Clinical and Experimental Emergency Medicine最新文献

{"title":"Precision resuscitation beyond neutral trials in cardiac arrest research.","authors":"Tae Nyoung Chung","doi":"10.15441/ceem.26.381","DOIUrl":"10.15441/ceem.26.381","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 3","pages":"251-253"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global academic productivity in emergency medicine and research output by countries of different income levels.","authors":"Alexei A Birkun","doi":"10.15441/ceem.25.144","DOIUrl":"10.15441/ceem.25.144","url":null,"abstract":"<p><strong>Objective: </strong>Despite disparities in the availability and quality of emergency care, the extent to which countries with different incomes participate in research on emergency medicine (EM) remains understudied. This study evaluated productivity in EM research depending on national income.</p><p><strong>Methods: </strong>Research published since 2004 in Scopus-indexed journals dealing with EM was analyzed quantitatively. Publication, citation, journal impact, and national socioeconomic data were compared. Automated topic modeling was applied using a latent Dirichlet allocation model.</p><p><strong>Results: </strong>The analysis included 154,458 publications (89.7% in English) from 177 countries. The studies received 1,817,635 citations. High-income countries (HICs) outperformed upper-middle-income countries (UMICs), lower-middle-income countries (LMICs), and low-income countries (LICs) by 11-, 41-, and 72-fold, respectively, by the weighted number of publications (per million population per country), and by 21-, 54-, and 171-fold, respectively, by the weighted count of citations. The annual number of publications is predicted to rise considerably for HICs, to a lesser extent for UMICs, and to far less for LMICs, but not for LICs. Research productivity was significantly related to national socioeconomic indicators. Topic modeling revealed that HICs pay relatively more attention to advances in resuscitation, whereas LICs focus more on injuries.</p><p><strong>Conclusion: </strong>While global research productivity for EM is rising, LICs lag far behind HICs. Priorities in EM research differ among countries with different incomes. The development of country-specific EM research agendas would help boost national academic productivity and determine context-appropriate interventions for improving outcomes in emergency care.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"326-335"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful resuscitation after out-of-hospital cardiac arrest caused by undiagnosed pheochromocytoma-induced cardiomyopathy.","authors":"Yusuke Suetsugu, Toshihiro Hatakeyama, Kaoru Watanabe, Hisao Matsushima","doi":"10.15441/ceem.25.185","DOIUrl":"10.15441/ceem.25.185","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"361-363"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How dispatchers recognize agonal and abnormal breathing in suspected cardiac arrest: a scoping review.","authors":"Sara Tararan, Guglielmo Imbriaco, Nicola Ramacciati, Alessandro Galazzi","doi":"10.15441/ceem.25.196","DOIUrl":"10.15441/ceem.25.196","url":null,"abstract":"<p><strong>Objective: </strong>Early recognition of out-of-hospital cardiac arrest is frequently hindered by the presence of agonal or abnormal breathing, which can lead to delays in dispatcher-assisted cardiopulmonary resuscitation. Improving the recognition of respiratory anomalies may optimize early intervention and improve survival outcomes. This scoping review aimed to map the strategies used by emergency medical dispatchers to identify respiratory anomalies predictive of cardiac arrest during emergency calls.</p><p><strong>Methods: </strong>A scoping review of the literature was conducted in accordance with JBI recommendations and reported following the PRISMA-ScR guidelines. The PCC (population, concept, and context) framework focused on emergency medical dispatchers, strategies to recognize breathing abnormalities predictive of cardiac arrest, and their application during emergency calls. Experimental, observational, and qualitative studies indexed in PubMed, Scopus, the Cochrane Library, and CINAHL up to June 30, 2025, were included.</p><p><strong>Results: </strong>Of 109 records identified, 16 studies met the inclusion criteria. Three thematic areas emerged: (1) modifications to dispatch protocols, including the addition of focused questions to improve detection of agonal breathing and cardiac arrest; (2) hand-on-belly assessment, which, although infrequently used, improved diagnostic accuracy but introduced modest delays in cardiopulmonary resuscitation initiation; and (3) the use of caller-reported breathing descriptors, which reduced missed or delayed recognition of cardiac arrest. Dispatcher training, caller-related factors, and the use of technological aids were identified as secondary cross-cutting themes.</p><p><strong>Conclusion: </strong>Strategies such as protocol modifications, hand-on-belly assessment, and the systematic use of breathing descriptors may enhance dispatcher recognition of cardiac arrest. Structured training that integrates technical competencies and communication skills is essential to optimize the implementation of these strategies. Further research should evaluate the effects of these interventions on survival outcomes across diverse cultural and organizational settings.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"277-291"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamically neutral intubation: management of a physiologically difficult airway.","authors":"Stefan M Kornstaedt, Aishwarya Palaniappan, Maximilian Weinhofer, Stephan Steger, Scott D Weingart","doi":"10.15441/ceem.26.064","DOIUrl":"10.15441/ceem.26.064","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"355-360"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the oscillometric cuff: the utility of point-of-care ultrasound-derived blood pressure in shock.","authors":"Komatineni Himaja Ravikumar, Rajat Naik, Sarbari Swaika, Mohammed Arif Abdul Salam","doi":"10.15441/ceem.26.079","DOIUrl":"10.15441/ceem.26.079","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 3","pages":"364-366"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological eye deviation as a prognostic marker in patients post-cardiac arrest: a retrospective observational study.","authors":"Jae Hwan Kim, Chiwon Ahn, Young Taeck Oh","doi":"10.15441/ceem.25.138","DOIUrl":"10.15441/ceem.25.138","url":null,"abstract":"<p><strong>Objective: </strong>Eye deviation is recognized as a clinical indicator of brain function in acute brain injury. This study investigated the association between radiological eye deviation on brain computed tomography (CT) and neurological outcomes in post-cardiac arrest patients.