Emergency Medicine International最新文献

{"title":"Defining the Efficiency of Manual Ventilation: A Comprehensive Systematic Review.","authors":"Julian Lasik, Tomasz Kłosiewicz, Mateusz Puślecki","doi":"10.1155/emmi/9961736","DOIUrl":"10.1155/emmi/9961736","url":null,"abstract":"<p><p>Manual ventilation is an essential skill for healthcare professionals, especially in emergency and resuscitation situations where mechanical ventilation may not be immediately available. However, improper manual ventilation can lead to serious complications such as barotrauma (lung injury caused by excessive pressure), hypoventilation (leading to insufficient oxygenation), hyperventilation (which can cause respiratory alkalosis and reduced cerebral blood flow), and gastric insufflation (which increases the risk of aspiration). This review aimed to analyze the definitions and methods used to assess manual ventilation efficiency in recent studies. A systematic database search was conducted for the period between 2014 and 2023. The primary inclusion criterion was the assessment of manual ventilation quality in adults. Out of 47 identified studies, eight met the inclusion criteria in the review. Most of the reviewed studies focused on key ventilation parameters including tidal volume and ventilation rate, which are critical for ensuring adequate ventilation. However, we found considerable variability in how \"effective ventilation\" was defined. This review highlights the approach that considers both extrinsic and intrinsic factors as a potentially more comprehensive method for assessing manual ventilation quality. This approach may offer a more consistent and effective framework for ensuring safe and efficient manual ventilation practices.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"9961736"},"PeriodicalIF":1.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Trauma Care in Tertiary Hospitals: Addressing Gaps and Pathways to Improvement.","authors":"Eesha Yaqoob, Shahzad Ali Khan, Dua Abbas Zaidi, Bipin Chaurasia, Fazal Ullah Khan, Kyriacos Evangelou, Nimirta Sahitia, Saad Javed","doi":"10.1155/emmi/2780171","DOIUrl":"10.1155/emmi/2780171","url":null,"abstract":"<p><p><b>Background:</b> Trauma is a major cause of morbidity and mortality globally, with road traffic accidents projected to be the leading cause of death by 2030. In developing countries like Pakistan, trauma patients face significant challenges in receiving timely and effective care. This study aimed to evaluate trauma centers in tertiary care hospitals in the twin cities of Pakistan to highlight gaps and pitfalls in trauma patient management. <b>Methods:</b> A descriptive cross-sectional study was conducted using the World Health Organization's Hospital Emergency Unit Assessment Tool (HEAT) at five major public sector hospitals in Islamabad and Rawalpindi. Data collection involved collaboration between the Violence, Injury Prevention and Disability Unit and key informants, including Emergency Room in-charges and Heads of Departments. Information on trauma protocols and guidelines was gathered. <b>Results:</b> All hospitals provided 24/7 emergency services with access to operating rooms and laboratories. However, significant disparities were found in equipment availability, particularly portable X-rays (40% availability) and RDT/HIV testing (20% availability). Protocol adherence varied, with 80% of hospitals having clinical management protocols but only 20% having specific protocols for conditions like asthma exacerbation and maternal hemorrhage. This study identifies infrastructural deficiencies and highlights systemic barriers that contribute to inadequate trauma care delivery, underscoring the need for targeted reforms. <b>Conclusion:</b> The study highlights significant gaps in trauma care management in Pakistani tertiary care hospitals, including shortages of personnel, infrastructure deficiencies, and lack of standardized protocols. These findings underscore the urgent need for systemic improvements in trauma care delivery. Recommendations include increased investment in medical infrastructure, addressing staffing and training deficiencies, and standardizing clinical management protocols to enhance trauma care outcomes and reduce morbidity and mortality rates in Pakistan. This research contributes novel insights into the specific barriers faced by trauma care systems in Pakistan, which have not been previously addressed in existing literature.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"2780171"},"PeriodicalIF":1.