European Journal of Emergency Medicine最新文献

{"title":"Refrigerated crystalloids as a cooling adjunct in the hyperthermic older adult during heatwaves.","authors":"Paolo Sossai","doi":"10.1097/MEJ.0000000000001366","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001366","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668743","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":"Mental illness and epilepsy are not attributable to out-of-hospital resuscitation after cardiac arrest unless other causes have been ruled out.","authors":"João Gama-Marques, Josef Finsterer","doi":"10.1097/MEJ.0000000000001340","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001340","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"33 4","pages":"292-293"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301414","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":"Quality improvement in emergency medicine: a structured approach.","authors":"Jay Banerjee, Rosa McNamara, Una Geary","doi":"10.1097/MEJ.0000000000001327","DOIUrl":"10.1097/MEJ.0000000000001327","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"211-213"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431734","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 infection and mortality in acute heart failure in the emergency department: a cohort study.","authors":"Marianne Klinguer, Florian Zores, Mathieu Oberlin, Virginie Restouilh, Pierre Boyer, Sabrina Kepka, Pascal Bilbault, Julien Godet, Pierrick Le Borgne","doi":"10.1097/MEJ.0000000000001345","DOIUrl":"10.1097/MEJ.0000000000001345","url":null,"abstract":"<p><strong>Background and importance: </strong>Acute heart failure (AHF) is a frequent cause of emergency department (ED) admissions, yet the prognostic impact of infection as a trigger remains insufficiently characterized.</p><p><strong>Objective: </strong>To evaluate the impact of infection as a trigger of AHF on in-hospital mortality and postdischarge survival.</p><p><strong>Design: </strong>Retrospective observational cohort study.</p><p><strong>Settings and participants: </strong>All adult patients presenting with AHF to the ED of Strasbourg University Hospital in 2020 were included. Clinical and outcome data were collected from 1296 ED visits.</p><p><strong>Intervention or exposure: </strong>Infection and other AHF triggers were defined through adjudication based on clinical, imaging, and microbiological data collected throughout the hospital stay.</p><p><strong>Outcome measures and analysis: </strong>The primary outcome was in-hospital mortality. Analyses were performed using inverse probability weighting (IPW). Postdischarge survival was assessed using IPW-weighted Kaplan-Meier estimates and Cox models.</p><p><strong>Main results: </strong>Infection was identified in 119 ED visits [9.2%, 95% confidence interval (CI): 7.7-10.9]. Patients with infection had higher in-hospital mortality than those without infection (30.3% vs. 9.0%, P  < 0.001). In IPW-weighted analyses, infection was independently associated with in-hospital mortality [odds ratio (OR) = 2.76, 95% CI: 1.64-4.66]. In contrast, atrial fibrillation (OR = 0.45, 95% CI: 0.23-0.87) and acute coronary syndrome (OR = 0.08, 95% CI 0.01-0.58) were associated with lower in-hospital mortality. Infection was also associated with reduced postdischarge survival (hazard ratio = 1.64, 95% CI: 1.14-2.37, P  = 0.008).</p><p><strong>Conclusion: </strong>Infection is a strong and independent predictor of short- and long-term mortality in patients presenting with AHF in the ED.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"255-263"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766283","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":"Prevalence and incidence of pulmonary embolism in China: a scoping review.","authors":"Yulin Li, Mathilde Papin, Théophile Vieux, Amélie Vromant, Yonathan Freund, Héloïse Bannelier","doi":"10.1097/MEJ.0000000000001353","DOIUrl":"10.1097/MEJ.0000000000001353","url":null,"abstract":"<p><p>Pulmonary embolism is associated with significant in-hospital mortality and represents a major challenge to health systems worldwide. In Europe and North America, the reported incidence of pulmonary embolism has been reported more extensively, but data from China remain insufficient, with substantial discrepancies compared with Western epidemiology. To synthesize contemporary evidence on the epidemiology and diagnostic evaluation of pulmonary embolism in China, with emphasis on incidence and prevalence by denominator, care setting, and geographic distribution. We conducted a Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews-compliant scoping review of studies published from database inception to 30 May 2025, across international and Chinese databases. Eligible studies reported pulmonary embolism epidemiology in Chinese healthcare settings and provided calculable denominators (population, hospital admissions, or emergency department visits). Outcomes were analyzed separately by denominator and synthesized descriptively. Of 5199 records identified, 29 studies met the inclusion criteria, and 12 could be assessed for