Clinical and Experimental Emergency Medicine最新文献

{"title":"Unexpected Right Upper Lobe Atelectasis in an Intubated Patient: Tracheal Bronchus.","authors":"Kiyoshi Takemoto, Kazuaki Atagi","doi":"10.15441/ceem.26.132","DOIUrl":"https://doi.org/10.15441/ceem.26.132","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599716","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}

{"title":"Patient-reported outcomes in cannabinoid hyperemesis syndrome patients treated in the emergency department: a pilot study.","authors":"Ryan Heidish, Aditya Loganathan, Taylor Bolden, Ziva Cooper, Meylakh Barshay, Isabella Lagunzad, Andrew C Meltzer","doi":"10.15441/ceem.25.032","DOIUrl":"10.15441/ceem.25.032","url":null,"abstract":"<p><strong>Objective: </strong>Abdominal pain is one of the most common emergency department (ED) complaints, with many patients experiencing recurrent episodes due to cannabinoid hyperemesis syndrome (CHS), a syndrome characterized by pain and vomiting in the setting of chronic cannabis use. This pilot study aimed to demonstrate the ability to enroll patients with CHS, characterize patient-reported outcomes (PROs), and estimate 30-day revisit rates.</p><p><strong>Methods: </strong>This prospective observational study enrolled adult ED patients with CHS at an academic center and community affiliate. The inclusion required a prior diagnosis of CHS and ED clinician judgment that symptoms at time of enrollment were likely due to CHS. Exclusions included unstable clinical status or other high-risk conditions. Primary outcomes included characterization of symptoms, assessment of multiple domains of PROs, measurement of the use of both computed tomography (CT) scans and opioid analgesia, and frequency of 30-day ED return visits.</p><p><strong>Results: </strong>A total of 18 participants were enrolled (mean age, 34 years; 10 female patients, 55.6%). Automated chart reviews were completed for each outcome of interest at 30 days and at 12 months. Pain severity was high (mean triage pain score, 6.2±4.3) and prior CT imaging was noted in 13 patients (72.2%) in the past 5 years. Opioids were administered in four patients (22.2%), while the 29-Item Patient-Reported Outcome Measurement Information System (PROMIS-29) scores highlighted high risk of anxiety (mean T-score, 56.11±11.45) and how pain interfered with normal activities of living (mean T-score, 62.24±11.11). Return visits occurred in three patients (16.7%) within 30 days.</p><p><strong>Conclusion: </strong>ED patients with CHS show a significant burden on PROs and high 30-day revisit rates. Future studies should consider interventions that address PROs and reduce ED revisits.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"213-220"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653772","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":"Required training experience and essential emergency procedures for a competency-based emergency medicine residency program in Korea: two modified Delphi consensus studies.","authors":"Kyung Hye Park, Young-Min Kim","doi":"10.15441/ceem.26.003","DOIUrl":"10.15441/ceem.26.003","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 2","pages":"221-226"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410824","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":"The most common airway foreign bodies removed with an anti-choking suction device: a descriptive retrospective study.","authors":"Špela Metličar, Gregor Štiglic, Nino Fijačko","doi":"10.15441/ceem.25.105","DOIUrl":"10.15441/ceem.25.105","url":null,"abstract":"<p><strong>Objective: </strong>Foreign body airway obstruction (FBAO) is one of the leading causes of accidental death worldwide, with food being among the most common causes. The aim of this study was to provide an overview of the most frequent foreign bodies removed from the airway using an anti-choking suction device.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed a database obtained from LifeVac, which has collected data on the use of the LifeVac device since 2016.</p><p><strong>Results: </strong>We analyzed data from 1,062 patients who experienced FBAO and had the obstruction removed using a LifeVac device. These cases spanned 16 countries, with the majority reported in the United States (n=853, 80.3%), where infants were the most represented age group (n=283, 26.6%). Meat was the most common foreign body (n=178, 16.8%). Most victims had no documented medical conditions (n=746, 70.2%). The LifeVac device achieved success on the first attempt in approximately one-third of cases (n=382, 36.0%). Fewer than half of the victims (n=368, 34.7%) sought medical attention afterward. The highest first-attempt success rate occurred in the supine position (247 of 612, 40.4%).</p><p><strong>Conclusion: </strong>Among LifeVac-reported FBAO cases, infants were the most commonly affected group, meat was the most frequent foreign body, and the highest first-attempt success rate was observed in the supine position. These findings highlight populations and scenarios that may benefit from targeted prevention and timely intervention.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"188-197"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653828","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":"Epidemiology of hyperkalemia among US emergency department patients without end-stage renal disease from 2016 to 2024.","authors":"Michael Gottlieb, Robert Hlavin, Sabrina Rabin, Eric Moyer, Jay L Koyner, Kyle Bernard, Kevin G Buell","doi":"10.15441/ceem.25.149","DOIUrl":"10.15441/ceem.25.149","url":null,"abstract":"<p><strong>Objective: </strong>Hyperkalemia is a potentially life-threatening condition among patients presenting to the emergency department (ED). However, most epidemiological studies have focused on those with end-stage renal disease (ESRD), and recent large-scale data on the incidence and management of hyperkalemia in non-ESRD ED patients remain limited.</p><p><strong>Methods: </strong>This was a retrospective cohort study of adults (≥18 years) without ESRD who presented to the ED with hyperkalemia between January 1, 2016, and December 31, 2024. Patients were identified using ICD-10 codes from the Epic Cosmos database. The primary outcome was the incidence of hyperkalemia among all ED visits. Secondary outcomes included admission rates, cardiac arrest, hemodialysis, and administration of medications used to treat hyperkalemia. Data were analyzed using summary statistics and odds ratios with 95% confidence intervals.