European Journal of Emergency Medicine最新文献

{"title":"The European Society for Emergency Medicine (EUSEM) position on the health and humanitarian crisis in Gaza.","authors":"Niccolò Parri, Jim Connolly, Tatjana Rajkovic, Carmen Diana Cimpoesu, Robert Leach","doi":"10.1097/MEJ.0000000000001279","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001279","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical microsystems: a helpful approach for quality improvement in emergency medicine.","authors":"Una Geary, Jay Banerjee, Rosa McNamara","doi":"10.1097/MEJ.0000000000001284","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001284","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of physician-staffed helicopter transport in patients with cardiogenic shock complicating acute coronary syndrome.","authors":"Yu Suresvar Singh, Manabu Ogita, Satoru Suwa, Yuji Nishizaki, Youichi Yanagawa","doi":"10.1097/MEJ.0000000000001244","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001244","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"32 5","pages":"380-381"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exclusion of intracranial lesions in mild traumatic brain injury using glial fibrillary acidic protein and ubiquitin C-terminal hydrolase-L1: a European multicenter study.","authors":"Lara Milevoj Kopcinovic, Nora Nikolac Gabaj, Ivana Lapić, Dunja Rogić, Oana Roxana Oprea, Minodora Dobreanu, Jakub Nożewski, Mariusz Sieminski, Ewelina Stępniewska, Małgorzata Dąbrowska, Barbara Mroczko, Marzena Wojewódzka-Żelezniakowicz, Rakesh Jalali, Marcin Baluch, Joanna Malinowska, Jerzy Romaszko, Evgenija Homšak, Gregor Prosen, Matej Strnad, Helena Ferreira da Silva, Martina Pavletić, Vesna Šupak-Smolčić, Lidija Bilić-Zulle, Ana Tancabel Mačinković, Mate Lerga, Dušan Dobrota, Daniel Čierny, Štefan Sivák, Egon Kurča, Martina Martiníková","doi":"10.1097/MEJ.0000000000001234","DOIUrl":"10.1097/MEJ.0000000000001234","url":null,"abstract":"<p><strong>Background: </strong>Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) are blood biomarkers that able to aid in the assessment of mild traumatic brain injury (mTBI) patients and reduce computed tomography (CT) overuse.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the predictive performance of individual biomarkers and their combination (i.e. mTBI assay) in detecting clinically significant intracranial injuries in mTBI. Furthermore, the influence of older age on the predictive performance of individual biomarkers and their combination was investigated.</p><p><strong>Methods: </strong>This prospective multicenter study was conducted in 12 European healthcare centers. Adults with suspected mTBI presenting to the emergency department (ED) of each participating healthcare center within 12 h of head trauma were enrolled. GFAP and UCH-L1 were determined in blood samples collected from each participant. Head CT was considered as reference standard for the presence of intracranial injury.</p><p><strong>Results: </strong>The mTBI assay yielded the highest sensitivity [95.5%, 95% confidence interval (CI): 89.9-98.5] and the highest negative predictive value (NPV) value (97.3%, 95% CI: 93.9-98.9) for the exclusion of intracranial lesions in mTBI. The sensitivities and NPVs of individual biomarkers were lower compared with the mTBI assay. In adults over 65 years, the individual biomarkers and the mTBI assay displayed the weakest diagnostic performances. After optimizing cutoff values for the mTBI assay for older adults, the following diagnostic accuracy measures were obtained: sensitivity 87.7%, 95% CI: 77.2-94.5 and NPV: 94.4%, 95% CI: 89.6-97.0 ( P  < 0.001).</p><p><strong>Conclusion: </strong>The mTBI assay yielded high sensitivity and NPV for the exclusion of significant intracranial injuries in mTBI patients presenting to the ED within 12 h from injury, performing better than individual biomarkers. A significant age-dependent influence on the predictive performances of the individual biomarkers and the mTBI assay was demonstrated.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"351-358"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraosseous versus intravenous vascular access in adults with out-of-hospital cardiac arrest: a meta-analysis with trial sequential analysis and meta-regression analysis.","authors":"Ahmed Ibrahim, Laila Shalabi, Sofian Zreigh, Shrouk Ramadan, Mohamed Adel Elsawy, Bahaa Shat, Matthieu Legrand","doi":"10.1097/MEJ.0000000000001267","DOIUrl":"10.1097/MEJ.0000000000001267","url":null,"abstract":"<p><p>Establishing vascular access during cardiopulmonary resuscitation is essential for delivering guideline-recommended medications. This meta-analysis aims to compare the clinical effectiveness of initial vascular access attempts through the intraosseous route to the intravenous route in patients with out-of-hospital cardiac arrest (OHCA). A comprehensive literature search was conducted across PubMed, Cochrane, Scopus, and Web of Science, up to March 2025, for randomized controlled trials (RCTs) and propensity score-matched (PSM) observational studies comparing initial attempt intraosseous access with initial intravenous access in patients with OHCA. R Studio version 4.4.2 was used to perform statistical analysis applying a random-effect model. Trial sequential analysis (TSA) was conducted to determine the robustness of findings and estimate required information size (RIS). Four RCTs and four PSM studies involving 28 632 patients with OHCA were identified. The analysis revealed no significant differences between initial vascular access attempts via the intraosseous route compared