incidence or prevalence. Population-based incidence ranged from 1.2 to 11.7 per 100 000 person-years (four studies; median = 6.25). Among hospital admissions, pulmonary embolism prevalence ranged from 0.1 to 5.9‰ ( N  = 11), with multicenter and nationwide datasets reporting more consistent estimates around 1.1-1.2‰ ( N  = 2). Among emergency department visits, reported prevalences were 0.04and 1.1‰ ( N  = 2). No study reported the prevalence of pulmonary embolism among patients presenting with clinical suspicion of pulmonary embolism; estimates were rather derived from cohorts evaluated with imaging. Most studies were retrospective and conducted in tertiary hospitals, with geographic clustering in South China and North China. Reported pulmonary embolism incidence and prevalence in China vary substantially across different clinical settings. Population-based incidence is lower than in Western cohorts, whereas among selected emergency department patients undergoing imaging or diagnostic work-up for pulmonary embolism, positivity rates are higher than those reported in Western countries. These findings may suggest under-testing among Chinese emergency department patients.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"219-227"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867334","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 liquid crystal vein locator on intravenous catheterization in young children: a randomized trial.","authors":"Han-Ping Wu, Bei-Cyuan Guo, Yu-Jun Chang, Chun-Yu Chen, Sheng-Ling Jan, En-Pei Lee","doi":"10.1097/MEJ.0000000000001355","DOIUrl":"10.1097/MEJ.0000000000001355","url":null,"abstract":"<p><strong>Background and importance: </strong>Peripheral intravenous catheterization (PIVC) in young children is notoriously challenging because of factors like poor patient cooperation and small vessel diameter. Repeated attempts cause distress and delay critical emergency treatment.</p><p><strong>Objectives: </strong>This study aimed to evaluate the effect of a novel liquid crystal display-based near-infrared vein locator on PIVC performance in children aged under 3 years.</p><p><strong>Design: </strong>This is a prospective, randomized controlled trial.</p><p><strong>Settings and participants: </strong>A total of 105 children aged 0-3 years requiring PIVC were enrolled in a pediatric emergency department.</p><p><strong>Intervention: </strong>Participants were randomly assigned to undergo PIVC using either a liquid crystal vein locator (study group, n  = 50) or the traditional landmark-based method (control group, n  = 55).</p><p><strong>Outcome measures and analysis: </strong>The primary endpoint was the first-attempt success rate. Secondary endpoints included the number of puncture attempts, vein localization time, and total insertion time. Multivariable logistic and Poisson regression models were used to adjust for covariates, such as vein difficulty and patient demographics. Analyses included effect sizes with 95% confidence intervals (CIs).</p><p><strong>Main results: </strong>The baseline characteristics of both groups were comparable. The first-attempt success rate was significantly higher in the study group compared to the control group (86.0% vs. 54.5%; absolute difference: 31.5%; 95% CI: 15.2-47.8%). The study group also demonstrated a significantly shorter median vein localization time (16.5 vs. 60.0 s) and median total insertion time (40.0 vs. 185.0 s). In addition, the device significantly reduced the median number of puncture attempts (adjusted rate ratio: 0.77; 95% CI: 0.66-0.90). Multivariable analysis revealed that device assistance was an independent predictor of first-attempt success (adjusted odds ratio: 3.35; 95% CI: 1.13-9.95).</p><p><strong>Conclusion: </strong>In this study, the use of a liquid crystal vein locator was associated with a significantly higher first-attempt success rate, fewer puncture attempts, and reduced procedural times for PIVC in young children.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"248-254"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971506","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 department-based computed tomography scanners: rationale and clinical importance.","authors":"Wilhelm Behringer, Martin W Dünser, Harald Herkner, Christian Loewe, Christoph Testori","doi":"10.1097/MEJ.0000000000001344","DOIUrl":"10.1097/MEJ.0000000000001344","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"214-216"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867283","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":"The effect of feedback on the diagnostic process of physicians at the emergency department: a systematic review.","authors":"Laurens A Schols, Laura Zwaan, Andrea M Woltman, Renee A Scheepers, Juanita A Haagsma, Pleunie P M Rood","doi":"10.1097/MEJ.0000000000001337","DOIUrl":"10.1097/MEJ.0000000000001337","url":null,"abstract":"<p><p>In the emergency department (ED), the diagnostic process is complex. Discrepancies between the initial diagnosis in the ED and the final discharge diagnosis occur in 12-15%. Emergency physicians are often unaware of these