</p><p><strong>Results: </strong>Among 246,235,769 ED visits, 803,186 (0.33%) had an ICD-10 code for hyperkalemia, and 539,033 (67.11%) of these patients were admitted to the hospital. Cardiac arrest occurred in 18,044 cases (2.25%). Sodium bicarbonate was administered in 38.75% of patients, calcium gluconate or chloride in 32.64%, sodium zirconium cyclosilicate in 24.68%, sodium polystyrene sulfonate in 23.12%, and patiromer in 3.04%. Only 2.99% received hemodialysis.</p><p><strong>Conclusion: </strong>Among adult ED patients without ESRD, hyperkalemia was uncommon but clinically important, with two-thirds requiring admission and approximately 2% experiencing cardiac arrest. Sodium bicarbonate and calcium were frequently administered, while hemodialysis was rare.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 2","pages":"159-166"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410677","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":"Association of acute opioid-induced euphoria and analgesia with subsequent opioid prescriptions in an emergency department-based prospective cohort study.","authors":"Spencer Brown, Eddie Irizarry, Andrew Williams, Michelle Davitt, Jesse Baer, Benjamin W Friedman","doi":"10.15441/ceem.25.056","DOIUrl":"10.15441/ceem.25.056","url":null,"abstract":"<p><strong>Objective: </strong>Emergency physicians have become hesitant to treat patients with opioids because of downstream sequelae related to opioid use disorder. We enrolled a prospective cohort to determine whether the experience of a patient receiving an intravenous (IV) opioid was associated with multiple opioid prescriptions. Specifically, we tested whether greater improvements in pain and a larger euphoric response could predict which previously opioid-naive patients exposed to IV opioids would fill at least two opioid prescriptions in the subsequent 6 months.</p><p><strong>Methods: </strong>We recorded pain scores (range, 0-10) before and 15 minutes after opioid-naive emergency department patients were given IV opioids to manage severe pain. We also determined opioid-induced euphoria (range, 0-10 points) by querying how good, how high, how much euphoria the opioid caused, and how likely the participant was to want the opioid again. Sixmonth outcomes were ascertained using the state prescription monitoring database.</p><p><strong>Results: </strong>Among 506 patients, 32 (6.3%) filled at least two prescriptions during the 6 months following the emergency department visit. TThere were no differences between those who filled ≥2 prescriptions and those who did not with regard to pain relief (P=0.54), how good the medication made participants feel (P=0.91), how high the medication made participants feel (P=0.97), how much euphoria the opioid caused (P=0.23), or how likely the participant was to want the medication again (P=0.37).</p><p><strong>Conclusion: </strong>Filling at least two opioid prescriptions was uncommon after initial exposure to therapeutic IV opioids and was unrelated to either analgesic efficacy or opioid-induced euphoria.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"207-212"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653701","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":"Development of a competency-based emergency medicine residency training model in Korea.","authors":"Young-Min Kim, Chan Woong Kim, Kyung Hye Park, Hyo Joon Kim, Kyung Jun Song, Sung Phil Chung, Dong Ryul Ko, Tae Han Kim","doi":"10.15441/ceem.26.006","DOIUrl":"10.15441/ceem.26.006","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"227-235"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638134","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":"2025 Update of the Korean Guidelines for Cardiopulmonary Resuscitation.","authors":"Sung Phil Chung, Sung Oh Hwang","doi":"10.15441/ceem.26.080","DOIUrl":"10.15441/ceem.26.080","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 2","pages":"113-114"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410702","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":"Ketorolac analgesia in the emergency department in adults: a systematic review and meta-analysis.","authors":"Antimo Tessitore, Luisa Zupin, Fulvio Celsi, Valeria Capaci, Alessandro Amaddeo, Egidio Barbi, Giorgio Cozzi","doi":"10.15441/ceem.25.002","DOIUrl":"10.15441/ceem.25.002","url":null,"abstract":"<p><strong>Objective: </strong>Acute painful conditions are a common reason for emergency department (ED) referral, and a broad variety of analgesic drugs can be used. Among them, ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that has been increasingly used in the past two decades. To clarify the evidence for using ketorolac in EDs, a systematic review and meta-analysis was performed.</p><p><strong>Methods: </strong>A search was performed in PubMed for English-language articles published on or before February 2023. Only randomized controlled trials in adult patients with acute painful conditions treated in an ED were selected. A meta-analysis was performed to evaluate the effectiveness of ketorolac in different pain conditions.</p><p><strong>Results: </strong>Forty randomized controlled trials were selected, including studies focused on acute renal colic, headache, traumatic and nontraumatic musculoskeletal pain, and biliary colic. In these studies, ketorolac was mainly compared to opioids and showed a similar analgesic efficacy. On the other hand, ketorolac does not seem to have a stronger analgesic effect than other NSAIDs.</p><p><strong>Conclusion: </strong>This systematic review indicates that ketorolac may be a valuable alternative to opioids for inducing analgesia in adult ED patients. This meta-analysis showed no significant difference in efficacy between ketorolac and other drugs. Nevertheless, the evidence comparing its efficacy with other common NSAIDs is sparse and should be further explored in future studies.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"140-158"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844697","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":"Epidemiology of acute stroke in emergency departments in Korea, 2020-2024: a report using the National Emergency Department Information System (NEDIS) database.","authors":"Sangun Nah, Eunsil Ko, So-Hyun Han, Hyo Jin Kim, Hanseok Chang, Sangsoo Han","doi":"10.15441/ceem.26.018","DOIUrl":"10.15441/ceem.26.018","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"236-243"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638151","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}