Clinical and Experimental Emergency Medicine最新文献

{"title":"Skull fractures may be associated with hyperfibrinolysis in patients with isolated traumatic brain injury.","authors":"Gaku Fujiwara, Naoto Shiomi","doi":"10.15441/ceem.24.344","DOIUrl":"10.15441/ceem.24.344","url":null,"abstract":"<p><strong>Objective: </strong>To identify relationships between skull fracture (SF) and hyperfibrinolysis (HF) among patients with isolated traumatic brain injury (TBI).</p><p><strong>Methods: </strong>This was a retrospective cohort study based on a nationwide neurotrauma database in Japan. Adult patients with isolated TBI (head Abbreviated Injury Scale [AIS] >2, any other AIS <3) and who were registered in the multicenter neurotrauma registry from 2015 to 2017 were included. To examine the relationship between SF and HF, we conducted multivariable logistic regression analyses to calculate the adjusted odds ratios (aORs) with their 95% confidence intervals (CIs) for HF. HF was defined as a D-dimer level ≥38 mg/L on arrival based on a previous study.</p><p><strong>Results: </strong>A total of 335 patients were enrolled and the median age of the cohort was 64 years (interquartile range, 44-76 years). HF was observed in 161 patients (48.1%). The association of SF with HF yielded an aOR of 4.78 (95% CI, 2.71-8.42) compared to non-SF in multivariable logistic regression analysis. In addition, the associations of skull base fracture, skull vault fracture, and combination of skull base and vault fracture with HF yielded the corresponding aORs of 3.60 (95% CI, 1.20-10.81), 4.99 (95% CI, 2.63-9.44), and 4.84 (95% CI, 2.41-9.72), respectively, relative to non-SF.</p><p><strong>Conclusion: </strong>This multicenter observational study demonstrated the association of SF with HF in patients with isolated TBI.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"65-73"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844788","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":"Emergency department presentations for suicide and self-harm in Korea, 2020-2024: an epidemiological study using the National Emergency Department Information System (NEDIS) database.","authors":"Yuri Choi, Jinwoo Jeong, Borami Lim, Myeong Il Cha","doi":"10.15441/ceem.26.020","DOIUrl":"10.15441/ceem.26.020","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 1","pages":"98-104"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670739","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":"A false-positive Focused Assessment with Sonography in Trauma (FAST) in a trauma patient.","authors":"Lindsay Taylor, Fred Milgrim, Matthew Riscinti, Michael Gottlieb","doi":"10.15441/ceem.25.011","DOIUrl":"10.15441/ceem.25.011","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 1","pages":"110-111"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670713","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":"Mortality due to minimal bentazone intoxication: a case report.","authors":"Yumin Jeon, Sejoong Ahn, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sukyo Lee","doi":"10.15441/ceem.24.217","DOIUrl":"10.15441/ceem.24.217","url":null,"abstract":"<p><p>Bentazone is a widely used herbicide considered a moderate hazard. Fatalities associated with its use are rare, with deaths reported only after intake of ≥200 mL. In some studies, bentazone intoxication is accompanied by generalized rigidity. Malignant hyperthermia is a pharmacogenetic disease that presents a hypermetabolic response to anesthetic gases or depolarizing muscle relaxants due to calcium channel dysfunction. The classic symptoms of malignant hyperthermia include hyperthermia and muscle rigidity. We report the case of a 65-year-old man who died 4 hours after presenting to the emergency department after ingesting approximately 75 mL of Basagran M60 (bentazone 33.6%, 25.2 g). This is the smallest dose (364 mg/kg) reported in a fatal case to date. Electrocardiogram changes, including QRS widening and QT prolongation, were present, and hypocalcemia was confirmed. We propose that bentazone intoxication causes patient deterioration by a mechanism similar to that of malignant hyperthermia.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"86-89"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723218","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 cardiac arrest and acute myocardial infarction in emergency departments in Korea, 2020-2024: a report using the National Emergency Department Information System (NEDIS) database.","authors":"Sejoong Ahn, Jung Eon Kim, Sung-Keun Ko, Eunsil Ko","doi":"10.15441/ceem.25.318","DOIUrl":"10.15441/ceem.25.318","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 1","pages":"90-97"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670781","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":"Artificial intelligence in emergency medicine critical care.","authors":"Samita M Heslin, Robert Nocito, Scott D Weingart","doi":"10.15441/ceem.26.057","DOIUrl":"10.15441/ceem.26.057","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 1","pages":"1-4"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670757","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":"Public awareness of medical emergency telephone numbers: a scoping review.","authors":"Alexei A Birkun","doi":"10.15441/ceem.24.289","DOIUrl":"10.15441/ceem.24.289","url":null,"abstract":"<p><p>Prompt activation of emergency medical services (EMS) constitutes the fundamental component of bystander response to time-dependent health crises. A clear understanding of the public ability to access EMS can help to guide interventions aimed at enhancing community preparedness for emergencies. This review was conducted to summarize studies that examined public knowledge of emergency phone numbers. This scoping review encompassed articles published since 2004 that reported the proportion of subjects who knew emergency phone numbers. Data sources included PubMed, Google Scholar, and references of included articles. Relevant data from eligible publications were extracted manually to an author-developed data-charting sheet and analyzed descriptively. Forty-eight articles were analyzed. Reported studies, mostly cross-sectional surveys, were conducted in 26 countries, including 16 high-income, 9 middle-income, and 1 low-income country. The percentage of subjects who knew emergency numbers varied from 0% to 97.8% (median, 64.3%; interquartile range [IQR], 32.8%-80.0%). For high-income countries, the median was significantly higher than for low- and middle-income nations (69.6% [IQR, 54.1%-84.2%] vs. 34.6% [IQR, 19.4%-61.5%], P=0.003). The studies were generally inconsistent regarding the association of subjects' sociodemographic factors with knowledge of emergency numbers, suggesting the existence of geography-specific patterns. Available studies observed low community knowledge of emergency numbers, especially in low- and middle-income countries, and suggest that the problem has a global scale. Further research efforts are required to determine the best strategies for enhancing the public ability to access EMS.