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Protective Effects of Sivelestat Sodium on the Basis of Corticosteroid Therapy in Patients With Moderate-to-Severe Acute Respiratory Distress Syndrome.","authors":"Yujie Ma, Guofu Tang, Xiaotong Liu, Qiang Gao","doi":"10.1155/emmi/1824299","DOIUrl":"10.1155/emmi/1824299","url":null,"abstract":"<p><p><b>Objective:</b> We aimed to evaluate the protective effects of sivelestat sodium on the basis of corticosteroid therapy in patients with moderate-to-severe acute respiratory distress syndrome (ARDS). <b>Methods:</b> We retrospectively investigated 127 patients with confirmed moderate-to-severe ARDS treated in the intensive care unit (ICU) at Dazhou Central Hospital. Patients were divided into the control group (corticosteroids alone) and the combination therapy of steroids and sivelestat sodium (CTSSS) group according to the therapeutic interventions. The primary outcome was in-hospital mortality. And the baseline characteristics and laboratory findings of patients were collected for analysis. <b>Results:</b> The overall mortality rate in 127 patients was 48.8%. There was no statistically significant difference in in-hospital mortality between the CTSSS group and the control group (45.3% vs. 56.1%). In the subgroup of patients aged < 80 years or with an Acute Physiology and Chronic Health Evaluation (APACHE) II score < 30, CTSSS could reduce the risk of mortality (odds ratio [OR] = 0.41, 95% confidence interval [CI], 0.17-0.96, <i>p</i>=0.041; OR = 0.31, 95% CI, 0.13-0.77, <i>p</i>=0.012; respectively). Among patients aged 80 years or older, those with CTSSS exhibited a significantly elevated risk of mortality (OR = 13; 95% CI, 1.20-140.73; <i>p</i>=0.035). <b>Conclusion:</b> Compared with corticosteroids alone, CTSSS could improve oxygenation index, increase lymphocyte count, protect extrapulmonary organs and reduce in-hospital mortality rate in patients with moderate-to-severe ARDS in specific subgroups (age < 80 years or APACHE II score < 30). It might be advisable to avoid CTSSS in moderate-to-severe ARDS patients aged 80 years or older. Prospective studies involving larger sample sizes are needed to verify these findings.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"1824299"},"PeriodicalIF":1.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of the Identification and Prognosis Prediction of SOFA-Based Sepsis-3 for Septic Patients in the Emergency Department Compared With Sepsis-2.","authors":"Yi-Jie Zhang, Wei Fang, Zhen Wang","doi":"10.1155/emmi/1762179","DOIUrl":"10.1155/emmi/1762179","url":null,"abstract":"<p><p><b>Aim:</b> To evaluate the value of the Sequential Organ Failure Assessment (SOFA) score, a Sepsis-3 criterion, for identification and prognosis prediction among adult patients with sepsis in the emergency department (ED) compared with the Sepsis-2. <b>Methods:</b> Adult patients with suspected sepsis presenting to the ED were retrospectively identified via Sepsis-2/Sepsis-3 criteria. The vital signs, laboratory test results, etc., were collected, and the SOFA/quick SOFA (qSOFA) scores and National Early Warning Score (NEWS) were calculated accordingly. ROC curves were generated to evaluate mortality prediction accuracy. <b>Results:</b> Among the 481 patients included, 288/339 met the Sepsis-2/Sepsis-3 criteria, respectively, with moderate between-protocol consistency (Kappa = 0.507, <i>p</i> < 0.001; concordance = 77.3%); 115 patients (23.9%) died in hospital or within 28 days. SOFA/qSOFA scores and NEWS were significantly greater in the sepsis and death groups (<i>p</i> < 0.001), but there was no between-group difference for Sepsis-2/Sepsis-3. The temperature (T) and respiratory rate (RR) increased in the death group, whereas the systolic blood pressure (SBP) decreased. The usefulness of the SOFA score (AUC = 0.644) for predicting mortality was lower than that of qSOFA score (AUC = 0.716) and NEWS (AUC = 0.718), which could be improved (AUC = 0.701-0.721) by combining with two/three of variables (T, RR, and SBP). <b>Conclusion:</b> Compared with Sepsis-2, Sepsis-3 identified more patients with sepsis and was suitable for ED use. The SOFA score had lower mortality prediction accuracy than the qSOFA score and NEWS, which could be significantly improved by combining with two/three variables (T, RR, and SBP).</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"1762179"},"PeriodicalIF":1.