European Journal of Emergency Medicine最新文献

{"title":"Evaluation of the use of artificial intelligence in the detection of appendicular skeletal fractures in adult patients consulting in an emergency department, a retrospective study.","authors":"Evelyne Dubreucq Guerif, Sophie Agut, Alexandra Rousseau, Rudy Bompard, Hélène Goulet","doi":"10.1097/MEJ.0000000000001193","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001193","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"32 2","pages":"144-146"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515088","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":"Evolving pediatric airway management: supraglottic devices as a first-line option?","authors":"François Javaudin, Quentin Le Bastard","doi":"10.1097/MEJ.0000000000001225","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001225","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"32 2","pages":"77-78"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515214","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":"Gender disparities in diagnostic procedures of primary hyperventilation.","authors":"Basil Ryser, Sarah Merz, Simon Flueckiger, Aristomenis Exadaktylos, Gregor Lindner","doi":"10.1097/MEJ.0000000000001201","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001201","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"32 2","pages":"147-148"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515217","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":"Association between pre-arrest left ventricular ejection fraction and survival in nontraumatic out-of-hospital cardiac arrest.","authors":"Yi-Ju Ho, Chun-Ju Lien, Ren-Jie Tsai, Cheng-Yi Fan, Chi-Hsin Chen, Chien-Tai Huang, Ching-Yu Chen, Yun-Chang Chen, Chun-Hsiang Huang, Wen-Chu Chiang, Chien-Hua Huang, Chih-Wei Sung, Edward Pei-Chuan Huang","doi":"10.1097/MEJ.0000000000001181","DOIUrl":"10.1097/MEJ.0000000000001181","url":null,"abstract":"<p><strong>Background and importance: </strong>Out-of-hospital cardiac arrest (OHCA) poses major public health issues. Pre-arrest heart function is a prognostic factor, but the specific contribution of pre-arrest echocardiographic evaluation in predicting OHCA outcome remains limited.</p><p><strong>Objective: </strong>The primary objective was to investigate the association between left ventricular ejection fraction (LVEF) measured in echocardiography prior to OHCA and survival to hospital discharge.</p><p><strong>Design, settings, and participants: </strong>This multicenter retrospective cohort study analyzed data from the National Taiwan University Hospital and its affiliated hospitals. We included adult nontraumatic OHCA patients who were treated by the emergency medical services (EMS) and underwent echocardiography within 6 months prior to the OHCA event from January 2016 to December 2022. Data included demographics, preexisting diseases, resuscitation events, and echocardiographic reports.</p><p><strong>Outcomes measure and analysis: </strong>The primary outcome was the survival to hospital discharge after post-arrest care. Statistical analysis involved multivariable logistic regression to modify potential confounders, reported as adjusted odds ratio (aOR) and 95% confidence interval (CI), and evaluate the association between echocardiographic findings and survival to hospital discharge.</p><p><strong>Main results: </strong>This study analyzed 950 patients, with 33.6% surviving to discharge. A higher pre-arrest LVEF was independently associated with increased survival. Compared to patients with LVEF < 40%, those with LVEF between 40% and 60% had significantly higher odds of survival (aOR = 3.68, 95% CI = 2.14-6.35, P  < 0.001), and those with LVEF > 60% had even greater odds of survival (aOR = 5.46, 95% CI = 3.09-9.66, P  < 0.001). There was also an association between lower tricuspid regurgitation pressure gradient and survival (aOR = 0.98, 95% CI = 0.97-1.00, P  = 0.015). Younger age, male gender, dyslipidemia, stroke, cancer, witnessed arrest, initial shockable rhythm, and shorter low-flow time are other significant predictors of survival.</p><p><strong>Conclusion: </strong>In adult, nontraumatic, EMS-treated OHCA patients, a higher LVEF 6 months prior to OHCA was associated with improved survival at hospital discharge.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"131-140"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282365","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":"In response to comment on: Prehospital interventions and outcomes in traumatic cardiac arrest: a population-based cohort study using Danish helicopter emergency medical services data.","authors":"Signe Amalie Wolthers, Thea Palsgaard Møller, Mathias Geldermann Holgersen, Niklas Breindahl, Theo Walther Jensen, Lars Bredevang Andersen, Stig Nikolaj Fasmer Blomberg, Søren Mikkelsen, Jacob Steinmetz, Helle Collatz Christensen","doi":"10.1097/MEJ.0000000000001203","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001203","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"32 2","pages":"150"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514964","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":"Timing of antibiotic administration in sepsis: always within 1 h?","authors":"Jean-Louis Vincent","doi":"10.1097/MEJ.0000000000001223","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001223","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"32 2","pages":"75-76"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514972","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":"Stroke alert! Autoimmune ischemic vascular emergencies of the eye.","authors":"Jagannadha Avasarala, Suhas Gangadhara, Mangayakarasi Thandampallayam","doi":"10.1097/MEJ.0000000000001213","DOIUrl":"10.1097/MEJ.0000000000001213","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"85-86"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946745","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":"Comparison of outcomes between successful and failed prehospital advanced airway management by paramedic staff in patients with out-of-hospital cardiac arrest.","authors":"Wataru Takayama, Momoko Sugimoto, Koji Morishita, Yasuhiro Otomo, Nobuya Kitamura, Takashi Tagami","doi":"10.1097/MEJ.0000000000001231","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001231","url":null,"abstract":"<p><strong>Background and importance: </strong>Although advanced airway management is beneficial for patients with out-of-hospital cardiac arrest (OHCA) in certain situations, the impact of advanced airway management success or failure by the emergency medical service (EMS) crew on the clinical time course and outcomes has not yet been thoroughly evaluated.