealth by Liberalising the Target O₂ in Mechanically ventilated intensive care unit (ICU) Patients to determine the effectiveness of a multimodal educational and electronic health record order panel intervention in limiting occult hypoxaemia and hyperoxaemia in patients receiving invasive mechanical ventilation by targeting a prespecified oxygen saturation (S(p)O₂ 90%-96%) range.

Pediatric cardiac arrest in the emergency department is rare. We emphasize the importance of preparedness for pediatric cardiac arrest and offer strategies for the optimal recognition and care of patients in cardiac arrest and peri-arrest. This article focuses on both prevention of arrest and the key elements of pediatric resuscitation that have been shown to improve outcomes for children in cardiac arrest. Finally, we review changes to the American Heart Association Guidelines for...

Critical care principles and techniques continue to hold promise for improving patient outcomes in time-dependent diseases encountered by emergency medical services such as cardiac arrest, acute ischemic stroke, and hemorrhagic shock. In this review, the authors discuss several current and evolving advanced critical care modalities, including extracorporeal cardiopulmonary resuscitation, resuscitative endovascular occlusion of the aorta, prehospital thrombolytics for acute ischemic stroke, and...

CONCLUSIONS: Protocolized weaning was associated with shorter mechanical ventilation duration in some analyses, although the certainty of this evidence is low due to high risk of bias and heterogeneity.

Sepsis is a recognized risk factor for upper gastrointestinal bleeding, yet sepsis-specific randomized evidence informing stress ulcer prophylaxis remains limited. This protocol describes the rationale, methods, and statistical analysis plan for a post hoc subgroup analysis evaluating pantoprazole versus placebo in invasively ventilated critically ill adults with septic shock enrolled in the REVISE trial (NCT03374800). This study will be a post hoc extended subgroup analysis of the...

CONCLUSION: With appropriate training and improved knowledge of local resources, APPs could enhance weight management by optimising brief advice provision and signposting to relevant services.

Although older adults (>65 years of age) are considered the highest-risk population for fall-related injuries, adults with intellectual and/or developmental disability (IDD) or cerebral palsy (CP) are also at increased fall risk. We aimed to compare the incidence of fall-related emergency department (ED) visits with injury and age-related trends among adults aged 18-80 years with IDD or CP and a non-IDD/CP comparison group using the 2019 Healthcare Cost and Utilization Project State Emergency...

CONCLUSIONS: The nurse-led educational intervention was effective, demonstrating statistically significant improvements across all areas without reflecting medium-term losses.

Mechanical ventilation is a well-recognized risk factor for acute kidney injury (AKI), but the specific role of mean airway pressure (P(mean)) remains insufficiently defined. We conducted a multicenter retrospective cohort study including 17,428 mechanically ventilated patients from the MIMIC-IV and eICU-CRD databases. To evaluate the association between P(mean) within the first 24 h of ventilation and subsequent AKI, we applied machine learning-based feature selection, multivariable regression,...

AIM: Demand for acute radiology services has increased globally, including in Ireland. Radiology Specialist Registrars (SpRs) play a significant role in managing this workload. However, rising demand can influence workflow, performance, and service delivery. Understanding workload trends is essential to ensure high-quality care. This study evaluates trends in out-of-hours imaging workload for radiology SpRs in a tertiary referral centre over a five-year period. The analysis includes the volume...

AIM: Protocol 37 is the process in Ireland that facilitates emergency inter-hospital transfers. We performed a five-year retrospective review of emergency transfers from a Model 3 Emergency Department (ED). The aim of the study was to identify delays and reasons for delays to transfer.

INTRODUCTION: Basic life support (BLS) training in schools is a public health priority, but long-term retention of basic knowledge is poorly understood. The objective was to quantify the learning and forgetting curves of six threshold concepts (TC) of BLS in secondary school students and examine demographic moderators.

CONCLUSION: This retrospective study shows that LLMs outperformed EDJPs in diagnostic accuracy, differential diagnosis comprehensiveness and response efficiency for emergency internal medicine diseases, demonstrating significant potential for clinical decision support. Subsequent efforts will focus on exploring how to effectively integrate into physician-led collaborative workflows to enhance emergency care quality and efficiency.

Currently, medical institutions lack a comprehensive and reliable quality control indicator system that leverages information platforms to assist nursing staff in managing instruments and equipment. To address this issue, a nursing quality control index system was designed based on management requirements, nursing operation procedures, and quality standards for emergency life support medical equipment. This index system uses an improved support vector machine (SVM) model to facilitate...

BACKGROUND Congenital chylothorax is a rare condition characterized by the accumulation of lymph in the pleural space. It is the most common cause of neonatal pleural effusion, with low incidence and male predominance. When it is complicated by other conditions, diagnosis and management become challenging. This report aims to present a rare case of bilateral congenital chylothorax with a complicated clinical course, highlighting the associated diagnostic and management challenges. CASE REPORT We...

CONCLUSION: Nurses' acceptance of the digital triage platform was primarily associated with perceived improvements in work performance. While extending the UTAUT model with context-specific constructs enhanced explanatory power, results should be interpreted with caution given limitations such as cross-sectional design, construct overlap and shared method variance. The results emphasize the need for contextualized frameworks when evaluating eHealth implementation in primary healthcare.

INTRODUCTION: The management of newborns with persistent pulmonary hypertension has critical importance. These infants require immediate on-site intensive care, which must be continued during transport until arrival at a tertiary regional center. Inhaled nitric oxide is an effective pulmonary vasodilator, and its use during transport may support the treatment of pulmonary hypertension and ensure adequate gas exchange until handover in the intensive care unit. Since March 2018, the Neonatal...

Early risk stratification may support emergency department (ED) decision-making for patients hospitalized with heart failure (HF), yet commonly used tools may perform differently across clinically relevant outcomes. We conducted a retrospective observational cohort study using MIMIC-IV (v3.1) linked to MIMIC-IV-ED (2011-2019). Adult ED encounters with HF International Classification of Diseases-9/10 codes from the ED diagnosis table that were linkable to an inpatient admission were included. The...

About 339 million people worldwide have asthma, and its prevalence is increasing. The asthma pay-for-performance (P4P) program was implemented, but the effectiveness of P4P programs is still controversial. The study evaluated the relationship between participation in the pay-for-performance (P4P) program and emergency service utilization and hospital admission utilization among asthma patients. This population-based cohort study included those who were newly diagnosed asthma patients from 2011...