Clinical and Experimental Emergency Medicine最新文献

Case of multiple acute cerebral infarctions after blunt cerebrovascular injuries. 钝性脑血管损伤后多发性急性脑梗塞病例。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI: 10.15441/ceem.24.276

Noriatsu Ohtsuka, Toshihiro Hatakeyama, Atsuki Hayamizu

引用次数: 0

Pediatric Trauma Management in Switzerland: Insights from a Nationwide Survey. 瑞士的儿科创伤管理：一项全国性调查的启示。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI: 10.15441/ceem.24.251

Leopold Simma

{"title":"Pediatric Trauma Management in Switzerland: Insights from a Nationwide Survey.","authors":"Leopold Simma","doi":"10.15441/ceem.24.251","DOIUrl":"https://doi.org/10.15441/ceem.24.251","url":null,"abstract":"Objective: To explore and analyze pediatric trauma care practices across designated pediatric trauma centers (PTCs) in Switzerland. The focus is on reception, trauma team activation (TTA), trauma team composition, patient volumes, and infrastructure.Methods: A national online survey was conducted among all eight PTCs in Switzerland with an 18- item questionnaire. The survey investigated organizational aspects, criteria for TTA, patient volume, and communication modalities in pediatric emergency departments (PEDs).Results: All PTCs responded, revealing varied methods of TTA, and with reception of major trauma either within PEDs or at adjacent adult trauma facilities. Trauma team composition and activation criteria also differ among centers, with nonsurgeons often leading the teams and anesthesia as a default for airway management. TTA criteria vary widely, with the most common being the request of prehospital crew (62.5%) and physician discretion (50%). Trauma resuscitation is predominantly led by PED attendings (75%).Conclusion: The survey provides insights into the state of pediatric trauma care in Switzerland and emphasizes the importance of multidisciplinary teams and the variability in trauma management practices, which are often tailored to local circumstances. Despite the limitations of self-reported data and the small sample size due to the country's size, the results suggest that a national trauma registry would help to evaluate and optimize pediatric trauma care protocols.","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epidemiology of Deep Venous Thrombosis Among United States Emergency Departments Over an Eight-Year Period. 八年间美国急诊科深静脉血栓的流行病学。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI: 10.15441/ceem.24.299

Eric Moyer, Kyle Bernard, Michael Gottlieb

{"title":"Epidemiology of Deep Venous Thrombosis Among United States Emergency Departments Over an Eight-Year Period.","authors":"Eric Moyer, Kyle Bernard, Michael Gottlieb","doi":"10.15441/ceem.24.299","DOIUrl":"https://doi.org/10.15441/ceem.24.299","url":null,"abstract":"Introduction: Deep vein thrombosis (DVT) is a significant cause of morbidity and mortality worldwide, accounting for substantial healthcare utilization. However, as management strategies have evolved, there is a critical need for current data on incidence, admission rates, and medical management of DVT in the ED setting.Methods: This cross-sectional study analyzed ED presentations for DVT from 2016-2023 using the Cosmos database. Inclusion criteria comprised patients aged ≥18 years with an ICD-10 code for acute extremity DVT. Outcomes included incidence rates, admission rates, and anticoagulant prescriptions. Data were analyzed using descriptive statistics, and subgroup analyses were performed for upper and lower extremity DVTs.Results: Out of 190,144,463 total ED encounters, DVT represented 368,044 cases (0.2%). Among these cases, 119,986 (32.6%) were admitted, with admission rates stable over the study period. Apixaban was the most prescribed anticoagulant (40.3%), followed by rivaroxaban (28.3%), enoxaparin (7.9%), warfarin (3.6%), and dabigatran (0.3%). Use of apixaban increased from 12.4% in 2016 to 56.2% in 2023. Lower extremity DVTs comprised 88.5% of cases, with a 32.1% admission rate, while upper extremity DVTs accounted for 11.7% of cases, with a 37.0% admission rate.Conclusion: This study provides a summary of DVT presentations and management in United States EDs over an eight52 year period. The findings highlight stable incidence rates, reduced admission rates compared to historical data, and a significant shift towards the use of DOACs, particularly apixaban, for outpatient management. These trends underscore the importance of evidence-based practices 54 and ongoing research to optimize DVT management and improve patient outcomes.","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Floating thrombus involving the aortic arch in a woman. 一名女性主动脉弓上的漂浮血栓。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI: 10.15441/ceem.24.292