</p><p><strong>Methods: </strong>This single-center retrospective observational study included adult patients with out-of-hospital cardiac arrest of presumed medical cause who achieved return of spontaneous circulation and underwent brain CT within 24 hours between January 2012 and December 2022. Radiological lateral eye deviation angles were quantitatively measured on brain CT images. Multivariable logistic regression analysis was performed to identify independent predictors of poor neurological outcome at hospital discharge and in-hospital mortality. Receiver operating characteristic curve analysis was used to assess the diagnostic performance of eye deviation angles and serum biomarkers.</p><p><strong>Results: </strong>Among 141 patients, 127 had poor neurological outcomes. Nonconjugate eye deviation was more frequent in the poor outcome group (71.7% vs. 42.9%) and showed a significant association in univariable analysis (odds ratio, 3.37; 95% confidence interval, 1.10-10.90; P=0.035), but it lost significance after multivariable adjustment. The diagnostic accuracy of the conjugate eye deviation angle was modest (area under the curve [AUC], 0.611) and inferior to that of serum S-100B protein (AUC, 0.790).</p><p><strong>Conclusion: </strong>Radiological eye deviation on brain CT alone is insufficient to reliably predict neurological outcomes after cardiac arrest. Further large-scale studies incorporating multimodal approaches are warranted to clarify its prognostic value.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 3","pages":"303-310"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From nonagentic large language models to multiagent systems in emergency medicine: a scoping review.","authors":"Hyesung Kim, Seunghoon Jo, Min Hyuk Lim, Dong Hyun Choi","doi":"10.15441/ceem.26.136","DOIUrl":"10.15441/ceem.26.136","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review aimed to examine studies of nonagentic large language models (LLMs), LLM-based agents, and multiagent systems in emergency medicine and to identify current research trends and major gaps by analyzing their scope of clinical application, system structures, evaluation approaches, and input data characteristics.</p><p><strong>Methods: </strong>The Web of Science, Scopus, PubMed, and CINAHL were searched for literature published from March 8, 2021, to March 7, 2026. English-language full-text studies published during this period were included if they addressed the application, evaluation, or benchmarking of nonagentic LLMs, LLM-based agents, or multiagent systems in emergency medicine or the emergency department. Additional studies were identified through reference tracking and supplementary searching. In total, 35 studies were analyzed.</p><p><strong>Results: </strong>Of the 35 included studies, 26 were application studies, 6 were framework studies, and 3 were benchmark studies. Nonagentic LLMs were the most common system type (n=25), followed by LLM-based agents (n=7) and multiagent systems (n=3). Inputs were predominantly text-based, and evaluation mainly relied on expert comparison, retrospective record review, vignette-based comparison, and task-specific performance metrics. In contrast, workflow-level, prospective, and safety- and trustworthiness-oriented evaluations were limited.</p><p><strong>Conclusion: </strong>LLMs in emergency medicine have shown potential for task-level decision support and documentation. However, the current literature remains focused on nonagentic LLM-based task support, whereas studies that reflect the dynamic workflow of real emergency departments remain limited. Future research should expand toward workflow-aware design, operational evaluation, multimodal data integration, multiagent-based role coordination, and validation of safety and trustworthiness.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"263-276"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are two planes better than one? A comparative analysis of transverse versus sagittal suprapubic views in the Focused Assessment with Sonography in Trauma (FAST) examinations.","authors":"Matthew Alfarano, Amy Marks, Daven Patel, Evelyn Schraft, Tina Sundaram, Aylin Ornelas Loredo, Ohm Shukla, Nhat Nguyen, Gary D Peksa, Michael Gottlieb","doi":"10.15441/ceem.25.215","DOIUrl":"10.15441/ceem.25.215","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the diagnostic value of the sagittal and transverse views of the suprapubic window during a Focused Assessment with Sonography in Trauma (FAST) or extended FAST (eFAST) examination.</p><p><strong>Methods: </strong>This retrospective chart review analyzed suprapubic windows of FAST/eFAST images performed from August 15, 2017, to August 1, 2024. Each ultrasound video was reviewed for the presence or absence of free fluid, image quality, and diagnostic confidence. Reviewers were blinded to clinical information and did not assess more than one imaging plane in the same patient.</p><p><strong>Results: </strong>Of the 958 FAST/eFAST studies identified, 497 met inclusion criteria. Of these, 433 (87.1%) were diagnostic, while 64 (12.9%) were nondiagnostic in at least one imaging plane. Among diagnostic images, 93 (21.5%) sagittal views and 74 (17.1%) transverse views were positive for free fluid. A total of 32 exams (34.4%) showed free fluid in the sagittal views but were negative on the transverse view, whereas 13 cases (17.6%) were positive on the transverse view but negative on the sagittal view. Using both views reduced overall nondiagnostic rate from 12.9% to 1.2%.</p><p><strong>Conclusion: </strong>Using both sagittal and transverse views in the suprapubic window during a FAST/ eFAST examination can reduce the nondiagnostic rates and improve identification of free fluid. The observed discrepancies between views and variability in the image quality and confidence support a multiview approach.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"336-341"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diverging trends in the incidence and mortality of acute severe trauma in Korea, 2020-2024: an analysis based on the National Emergency Department Information System (NEDIS) data and the 2024 healthcare crisis.","authors":"Sunju Kim, Oh Hyun Kim, Myeong Il Cha, Jung Eon Kim, Seung Joon Lee","doi":"10.15441/ceem.26.096","DOIUrl":"10.15441/ceem.26.096","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"342-349"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}