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"28-36"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977856","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":"Emergency medicine physicians treating urine cultures when it is not clear they should.","authors":"Amanda Doodlesack, Clifford Marks, Nicolette Castaneda, Jonathan Edlow, Shamai A Grossman","doi":"10.15441/ceem.25.206","DOIUrl":"10.15441/ceem.25.206","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"13 1","pages":"105-109"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670710","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":"Assessing emergency department physician workload: A NASA-TLX analysis by experience and care type.","authors":"Donghyun Kim, Junsang Yoo, Ye Rim Lee, Ji Sim Yoon, Seung Jin Maeng, Minha Kim, Sejin Heo, Jong Eun Park, Gun Tak Lee, Se Uk Lee, Taerim Kim, Sung Yeon Hwang, Hee Yoon, Won Chul Cha, Hansol Chang","doi":"10.15441/ceem.25.219","DOIUrl":"https://doi.org/10.15441/ceem.25.219","url":null,"abstract":"<p><strong>Objective: </strong>Emergency department (ED) physicians face substantial cognitive and physical demands, yet workload data applicable to real-world staffing and operational decisions remain limited. This study aimed to quantify perceived workload across diverse ED tasks using the NASA Task Load Index (NASA-TLX) and to determine how workload varies by physician experience, patient acuity, and clinical context. A secondary aim was to generate practical insights that may inform resource allocation and experience-based task distribution in the ED.</p><p><strong>Methods: </strong>We conducted an observational survey of interns, residents, and specialists working in the ED of a tertiary hospital between June and July 2022. NASA-TLX questionnaires were administered to assess workload across common procedures and patient-care tasks. Analyses were stratified by physician experience, Korean Triage and Acuity Scale (KTAS) level, and chief complaint. Nonparametric methods were used to evaluate differences in workload patterns.</p><p><strong>Results: </strong>Sixty physicians participated (30 interns, 30 residents/specialists). Procedures with high technical complexity, such as thoracentesis and lumbar puncture, showed the highest workload among interns. Among residents, workload decreased from postgraduate year 1 to 3 but rose again in year 4, reflecting increased supervisory responsibilities. Higher patient acuity (KTAS 1-2) and neurological chief complaints were consistently associated with elevated workload across all experience levels.</p><p><strong>Conclusion: </strong>Perceived workload in the ED varies significantly by task type, experience level, and patient acuity. These findings provide actionable data that may support evidence-based staffing decisions, workload redistribution, and training strategies to optimize physician performance and mitigate cognitive overload in resource-limited emergency departments.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303264","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":"Machine Learning-Based Clusters of Vital Signs and Lactate Levels Predict Vasopressor Use in Sepsis.","authors":"Daun Jeong, Minyoung Choi, Seung Jin Maeng, Hanbeom Yoon, Jong Eun Park, Gun Tak Lee, Sung Yeon Hwang, Tae Gun Shin, Sung Phil Chung, Tae Ho Lim","doi":"10.15441/ceem.25.247","DOIUrl":"https://doi.org/10.15441/ceem.25.247","url":null,"abstract":"<p><strong>Objective: </strong>Sepsis remains a major clinical challenge because of its complex, heterogeneous, and multidimensional clustering patterns. This study aimed to investigate the association between vasopressor administration and machine learning-derived clusters based on initial vital signs and lactate measurements obtained in emergency department (ED) and intensive care unit (ICU) settings.</p><p><strong>Methods: </strong>A retrospective cohort analysis was performed using data from the Korean Shock Society Septic Shock (KOSS) Registry (septic shock in the ED) and the Marketplace for Medical Information in Intensive Care (MIMIC)-IV database (ICU patients with suspected infection). To derive clusters, k-means clustering was applied to six initial vital signs and serum lactate measurements. The primary outcome was vasopressor administration. Secondary outcomes included second vasopressor administration and 28-day mortality.</p><p><strong>Results: </strong>A total of 17,500 patients were included in the analysis (KOSS cohort, n=7,130; MIMIC-IV cohort, n=10,370). K-means clustering identified three distinct clusters in each cohort. In the KOSS cohort, Cluster 3 was characterized by the lowest mean arterial pressure (MAP) (62 mmHg [IQR, 53-71]) and the highest diastolic shock index (DSI) (2.6 [2.3-3.0]). This cluster was associated with the highest rates of vasopressor administration (93.9%), second vasopressor administration (33.5%), and 28-day mortality (25.3%) (all p<0.001). Comparable physiological and clinical patterns were observed in the MIMIC-IV cohort, in which Cluster 3 likewise demonstrated the lowest MAP (68 mmHg [60-76]) and highest DSI (2.0 [1.8-2.3]). This group similarly exhibited the poorest outcomes, including vasopressor administration (41.0%), second vasopressor administration (16.7%), and 28-day mortality (29.0%).</p><p><strong>Conclusion: </strong>Machine learning-derived clusters based on initial vital signs and serum lactate levels demonstrated different patterns of vasopressor use and mortality. The clinical utility of this approach for guiding timely or targeted vasopressor therapy requires prospective validation.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003262","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}