</p><p><strong>Objectives: </strong>To evaluate the impact of EMS crew members' prehospital advanced airway management failure on patient outcomes in OHCA.</p><p><strong>Design: </strong>Retrospective multicentre registry study.</p><p><strong>Setting and participants: </strong>Data from an OHCA survey in a Japanese retrospective multicentre study conducted between 2019 and 2021 were reviewed.</p><p><strong>Outcome measures and analysis: </strong>Patients who underwent advanced airway management were divided into success and failure groups. The baseline characteristics and outcomes of the two groups were evaluated. Propensity score matching was performed by creating matched success and failure groups to analyse sensitivity. The primary outcome was 30-day survival, and secondary outcomes were favourable neurological outcomes at discharge, time from on-scene EMS arrival to hospital arrival, and return of spontaneous circulation (ROSC).</p><p><strong>Main results: </strong>Overall, 4474 patients who underwent prehospital advanced airway management were analysed. Among them, 4074 and 400 patients were in the success and failure groups, respectively. The 30-day survival rates (success vs. failure, 4.4 vs. 2.3%; P = 0.043) and ROSC (29.9 vs. 16.8%; P < 0.001) in the failure group were lower than those in the success group. There were no significant differences in survival rate at hospital discharge (3.6 vs. 2.0%; P = 0.093) and favourable neurological outcomes (1.3 vs. 1.3%; P = 0.930) between the groups. The median time from on-scene EMS arrival to hospital arrival (min) [28.0 (22.0-34.0) vs. 29.0 (25.9-35.0); P < 0.001] in the failure group was longer than that in the success group. After propensity score matching, the results showed a similar trend.</p><p><strong>Conclusion: </strong>Prehospital advanced airway management failure was associated with lower 30-day survival rates, ROSC, and a longer time between EMS arrival and hospital arrival. These findings suggest that failure of prehospital advanced airway management could potentially worsen the outcomes of patients with OHCA.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763513","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":"Awareness and preparedness of health systems and emergency medicine systems to the climate change challenges and threats: an international survey.","authors":"Roberta Petrino, Luis Garcia-Castrillo, Graziano Uccheddu, Letizia Meucci, Roberta Codecà","doi":"10.1097/MEJ.0000000000001196","DOIUrl":"10.1097/MEJ.0000000000001196","url":null,"abstract":"<p><strong>Background and importance: </strong>Climate change is widely recognised as a critical public health challenge.</p><p><strong>Objective: </strong>The objective of this study was to assess the awareness, preparedness and mitigation plans for climate change threats.</p><p><strong>Design, settings and participants: </strong>A cross-sectional observational study targeting emergency medical societies in different countries was conducted between 15 February and 15 March 2024.</p><p><strong>Intervention or exposure: </strong>The survey featured 16 closed questions on climate change awareness, preparedness and risks. Focus groups of 4-6 members were organised by country. Results were correlated to income levels, United Nations (UN) regional classification and the World Risk Index.</p><p><strong>Outcome measure and analysis: </strong>The questions were ranked using a Likert-like scale from 0 to 9 (9 being the highest). Descriptive statistics used central tendency estimators, and inferential analysis used chi-square and Kruskal-Wallis tests, with the significance level set at P  < 0.05.</p><p><strong>Results: </strong>Forty-two focus groups responded, representing 36 countries: 21 (50%) high-income, seven (16.7%) low-income, five (11.9%) lower middle-income and nine (21.4%) upper middle-income countries, representing 31 of the 22 UN regions. According to the World Risk Index, the respondent countries belonged to the different categories as follows: very low risk, 6 (14%); low risk, 8 (19%); medium risk, 5 (12%); high risk, 8 (19%) and very high risk, 14 (34%). The estimated impact of climate change on national health systems had a mean score of 6.75 (SD = 2.16), while on Emergency Medical Systems was 6.96 (SD = 2.05). Overall, assessment and preparedness measures were reported by just 21.4 and 37.6% of respondents, respectively. Analysis by income did not show significant differences, with the exception of food supply. The main differences in the analysis by region were the risks of extreme weather events, vector-borne diseases and wildfires, whereas the World Risk Index was food and chain of supplies. Education and integration of health services were indicated by all as the main mitigation actions.</p><p><strong>Conclusion: </strong>Geographical position and country risk index influence risk perception among focus groups more than income economy, with vector-borne diseases, extreme weather events and food shortages being the threats with the most variability. The most important actions identified to mitigate Climate Change effects are educational and strategic plans.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"100-108"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590271","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":"Leveraging individual development plans to support women physicians navigating academic medicine.","authors":"Adaira I Landry, Jennifer L Kanapicki, Mary R C Haas, Wendy L Macias-Konstantopoulos, Lauren M Westafer, Marcia A Perry, Sreeja M Natesan","doi":"10.1097/MEJ.0000000000001224","DOIUrl":"10.1097/MEJ.0000000000001224","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"79-82"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413646","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}