with the intravenous route regarding survival to hospital discharge [odds ratio (OR): 0.94, 95% confidence interval (CI): 0.77-1.13, P  = 0.49], sustained return of spontaneous circulation (OR: 0.87; 95% CI: 0.74-1.02, P  = 0.09) or survival with favorable neurological outcomes (OR: 0.74, 95% CI: 0.54-1.03, P  = 0.08). Meta-regression identified initial shockable rhythm as a significant modifier of survival to hospital discharge ( P  = 0.012). TSA demonstrated the Z curve failed to reach the RIS, indicating that further studies are needed for conclusive evidence. In adults with OHCA, establishing vascular access through the intraosseous route demonstrates comparable effects to intravenous access in terms of survival and neurological outcomes. Further RCTs are needed to strengthen the evidence base and should assess long-term effects, promote protocol standardization, and enhance paramedic training.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"314-324"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency medicine practice in low- and middle-income settings: challenges in research and implementation.","authors":"Prithvishree Ravindra, Giles Cattermole, Vijaya Arun Kumar","doi":"10.1097/MEJ.0000000000001250","DOIUrl":"10.1097/MEJ.0000000000001250","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"310-311"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the score predicting imminent delivery on the management of unexpected out-of-hospital obstetrical deliveries: a cluster randomized clinical trial.","authors":"Agnes Ricard-Hibon, Vivien Brenckmann, Judith Gorlicki, Louis Soulat, Gilles Bagou, Catherine Pradeau, Fabrice Louvet, Emilien Arnaud, Xavier Combes, Eva Weinzorn, Eric Lecarpentier, Roch Joly, Sybille Goddet, Clothilde Martin, Line Jacob, Thierry Roupioz, Muriel Vergne, Laure Abensur Vuillaume, Charlene Duchanois, Jeanne-Marie Amalric, Toni Alfaiate, Lucie Biard, Frederic Adnet","doi":"10.1097/MEJ.0000000000001264","DOIUrl":"10.1097/MEJ.0000000000001264","url":null,"abstract":"<p><strong>Background and importance: </strong>Early identification of imminent deliveries is crucial for guiding the decision to dispatch emergency medical team to the prehospital setting.</p><p><strong>Objective: </strong>To study whether the use of the score predicting imminent delivery (SPID) at the emergency call center reduces the risk of prehospital delivery occurring without the presence of a physician-staffed mobile ICU team.</p><p><strong>Design, setting, and participants: </strong>Prospective multicenter cluster randomized controlled trial in 19 call centers in France. Calls from pregnant woman in labor with at least 33 weeks of amenorrhea were eligible. The emergency call center responses included medical advice, transport to the hospital by personal means or ambulance, or dispatch of the mobile ICU team.</p><p><strong>Intervention: </strong>In the intervention group, the use of the SPID was mandatory to guide decision-making.</p><p><strong>Outcomes measures and analysis: </strong>The primary outcome was the rate of prehospital deliveries occurring without the initial dispatch of a mobile ICU team. The secondary endpoints included the prehospital deliveries rate without the presence of a mobile ICU team on site, call duration, satisfaction score, and maternal and neonatal mortality.</p><p><strong>Main results: </strong>A total of 7782 pregnant women were included in the intention-to-treat analysis (3773 control and 4009 intervention), including 523 (7.0%) prehospital deliveries (6.3% intervention and 7.6% control) and a 22.3% rate of mobile ICU dispatch decision (20.8% intervention group and 23.8% control). Prehospital delivery without initial dispatch of a mobile ICU was less frequent in the intervention group compared to control: 0.95 vs. 2.01% [odds ratio (OR) 0.46; 95% confidence interval (CI), 0.31-0.70]. There was also a lower rate of prehospital delivery without the presence of a mobile ICU team on site in the intervention group: 1.92 vs. 3.34% (OR = 0.58; 95% CI, 0.42-0.82). There was no significant difference in the other secondary endpoints.</p><p><strong>Conclusion: </strong>In this multicenter randomized controlled trial, the systematic use of the SPID was associated with a reduction of prehospital deliveries occurring without the presence of a mobile ICU team.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"335-343"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793778","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":"Emergency medicine practice in low- and middle-income settings: ethical, educational and contextual imperatives for global health training.","authors":"Gabin Mbanjumucyo, Faith Komagum, Shweta Gidwani","doi":"10.1097/MEJ.0000000000001254","DOIUrl":"10.1097/MEJ.0000000000001254","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"312-313"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 shoulder reduction bench on sedation rates in the treatment of emergency department patients with anterior shoulder dislocations.","authors":"Phil Dowson, Jon Rees, Sarah Rhodes","doi":"10.1097/MEJ.0000000000001242","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001242","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"32 5","pages":"377-379"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celebrating milestones, broadening horizons.","authors":"Yonathan Freund, Ben Bloom","doi":"10.1097/MEJ.0000000000001266","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001266","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"32 5","pages":"305"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}