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential for Lung Recruitment Maneuvers Estimated by the Cytokines in Bronchoalveolar Lavage Fluid in Acute Respiratory Distress Syndrome.","authors":"Minjin Shen, Jiaping Huai","doi":"10.1155/emmi/5442038","DOIUrl":"10.1155/emmi/5442038","url":null,"abstract":"<p><p><b>Objective:</b> Lung recruitment maneuvers (RMs) is an important treatment for acute respiratory distress syndrome (ARDS) patients; however, assessing lung recruitability is imperative to avoid biotrauma and hemodynamic instability. This study aims to investigate whether the cytokine levels in the bronchoalveolar lavage fluid (BALF) of ARDS patients can serve as an indicator of their lung recruitability. <b>Methods:</b> This study included ARDS patients who received mechanical ventilation for over 24 h. Patients were categorized into lung recruitment maneuver effective (RM-E) group and lung recruitment maneuver noneffective (RM-N) group. Interleukin-6 (IL-6), interleukin-8 (IL-8) and interleukin-10 (IL-10) in BALF, lung ultrasound (LUS) scores, and the oxygenation index (P/F) were measured. The differences in cytokine levels between the two groups were compared, and correlations between changes in cytokine levels (ΔIL-6, ΔIL-8, and ΔIL-10), ΔLUS, and ΔP/F were analyzed. <b>Results:</b> Sixty-two patients were included in this study (38 in the RM-E group and 24 in the RM-N group). After the RM, compared with the RM-N group, an increase was observed in ΔIL-6 (<i>p</i>=0.013), ΔIL-8 (<i>p</i>=0.045), ΔIL-10 (<i>p</i>=0.039), and ΔLUS (<i>p</i>=0.045) in the RM-E group. A positive linear correlation was found between ΔIL-6 and ΔLUS (<i>r</i> = 0.504, <i>p</i> < 0.001). The area under the lung recruitment potential curve (AUC) predicted by ΔIL-6 was 0.794, the sensitivity was 94.7%, and the specificity was 70.8%. A positive linear correlation was found between ΔIL-6 and ΔLUS (<i>r</i> = 0.504, <i>p</i> < 0.001). The lung recruitment potential curve's AUC predicted by ΔIL-6 was 0.794, with a sensitivity of 94.7% and specificity of 70.8%. <b>Conclusion:</b> Lower levels of cytokines in BALF were observed in the RM-E group. It is possible that the cytokines in BALF, especially IL-6, could be used to determine the need for RM on the basis of lung recruitability.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"5442038"},"PeriodicalIF":1.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Trends in Pulmonary Embolism Visit in United State Emergency Departments and Associated Costs (2006-2018).","authors":"Ahmad Aalam, Diyaa Bokhary, Awad Alsabban, Ahmad Bakhribah","doi":"10.1155/emmi/6610196","DOIUrl":"10.1155/emmi/6610196","url":null,"abstract":"<p><p><b>Introduction:</b> Pulmonary embolism (PE) poses substantial morbidity and mortality risks, necessitating timely and accurate management in emergency departments (EDs). <b>Objectives:</b> This study explores the trends in PE presentations to US EDs from 2006 to 2018 and assesses the impact of different factors on management and cost. <b>Methodology:</b> This is a retrospective descriptive study conducted using the US Healthcare Cost and Utilization Project (HCUP) PE ED visits database. Data on ED visits, dispositions, and related costs were collected and analyzed. <b>Results:</b> From 2006 to 2018 there were more than 2 million PE ED visits in the US. There was an increase in visits per 100,000 persons from 42.17 in 2006-2008 to 64.27 in 2016-2018 (<i>p</i> value < 0.001). The proportion of uninsured patients declined from 5.07% to 4.70%, and the percentage of Medicaid-insured patients increased. There was a decrease in the admission rates from 92.47% to 75.97% in 2016-2018 (<i>p</i> value < 0.001). The mean cost per admitted patient increased from $32,794 to $47,344 in 2016-2018 (<i>p</i> value < 0.001). <b>Conclusion:</b> From 2006 to 2018, PE ED visits in the US increased with a noticeable decrease in admission rates and length of stay, likely secondary to advancement in diagnostic and therapeutic modalities like computed tomography pulmonary angiography and novel oral anticoagulants. However, the observed rising healthcare costs pose challenges to sustainable management. Further research studies are needed to address cost-effective strategies.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"6610196"},"PeriodicalIF":1.