Emergency Medicine Journal最新文献

{"title":"Footprint of social prescribing in emergency medicine in the UK.","authors":"Lucy Morris, Sarah Edwards","doi":"10.1136/emermed-2025-215578","DOIUrl":"10.1136/emermed-2025-215578","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":"516"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal update monthly top five.","authors":"Kieran Johnstone, Mohamed Gomaa Kamel, Johnathan Goves, Hanya El-Geresy, Richard Mifsud, Alex Novak, David Metcalfe, Liam Barrett","doi":"10.1136/emermed-2026-216284","DOIUrl":"https://doi.org/10.1136/emermed-2026-216284","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":"43 8","pages":"526-527"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking clinical narratives: how natural language processing and artificial intelligence can address data deficits and mitigate health inequities in urgent and emergency care.","authors":"Chris Humphries, Lisa Schölin, Gearóid Brennan, Jonathan Brett, Michael Eddleston, Adam Lloyd, Anna Miell, Matthew J Reed, Arlene Casey","doi":"10.1136/emermed-2025-215530","DOIUrl":"10.1136/emermed-2025-215530","url":null,"abstract":"<p><p>The Urgent and Emergency Care system generates a wealth of clinical information, but our ability to harness this for public health planning and to address health inequalities is constrained by systemic data quality issues. Modern natural language processing (NLP), driven by the context-aware capabilities of transformer-based architectures and large language models, offers a transformative opportunity to bridge this gap. By training machines to interpret and structure context-rich clinical notes at scale, we can translate complex patient stories into data ready for research and systems intelligence that reflects the realities of real-world care.This technology offers a potential route to addressing health inequities in vulnerable populations, such as those presenting with crises related to mental ill-health, alcohol and drug use. Current reliance on structured but oversimplistic data often fails to capture the complex intersectionalities of clinical and social contexts. This is due to factors like diagnostic overshadowing and unrecorded multimorbidity, leaving these patients statistically obscured within routine datasets, which fail to accurately represent volume or complexity. This data invisibility perpetuates a cycle of inaccurate disease burden estimates, under-resourced services and flawed policy. By unlocking the detailed narrative data within unstructured notes, NLP could allow us to identify the acute social stressors and psychiatric contexts that are currently invisible, making these inequities visible and actionable.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":"507-510"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of bystander and patient sex on cardiopulmonary resuscitation provision in out-of-hospital cardiac arrest.","authors":"Seunggu Na, Kyung Hun Yoo, Jaehoon Oh, Yongil Cho, Juncheol Lee, Tae Ho Lim, Hyunggoo Kang, Byuk Sung Ko, Jinsoo Kim","doi":"10.1136/emermed-2025-215272","DOIUrl":"10.1136/emermed-2025-215272","url":null,"abstract":"<p><strong>Background: </strong>Female patients who experience out-of-hospital cardiac arrest (OHCA) are less likely to receive bystander cardiopulmonary resuscitation (CPR) than male patients. However, the interaction between the patient and the sex of the bystander in CPR provision remains underexplored. Therefore, this study aimed to investigate the interaction between patient and sex of bystander in CPR provision during OHCA and to assess CPR rates based on dispatcher-assisted CPR (DA-CPR) administration status.</p><p><strong>Methods: </strong>This cohort study used prospectively collected nationwide registry data between January 2019 and June 2023. Adult patients with medical aetiology of OHCA who were transported by emergency medical services were included. The primary outcome was bystander CPR provision according to sex. The secondary outcome was the provision of bystander CPR based on DA-CPR administration status.</p><p><strong>Results: </strong>A total of 6487 patients with OHCA were included (median (IQR) age: 55 (52-64) years; male bystanders treated 3977 patients (61.3%)). The bystander CPR rate was lower when the patient and sex of bystander differed (male patient-male bystander, 85.0% vs male patient-female bystander, 79.2%; female patient-male bystander, 79.5% vs female patient-female bystander, 82.1%). Female bystanders were less likely to provide bystander CPR than male bystanders (adjusted OR (aOR): 0.83, 95% CI 0.73 to 0.95). The odds of a female bystander providing CPR to a male patient were significantly lower than those of a male bystander (aOR: 0.684, 95% CI 0.578 to 0.810). This difference was reduced when DA-CPR was administered (without DA-CPR, aOR: 0.673, 95% CI 0.475 to 0.952 vs with DA-CPR, aOR: 0.822, 95% CI 0.706 to 0.957).</p><p><strong>Conclusion: </strong>An interaction between the patient and the sex of bystander was observed, particularly when the patient was a male and the bystander was a female. DA-CPR may serve as a potential intervention to help mitigate this disparity.