Gabriele Pagliariccio, Massimo Mattioli, Ilenia Di Sario

引用次数: 0

Single Lumen Displacement of a Hemodialysis Catheter into the Azygous Vein on a Chest Radiograph. 胸片上血液透析导管向颧静脉的单腔移位。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI: 10.15441/ceem.24.298

Robert Hlavin, Michael Gottlieb

引用次数: 0

Assessing the efficacy of electrocardiogram for heart rate evaluation during newborn resuscitation at birth: a prospective observational study. 评估新生儿出生复苏期间心电图对心率评估的功效：一项前瞻性观察研究。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI: 10.15441/ceem.24.245

Kee Hyun Cho, Hyun Su Lee, Eun Sun Kim

{"title":"Assessing the efficacy of electrocardiogram for heart rate evaluation during newborn resuscitation at birth: a prospective observational study.","authors":"Kee Hyun Cho, Hyun Su Lee, Eun Sun Kim","doi":"10.15441/ceem.24.245","DOIUrl":"https://doi.org/10.15441/ceem.24.245","url":null,"abstract":"Objective: This study aimed to assess the efficacy of electrocardiogram (ECG) compared to pulse oximetry (PO) in detecting heart rate (HR) during high-risk newborn resuscitation.Methods: A prospective observational study was performed with high-risk delivery cases to measure the time required for HR detection. A conventional PO and a standard ECG monitor were used for HR assessment.Results: Forty-one infants were analyzed in the study, and 11 among them needed resuscitation. Nine were <32 gestational weeks (GA), 28 were 33-35 GA, and 4 were >36 GA at birth. ECG time for placement to HR detection was significantly faster than PO detection [30 (20-43.5) vs. 125 (100-175) seconds, P<0.001]. ECG time for placement to HR detection was the fastest in the infants below 32 GA at birth [19 (11.5-30) vs. 34.5 (25-44.25) vs. 39.5 (30-64.75) seconds, P=0.039).Conclusion: ECG effectively evaluated HR during neonatal resuscitation compared to PO. Low gestational age infants who need resuscitation often may benefit in HR evaluation with nearby standard ECG.","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute iodinate contrast medium reaction: look at the CT images! 急性碘酸造影剂反应：查看 CT 图像！

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI: 10.15441/ceem.24.295

Annapaola Truono, Nicola Romano, Lorenzo Bacigalupo, Antonio Castaldi

引用次数: 0

Predictive Factors of Emergency Department Length of Stay: Analyzing National Emergency Department Data. 急诊科住院时间的预测因素：分析全国急诊科数据。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI: 10.15441/ceem.24.309

Minha Kim, Sujeong Lee, Minyoung Choi, Doyeop Kim, Junsang Yoo, Tae Gun Shin, Jin-Hee Lee, Seongjung Kim, Hansol Chang, Eunsil Ko