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Benefit of STA-MCA Bypass Surgery in Chronic Terminal Internal Carotid and/or Middle Cerebral Artery Occlusion Patients With Impaired Collateral Circulation: Introducing a Novel Assessment Approach for Collateral Compensation.","authors":"Cheng Qiu, Yanping Zhang, Zhiqiang Yu, Yonghui Xu, Yongjiang Huang, Tianci Huang, Jun Ma, Jinbing Zhao","doi":"10.1155/emmi/5059097","DOIUrl":"10.1155/emmi/5059097","url":null,"abstract":"<p><p><b>Background:</b> Ischemic stroke is one of the major emergency diseases leading to death and disability worldwide, characterized by its acute onset and the urgent need for prompt medical intervention to reduce mortality and long-term disability. Chronic terminal internal carotid artery and/or middle cerebral artery occlusion (CTI/MCAO) is an important subtype of intracranial artery occlusive disease. The superficial temporal artery-to-MCA (STA-MCA) bypass has been proposed to improve cerebral blood flow (CBF) and cerebrovascular reserve (CVR), potentially enhancing neurological outcomes. However, its safety and efficacy in CTI/MCAO patients remain controversial. <b>Methods:</b> A total of 107 CTI/MCAO patients from Nanjing Brain Hospital, enrolled between July 2019 and June 2022, were divided into surgical and medical treatment groups. Cerebral perfusion and collateral formation were evaluated using pseudocontinuous arterial spin labeling (pCASL) and digital subtraction angiography (DSA). Modified Rankin scale (mRS) score and complication rates were compared between the two groups. In addition, correlations between Matsushima grades, early-arriving flow proportion (EFP), and lesion-side cerebrovascular (LCBV) scores were analyzed. <b>Results:</b> The surgical group showed significantly lower mRS scores than the medical group (<i>p</i>=0.018), with no significant differences in complication rates at the 6-month follow-up (<i>p</i>=0.861). CBF differed significantly among affected MCA segments (<i>p</i> < 0.001), particularly in the insular and opercular regions (M2-M3) (<i>p</i>=0.006). Matsushima grades in unilateral CTI/MCAO patients were negatively correlated with preoperative LCBV scores (<i>γ</i> _s = -0.468, <i>p</i>=0.005) and EFP (<i>γ</i> _s = -0.648, <i>p</i>=0.007). EFP demonstrated high accuracy in predicting LCBV scores in CTI/MCAO patients (AUC = 0.902, <i>p</i>=0.004). <b>Conclusion:</b> STA-MCA bypass surgery improved neurological outcomes in CTI/MCAO patients, particularly those with poor preoperative collateral compensation. EFP may serve as a reliable, noninvasive tool for assessing collateral circulation status in this population.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"5059097"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Trends Regarding the Cardiopulmonary Resuscitation: A Bibliometric Analysis of the Top 100 Cited Articles.","authors":"Ömer Faruk Turan, Ali Sami Yardımcı, Merve Yazla, Nurullah İshak Işık, Abdullah Osman Koçak, Burak Katipoğlu","doi":"10.1155/emmi/9975595","DOIUrl":"10.1155/emmi/9975595","url":null,"abstract":"<p><p><b>Introduction:</b> Despite significant medical and technological advancements, cardiac arrest remains a critical public health concern due to its persistently high mortality and morbidity rates. Consequently, research on cardiopulmonary resuscitation (CPR) is of significant importance. <b>Materials and Methods:</b> This study presents a bibliometric analysis of the 100 most-cited articles in the field of CPR identified using the Scopus database without time restrictions. Analyses were conducted using VOSviewer and Bibliometrix software. Original research articles published in English were included. <b>Results:</b> The study revealed contributions from 798 distinct authors across 18 journals, with citation counts ranging from 218 least-cited articles to 1194 most-cited articles. The most recent article was published in 2020, and the most frequently used keywords were \"CPR\" and \"heart arrest.\" In addition, 20% of the analyzed articles were funded by military organizations. <b>Conclusion:</b> This analysis highlights the significant contributions of emergency medicine researchers and the notable development of CPR literature, particularly between the late 1990s and the early 2000s. While the most-cited studies originated from journals with high H-indices, the citation frequency of these articles showed a consistent decline over time. Furthermore, impactful articles in this field were predominantly published in general medical journals rather than in specialized emergency medicine journals. This study provides a foundational resource for researchers, especially early career academicians, seeking to engage in CPR-related research.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"9975595"},"PeriodicalIF":1.