Emergency Medicine Journal最新文献

{"title":"Correspondence on 'Removing systolic blood pressure from the National Early Warning Score (NEWS) for mortality prediction: an observational study by Zaboli <i>et al</i>.","authors":"Aaron Weidman","doi":"10.1136/emermed-2025-215306","DOIUrl":"https://doi.org/10.1136/emermed-2025-215306","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039409","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":"<b>Correspondence on</b> \"Removing systolic blood pressure from the National Early Warning Score (NEWS) for mortality prediction: an observational study\" by Zaboli <i>et al</i>.","authors":"Nana Owusu Mensah Essel","doi":"10.1136/emermed-2025-215445","DOIUrl":"https://doi.org/10.1136/emermed-2025-215445","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039367","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":"Response to: Correspondence on \"Removing systolic blood pressure from the National Early Warning Score (NEWS) for mortality prediction: an observational study\" by Zaboli <i>et al</i>.","authors":"Arian Zaboli, Gianni Turcato","doi":"10.1136/emermed-2025-215426","DOIUrl":"https://doi.org/10.1136/emermed-2025-215426","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039395","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":"Association between community assault and adverse renal outcomes among patients with crush injury in South Africa: a retrospective cohort study.","authors":"Smitha Bhaumik, Clint Hendrikse, Janette Verster, Elaine Erasmus, Hendrick Lategan, Shaheem de Vries, Suzan Mukonkole, Maria Jamison, Adane Wogu, Mengli Xiao, Julia Dixon, Julia Finn, Lani Finck, Leigh Wagner, Willem Stassen, Craig Wylie, Lesley Hodsdon, Karlien Doubell, Mohammed Mayet, L'Oreal Snyders, Adit Ginde, Nee-Kofi Mould-Millman","doi":"10.1136/emermed-2024-214344","DOIUrl":"https://doi.org/10.1136/emermed-2024-214344","url":null,"abstract":"<p><strong>Background: </strong>Civilians in South Africa experience a high incidence of crush injury, or traumatic rhabdomyolysis. Community assault (CA) is a common mechanism of crush injury in South Africa, where victims are assaulted by multiple persons using a variety of objects. A crush injury places patients at risk of renal dysfunction. The study objective is to evaluate the association between CA and adverse renal outcomes (AROs) among patients with crush injury.</p><p><strong>Methods: </strong>In this secondary analysis of abstracted medical records, we examined clinical data from adult crush patients who presented to one of six trauma centres in the Western Cape Province of South Africa from September 2021 to December 2023. ARO was defined as potassium >6 mEq/L, creatinine >4 mg/dL, initiation of dialysis or death due to renal failure. We used multivariable logistic regression to evaluate the association between CA and ARO.</p><p><strong>Results: </strong>Of 976 crush patients (mean age 32 years, 89% male), half were victims of CA (n=464, 48%). 4% of the overall cohort had ARO, but less than 1% (n=7) received dialysis. More patients with CA developed ARO (n=27, 6%) compared with patients without CA (n=15, 3%) (unadjusted p=0.03). In-hospital all-cause mortality was not significantly different between CA and non-CA (8% vs 7%, p=0.58). After adjusting for age, sex, systolic blood pressure and injury severity, patients with CA had 2.42 times the odds of ARO than patients without CA (95% CI 1.20 to 4.85, p=0.01).</p><p><strong>Conclusion: </strong>This study suggests that CA is an independent risk factor for AROs among patients with crush injury in South Africa. Victims of CA with renal dysfunction require aggressive resuscitation and may warrant early transfer to tertiary care centres.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033026","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":"Effect of a portable therapeutic baby nest designed for neonates on physiological parameters, comfort and pain levels during venous blood sampling: a randomised controlled trial.","authors":"Aylin Arıkan, Figen Işık Esenay","doi":"10.1136/emermed-2024-214660","DOIUrl":"10.1136/emermed-2024-214660","url":null,"abstract":"<p><strong>Background: </strong>In Turkey, paediatric emergency departments often lack the specialised environments required for invasive procedures on neonates. Given their developmental vulnerability, it is crucial to use interventions that reduce discomfort and support physiological stability. This study introduces the portable therapeutic baby nest (PTBN), designed to provide developmentally supportive care aligned with the principles of the Newborn Individualized Developmental Care and Assessment Program.</p><p><strong>Methods: </strong>This two-phase study included 80 term neonates (40 per group). First, the PTBN was developed from February to April 2022. Second, its effectiveness was evaluated through a randomized controlled trial conducted from May to September 2022. The experimental group underwent venous blood sampling in the PTBN, and the control group on a standard stretcher. All procedures were video-recorded and assessed by two blinded nurses using the Physiological Parameter Monitoring Form, COMFORTneo and Neonatal Infant Pain Scale (NIPS).</p><p><strong>Results: </strong>Baseline characteristics were similar across groups (p>0.05). During and after sampling, the PTBN group had significantly lower heart and respiratory rates, higher oxygen saturation and lower NIPS and COMFORTneo scores compared with controls (p<0.05).</p><p><strong>Conclusion: </strong>The PTBN improved physiological stability, comfort and pain outcomes during venous sampling in neonates.</p><p><strong>Trial registration number: </strong>NCT05442619.