{"title":"Predictive Factors of Emergency Department Length of Stay: Analyzing National Emergency Department Data.","authors":"Minha Kim, Sujeong Lee, Minyoung Choi, Doyeop Kim, Junsang Yoo, Tae Gun Shin, Jin-Hee Lee, Seongjung Kim, Hansol Chang, Eunsil Ko","doi":"10.15441/ceem.24.309","DOIUrl":"https://doi.org/10.15441/ceem.24.309","url":null,"abstract":"Objective: This study aimed to identify and analyze the factors influencing Emergency Department Length of Stay (ED LOS) using a nationwide database to improve emergency care efficiency.Methods: This retrospective study utilized data from the National Emergency Department Information System (NEDIS) in South Korea, covering 25,578,263 ED visits from 2018 to 2022. Patient demographics, clinical characteristics, and ED operational variables were examined. The study employed univariate and multivariate logistic regression analyses to assess the association between these factors and prolonged ED LOS, defined as six hours or more.Results: Among the 25,578,263 patients included, median ED LOS was 2.1 hours (interquartile range [IQR], 1.050 - 3.830 hours), with 12.6% experienced a prolonged ED LOS. Elderly patients (aged ≥ 65 years) were significantly more likely to experience prolonged ED LOS (adjusted odds ratio [aOR]: 1.415, 95% confidence interval [CI]: 1.411-1.419). Patients transferred from other hospitals (aOR: 1.469, 95% CI: 1.463-1.474) and those arriving by 119 ambulances (aOR: 1.093, 95% CI: 1.077-1.108) also had higher odds of prolonged LOS. Conversely, pediatric patients had a lower likelihood of extended stays (aOR: 0.682, 95% CI: 0.678-0.686). Severe illness, including sepsis (aOR: 1.324, 95% CI: 1.311-1.340) and COVID-19 infection (aOR: 1.413, 95% CI: 1.399-1.427), were strongly associated with prolonged LOS.Conclusion: Prolonged ED LOS is influenced by a combination of patient demographics, clinical severity, and systemic factors. Targeted interventions focusing on older adults, severe illness, and operational inefficiencies, such as hospital transfers, are essential for reducing ED LOS and improving overall emergency care delivery.","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Measuring Burnout and Professional Fulfillment Among Emergency Medicine Residency Program Leaders in the United States: A Cross-Sectional Survey Study. 衡量美国急诊医学住院医师项目负责人的职业倦怠和职业成就感：一项横断面调查研究。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-09-06 DOI: 10.15441/ceem.24.255

Carl Preiksaitis, Kalen N Wright, Al'ai Alvarez, Teresa M Chan, Michael Gottlieb, Andrew G Little, Adaira Landry

{"title":"Measuring Burnout and Professional Fulfillment Among Emergency Medicine Residency Program Leaders in the United States: A Cross-Sectional Survey Study.","authors":"Carl Preiksaitis, Kalen N Wright, Al'ai Alvarez, Teresa M Chan, Michael Gottlieb, Andrew G Little, Adaira Landry","doi":"10.15441/ceem.24.255","DOIUrl":"https://doi.org/10.15441/ceem.24.255","url":null,"abstract":"Objective: Emergency medicine (EM) physicians face high burnout rates, even in academic settings. Research on burnout among EM residency program leaders is limited, despite their role in shaping the training environment and influencing resident well-being. This study aims to measure burnout and professional fulfillment among EM residency program leaders and identify contributing factors.Methods: A cross-sectional survey using the adapted Stanford Professional Fulfillment Index (SPFI) was conducted in 2023 to assess burnout and professional fulfillment among EM residency program leaders at US programs. The survey, tailored to EM leaders, was distributed to all current EM Program Directors (PDs) and Assistant or Associate Program Directors (APDs) from accredited US programs. Descriptive statistics and odds ratios were used to compare burnout and professional fulfillment across various groups.Results: A total of 112 of 281 PDs (39.9% response rate) and 130 of 577 APDs (22.5% response rate) participated. Professional fulfillment was reported by 59.8% of PDs and 58.5% of APDs. Burnout was experienced by 42.0% of PDs and 26.9% of APDs. Higher professional fulfillment correlated with alignment with expectations, positive work environments, and perceived appreciation, while burnout was strongly associated with negative impacts on personal health and relationships. About 27.7% of PDs and 23.8% of APDs expressed intentions to leave their current positions within 18 months.Conclusion: A significant portion of US EM residency program leaders experience burnout and low professional fulfillment. Addressing well-being in this population has important implications for education and mentorship provided to future physicians in the field.","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nonocclusive mesenteric ischemia in a toddler during hypothermia after cardiac arrest: a case report. 心脏骤停后低体温时幼儿肠系膜非闭塞性缺血：病例报告。

IF 1.9

Clinical and Experimental Emergency Medicine Pub Date : 2024-09-06 DOI: 10.15441/ceem.24.213

Koji Kanno, Kentaro Watanabe, Yu Kanokogi, Marina Tsujimura, Akira Yoshida, Tomoya Hanada, Yuji Yamagami, Yusuke Ito

引用次数: 0