discrepancies. Systematic feedback could serve as a valuable tool to enhance the diagnostic process. The potential methods and impact of such feedback remain poorly understood. This systematic review (PROSPERO: CRD42024491077) aimed to obtain insight into the types and timing of feedback provided to ED physicians about the diagnostic process and examined the effect on ED physicians' performance and confidence. Studies were included if they examined feedback on the diagnostic process to physicians in the ED. Five large international databases (MEDLINE, EMBASE, Cochrane libraries, Google Scholar, and Web of Science) were searched. Quality assessment was performed using Grading of Recommendations Assessment, Development and Evaluation. In total 1897 articles were screened, of which 11 were included in this review. Most of them were qualified as low-grade evidence. Feedback was given through in-person sessions, monthly group meetings, rapid diagnostic discussions, and computer-based feedback. Six studies reported feedback methods to improve diagnostic accuracy. Furthermore, reduction of adverse outcomes after feedback introduction was reported by two articles. Confidence was reported in one study. This review showed that - although there were few studies and generally of low quality - structured feedback may positively influence the diagnostic performance of ED physicians. The feedback strategies identified in this review could be used for future studies on their effectiveness. Furthermore, rigorous study designs, standardized outcome measures, and scalable feedback methods are needed.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"228-236"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697887","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":"The effect of oxygen administration on systemic oxidative stress in patients presenting in the emergency department: a prospective cohort study.","authors":"Renate Stolmeijer, Arno R Bourgonje, Harry van Goor, Ewoud Ter Avest","doi":"10.1097/MEJ.0000000000001347","DOIUrl":"https://doi.org/10.1097/MEJ.0000000000001347","url":null,"abstract":"","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":"33 4","pages":"289-291"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301370","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 point-of-care ultrasound-driven diagnostic pathway on diagnostic certainty in emergency department patients with dyspnea: a randomized controlled substudy.","authors":"Stig Holm Ovesen, Søren Helbo Skaarup, Rasmus Aagaard, Bo Løfgren, Stefan Posth, Michael Dan Arvig, Christian B Laursen, Hans Kirkegaard, Jesper Weile","doi":"10.1097/MEJ.0000000000001331","DOIUrl":"10.1097/MEJ.0000000000001331","url":null,"abstract":"<p><strong>Background and importance: </strong>In emergency department (ED) patients with dyspnea, diagnostic uncertainty has been linked to poorer outcomes. Point-of-care ultrasound (POCUS) may help reduce this uncertainty.</p><p><strong>Objective: </strong>To explore how POCUS influences ED physicians' diagnostic thinking and perceived uncertainty.</p><p><strong>Design, settings, and participants: </strong>This preplanned substudy of a randomized controlled trial across 10 Danish EDs compared diagnostic pathways with vs. without focused lung and cardiac ultrasound.</p><p><strong>Outcomes measure and analysis: </strong>Paired physician surveys and electronic health record data were used to evaluate predefined outcomes: (a) physicians' experienced benefit of diagnostic tests; (b) the number of differential diagnoses; (c) posttest probability estimates; (d) concurrent treatment; and (e) concordance between tentative diagnoses. The primary outcome of the parent trial was discharge alive within 24 h; this substudy focused on early diagnostic reasoning and certainty.</p><p><strong>Main results: </strong>Between 25 January 2023 and 23 August 2024, 40 physicians enrolled 674 patients. The median number of differential diagnoses was similar between groups [intervention: 3 (interquartile range - IQR: 2-4); control: 3 (IQR: 2-4)]. The proportion of patients with a reduced differential count was 65.3 vs. 72.9% [risk difference: -7.6, 95% confidence interval (CI): -14.9 to -0.3]. The median estimated probability of the leading diagnosis was higher with POCUS (80 vs. 73%). Concordance between initial and revised physician diagnoses was also higher (70.6 vs. 63.1%; risk difference: 7.5, 95% CI: 0.1-15.0), while concordance with final hospital diagnoses was similar (35.9 vs. 38.9%, risk difference: -3.0, 95% CI: -10.4 to 4.4).</p><p><strong>Conclusion: </strong>A POCUS-driven diagnostic pathway increased early diagnostic certainty, but not diagnostic certainty at the time of patient disposition. This was reflected in a higher initial diagnostic probability for the primary diagnosis and greater concordance between the primary tentative diagnoses recorded in the paired surveys.</p>","PeriodicalId":11893,"journal":{"name":"European Journal of Emergency Medicine","volume":" ","pages":"272-281"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497947","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}