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons and Features of Patients Who Leave the Emergency Department Without Being Seen.","authors":"Fahad Abuguyan, Abdulaziz Alhusainy, Omar Alsuliman, Sarah Alqahtani, Abdulrahman Alrajhi","doi":"10.1155/emmi/7199212","DOIUrl":"10.1155/emmi/7199212","url":null,"abstract":"<p><p><b>Background:</b> Emergency medicine practitioners encounter significant challenges related to patients who leave emergency departments (EDs) without being seen (LWBS) in the ED. We aimed to assess the characteristics, reasons, and rate of patients who left without being seen in the tertiary teaching hospital ED of King Khalid University Hospital in Riyadh, Saudi Arabia. <b>Methods:</b> A qualitative prospective observational study was conducted from January 4, 2023, to May 17, 2023, among patients who left the ED without being seen in the King Khalid University Hospital, King Saud University Medical City, a tertiary hospital in Riyadh, Saudi Arabia. Data were collected from the ED administrative database, phone surveys, and electronic files of the identified patients. Phone interviews with questionnaires were conducted with patients participating in the study within 1 week of their ED visit. <b>Results:</b> During the study period, 16,682 patients visited the adult ED and 636 (3.81%) remained unseen; 300 patients met the study criteria. Of these, 288 (96%) arrived at the hospital via private car and 12 (4%) used ambulances. Trauma and gastrointestinal, neurological, and cardiovascular complaints were the most common, reported by 24.33%, 18.33%, 12%, and 10% of patients, respectively. In our study, 55 patients (18.3%) experienced prolonged waiting times of more than four hours before leaving the ED. Most patients (75%) inquired about the reasons for not being seen by a physician while waiting; 137 (45.6%) asked a receptionist, 117 (39%) asked a nurse, and 28 (9.3%) asked a doctor. According to 76 (25.3%) patients, they should not have to wait, whereas 82 (27.3%) said that they should wait for an hour. When asked whether they would visit the same ED in the future, 213 (71%) answered yes and 87 (29%) answered no. <b>Conclusion:</b> We conclude that in our center, prolonged waiting time and ED overcrowding are the main reasons why patients leave the ED without seeing a physician. Younger patients are more prone to LWBS, with trauma and gastroenterological complaints being the most common presenting symptoms. The LWBS rate was 3.81% of the total ED visits during the study period.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"7199212"},"PeriodicalIF":1.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of the Protocol for Trauma Team Activation in Taipei: A Retrospective Study.","authors":"Wan-Lin Chen, Ju-Chi Ou, Shih-Yu Ko, Wen-Ching Li, Hon-Ping Ma","doi":"10.1155/emmi/9170229","DOIUrl":"10.1155/emmi/9170229","url":null,"abstract":"<p><p><b>Introduction:</b> Trauma triage is the use of trauma assessment for prioritizing patients for treatment or transport by injury severity. According to Taiwan Public Health Report, accidents and their adverse events were the sixth leading cause of death and accounted for over 7000 casualties in 2009. However, a lack of accuracy in identifying the severity of a patient's injury and their prehospital information can result in inappropriate triage. This study evaluated the efficacy of field triage guidelines governing trauma team activation in Taipei and explored the characteristics of undertriaged and overtriaged patients. <b>Methods:</b> This study retrospectively observed all patients with trauma transported to the emergency department of a medical center by Taipei City public ambulance from January 1, 2016, to December 31, 2019. A total of 2217 patients were included. The Cribari matrix method was used to assess undertriage and overtriage. A logistic regression was employed to analyze the effect of risk factors in patients with major trauma. <b>Results:</b> In this study, 320 and 1897 patients with trauma had full and limited trauma team activation, respectively. Among them, 664 patients with trauma were older than 65 years, and most of them were injured in a traffic accident. Among patients with major trauma, 24, 214, and 156 patients were aged < 20, 20-65, and > 65 years, respectively. A logistic regression analysis revealed that patients with a Glasgow Coma Scale score of less than 13, with systolic blood pressure level of less than 90, and with respiratory rate over 30 breaths per minute was more likely to be appropriately triaged. <b>Conclusion:</b> The Taipei prehospital field triage guidelines are acceptable but not an ideal tool for identifying patients with major trauma, with an overtriage rate of 48.12% and an undertriage rate of 12.03%. To decrease undertriage or overtriage rates, emergency medical service providers should receive comprehensive training.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"9170229"},"PeriodicalIF":1.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}