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599721","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":"Beyond the white coat: redefining healing through the eyes of a parent.","authors":"Noor Ul Ain, Zeeshan Ahsan","doi":"10.1136/emermed-2025-215427","DOIUrl":"https://doi.org/10.1136/emermed-2025-215427","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947078","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":"Scottish and Newcastle Antiemetic Protocol (SNAP) 12-hour acetylcysteine regimen for paracetamol overdose reduces anaphylactoid reactions without compromising hepatic protection in all age groups: a secondary analysis.","authors":"Christopher Humphries, Janice Pettie, Bridget Agboola, Thomas M Caparrotta, Robert W Hunter, Emma Morrison, Euan A Sandilands, David J Webb, Michael Eddleston, James Dear","doi":"10.1136/emermed-2024-214533","DOIUrl":"https://doi.org/10.1136/emermed-2024-214533","url":null,"abstract":"<p><strong>Background: </strong>Treatment with the 12-hour Scottish and Newcastle Antiemetic Protocol (SNAP) acetylcysteine regimen is associated with decreased length of stay and fewer anaphylactoid reactions in adult patients, and the protocol is now recommended by several UK organisations and used widely. One potential barrier to adoption is concern regarding the potential for variation in protocol performance with patient age. Anecdotally, this has led to slower adoption in paediatric settings.</p><p><strong>Methods: </strong>Secondary analysis of data from 2212 patients at the Royal Infirmary of Edinburgh, UK, treated with acetylcysteine for paracetamol overdose between 28 September 2013 and 27 September 2017. Patients were grouped into 10-year age ranges to allow comparison of treatment regimen performance across ages. Groups were compared for their rates of anaphylactoid reactions, duration of admission attributable to acetylcysteine infusion and severity of liver injury assessed by biochemical markers.</p><p><strong>Results: </strong>Patients in all age groups treated with SNAP experienced statistically significant reductions in anaphylactoid reactions. There were no significant differences in the severity of acute liver injury as assessed by biochemical results.</p><p><strong>Conclusion: </strong>This secondary analysis provides data to support the use of SNAP regardless of patient age and reassure clinicians that there is no evidence of previously unrecognised variation in protocol performance.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946998","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":"Knowing by heart.","authors":"Zhaohui Su","doi":"10.1136/emermed-2025-215383","DOIUrl":"https://doi.org/10.1136/emermed-2025-215383","url":null,"abstract":"","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947066","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":"Profile of paediatric mental health presentations to Australian emergency departments in 2018.","authors":"Jackson Newberry-Dupe, Marietta R John-White, Franz E Babl, Meredith L Borland, Elyssia M Bourke, Sandra Brownlea, Paul Buntine, Brooke Charters, Mathew Coleman, Tahnee Dunlop, Olga Gaitsgory, Shane George, Amit Kochar, Glenn A Melvin, Doris Tham, Bruce Tonge, Viet Tran, Simon Craig, Rohan Borschmann","doi":"10.1136/emermed-2024-214729","DOIUrl":"https://doi.org/10.1136/emermed-2024-214729","url":null,"abstract":"<p><strong>Objectives: </strong>Paediatric mental health presentations to emergency departments (EDs) are rising. Rural/Regional mental health service users face structural barriers to accessing general and specialist treatment, including physical distance and local service capacity and funding constraints. However, differences in patient characteristics and treatment pathways between major city and rural/regional EDs remain unclear. This study aimed to compare demographic and clinical profiles of paediatric mental health patients within each location.</p><p><strong>Methods: </strong>Retrospective cohort study of paediatric (aged 0-17 years) mental health presentations at 23 Australian EDs (metropolitan=18, rural/regional=five) from 1 January to 31 December 2018. At each site, up to 100 randomly selected unique patient medical records were included. Demographic and clinical characteristics were compared using logistic and linear mixed effects regression models.</p><p><strong>Results: </strong>2234 young people were recruited (metropolitan=1803, rural/regional=431). Mean age was 14.4 years (SD=2.6) and 59.4% were female. Frequent presentation reasons were suicidal ideation (853; 38.2%), self-harm (668; 29.9%) and behavioural disturbance (306; 13.7%). Of those with complete documentation, 703 (70.9%) had family history of mental illness and 933 (41.8%) reported recent interpersonal difficulties (eg, family/peer conflict). Three hundred and twenty-nine young people (14.7%) were admitted and 1024 (45.8%) were referred to public child and adolescent mental health services (CAMHS). Patients in rural/regional settings had shorter median waiting times for ED clinicians (24 vs 42 min) and mental health assessments (1.1 vs 2.5 hours), shorter median ED length of stay (2.9 vs 4 hours) and higher likelihood of referral to CAMHS on discharge (OR 2.19, 95% CI 1.22, 3.93).</p><p><strong>Conclusions: </strong>Characteristics of children and adolescents presenting with mental health concerns are broadly similar between metropolitan and rural/regional EDs, but treatment characteristics differ. Frequency of family mental illness and interpersonal difficulties highlights the benefits of family focused interventions. Given similar patient profiles, equitable resourcing of rural/regional services is warranted.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946996","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":"Early prophylactic antibiotics following endotracheal intubation for traumatic brain injury may reduce respiratory complications.","authors":"Luke Dearden, Melissa Drake, Daniel Horner","doi":"10.1136/emermed-2025-215149","DOIUrl":"https://doi.org/10.1136/emermed-2025-215149","url":null,"abstract":"<p><p>A rapid literature review was carried out to examine the evidence supporting early prophylactic antibiotics use following endotracheal intubation in patients traumatic brain injury (TBI), to reduce the risk of subsequent ventilator-associated pneumonia. Four papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. Current evidence suggests that early administration of prophylactic antibiotics to patients with severe TBI requiring endotracheal intubation reduces the risk of subsequent pneumonia.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947044","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}