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":"479-485"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infant with seizure.","authors":"Chih-Hao Wang, Po-Chih Lin, Che-Sheng Ho","doi":"10.1136/emermed-2026-216160","DOIUrl":"10.1136/emermed-2026-216160","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":"521-528"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We have recognised inequalities: now we must act.","authors":"Richard Body","doi":"10.1136/emermed-2026-216408","DOIUrl":"https://doi.org/10.1136/emermed-2026-216408","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":"43 8","pages":"461"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focusing on health inequalities in emergency care.","authors":"Sarah Edwards, Kirsty Challen","doi":"10.1136/emermed-2026-216367","DOIUrl":"https://doi.org/10.1136/emermed-2026-216367","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":"43 8","pages":"462-463"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute back pain with neurological deterioration after Valsalva manoeuvre.","authors":"Tom Jaconelli, Eilish Mckenna, Brook Adams","doi":"10.1136/emermed-2026-216098","DOIUrl":"https://doi.org/10.1136/emermed-2026-216098","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":"43 8","pages":"513-525"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staff perspectives on implementing opt-out blood-borne virus testing in English emergency departments: a qualitative study.","authors":"Siobhán Allison, Tom May, Jonathan Roberts, Rachel Hill-Tout, Stephen Hindle, Matthew Hickman, Lucy Yardley, Rachel Todd, Robyn Heath, Jeremy Horwood","doi":"10.1136/emermed-2025-215436","DOIUrl":"10.1136/emermed-2025-215436","url":null,"abstract":"<p><strong>Background: </strong>A significant challenge to achieving global 2030 elimination goals for blood-borne viruses (BBVs) is identifying undiagnosed individuals and relinking those who are no longer in care. To address this, the UK government has implemented opt-out BBV testing in emergency departments (EDs) to increase access to BBV testing in high prevalence areas. All adult ED patients having a routine blood test are automatically tested for HIV, hepatitis B and C, unless they opt out. This study aimed to identify barriers and facilitators to the implementation of ED opt-out BBV testing and provide recommendations for future rollouts.</p><p><strong>Method: </strong>Semi-structured interviews with 23 staff members across five ED sites in very high HIV prevalence areas were analysed thematically, informed by Normalisation Process Theory.</p><p><strong>Results: </strong>While there was some variation in staff knowledge and understanding of the programme, overall acceptance of the opt-out testing approach was found to be high. Training had a positive impact on staff understanding of the purpose of the intervention and the correct process, including the opt-out model. High workloads and competing priorities in EDs were significant barriers to testing. However, some specific systems and processes that facilitated the uptake of testing included automation and BBV champions. Giving the programme time to embed into practice and ensuring feedback loops and flexibility to 'tweak' the process was also essential to sustaining the programme.</p><p><strong>Conclusion: </strong>To embed opt-out testing into emergency care, sites should implement automated test ordering, staff training, clear communication and dedicated champions, which can help to support earlier diagnosis, reduce inequalities and improve patient outcomes.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":"500-506"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in rural prehospital ST-segment elevation myocardial infarction care.","authors":"Michael W Supples, Randy S Carpenter, Nicklaus P Ashburn, W Mark Brown, Anna C Snavely, Chadwick D Miller, Jason P Stopyra, Simon A Mahler","doi":"10.1136/emermed-2025-215309","DOIUrl":"10.1136/emermed-2025-215309","url":null,"abstract":"<p><strong>Background: </strong>In rural settings, women with ST-elevation myocardial infarction (STEMI) are less likely to receive timely reperfusion than men. We explore factors that may impact time to reperfusion by sex for patients with STEMI.</p><p><strong>Methods: </strong>We conducted a cohort study of adults with STEMI activations from 2016 to 2020 using regional North Carolina STEMI registry data, which included eight rural emergency medical services (EMS) agencies and three percutaneous coronary intervention (PCI) centres. The primary outcome was EMS first medical contact to PCI in ≤90 min. By sex, we evaluated prehospital time intervals (dispatch, response, time-to-ECG, catheterisation laboratory activation, on-scene, transport and total EMS) and door-to-balloon time with clustered Wilcoxon rank-sum tests. We also evaluated agency and patient factors associated with timely reperfusion using generalised estimating equations.</p><p><strong>Results: </strong>Of the 365 patients included, 30.1% (110/365) were female with a mean age of 62.5±12.7. Fewer women received PCI within 90 min compared with men (43.6% vs 67.8%, p<0.001). Women also experienced significantly longer total EMS time (42.5 vs 40.0 min, p=0.049) and door-to-balloon time (48.5 vs 40.0 min, p=0.01). Other time intervals were similar. After adjustment, women without exertional symptoms, with diabetes or with hypercholesterolaemia had lower odds of timely reperfusion. Among men, lower odds of timely reperfusion were observed among those without pain, who had catheterisation lab activation between 17:00 and 07:00, who were older or who had farther transport.</p><p><strong>Conclusion: </strong>In rural settings, women without exertional chest pain and those with comorbid conditions were less likely to have timely reperfusion. Women experienced significantly longer total EMS time and door-to-balloon time than men.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":"486-492"},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}