International Journal of Emergency Medicine最新文献

{"title":"Outcomes and guideline adherence for emergency department thoracotomy: a single-center experience in Saudi Arabia.","authors":"Mohammed Alageel, Tareq Al-Salamah, Latifa Alshabib, Yara Al-Digi","doi":"10.1186/s12245-025-00992-3","DOIUrl":"10.1186/s12245-025-00992-3","url":null,"abstract":"<p><strong>Background: </strong>Emergency department thoracotomy (EDT) is a high-risk, salvage procedure performed during the resuscitation of critically injured patients who are in extremis or experience cardiac arrest immediately before or after arrival at the emergency department (ED) following trauma. Despite its potential to improve outcomes in selected patients, its indications and ideal clinical applications remain controversial due to significant risks of morbidity and mortality. In Saudi Arabia, trauma is responsible for approximately 20% of fatalities and is the leading cause of disability-adjusted life-years lost among males. However, there is limited research on EDT outcomes in this region.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a tertiary academic trauma center in Riyadh with dedicated trauma and surgical services. Medical records from 2015 to 2023 were reviewed to identify adult patients who underwent EDT, using trauma team activations as a screening criterion. Data collected included demographics, mechanisms of injury, procedure indications, and timing.</p><p><strong>Results: </strong>During the study period, the center averaged 151 trauma activations per year, identifying 11 patients who underwent EDT. All were male, with a mean age of 35.64 ± 8.89 years. Blunt trauma was the cause in 64.6% of cases. Of these, 45.4% met the Eastern Association for the Surgery of Trauma (EAST) guideline recommendations for EDT, while 18.2% had contraindications. Traumatic arrest in the ED or prehospital settings was the most common indication 72.7%. Mean time between ED arrival to procedure initiation was 25.45 ± 15.85 min. One patient survived to discharge. Among 45 traumatic arrests screened, 4.44% lacked documentation for withholding EDT despite conditional guideline recommendations.</p><p><strong>Conclusions: </strong>Given the limited data available on EDT in the MENA region, our study offers important perspectives from a high-volume trauma center in KSA, where the rate of EDT was found to be very low. This low rate is likely due to the predominant injury patterns observed, presenting few candidates who might benefit from the procedure. At the same time, most patients who may have benefited based on guideline recommendations did undergo the procedure. These findings emphasize the need for heightened clinician awareness and systematic decision-making regarding EDT in trauma care. To enhance the generalizability of our findings and assess EDT's utility in regional settings, further research involving larger multicenter registries is necessary in the country and the region.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"197"},"PeriodicalIF":2.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualizing the landscape of ocular melanoma research: a bibliometric analysis.","authors":"Maya Lee, Ethan Nichols, Vindhya N Reddy, Latha Ganti","doi":"10.1186/s12245-025-01018-8","DOIUrl":"10.1186/s12245-025-01018-8","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular melanoma is a type of malignancy affecting the eye. Symptoms can include dark spots near or around the iris or the mucous membrane of the eyes. Treatments include radiation, laser therapy, and enucleation or evisceration of the eye.</p><p><strong>Method: </strong>A bibliometric analysis was conducted using the database Web of Science. VosViewer version 1.6.20 was utilized to import tab-delimited files and visualize the data from Web of Science.</p><p><strong>Results: </strong>Data was collected from 1990 to 2024, with 2021 being the highest publication year (258). The U.S. (1,950), Germany (405), and England (205) released the greatest number of publications. From those countries, Thomas Jefferson University and Leiden University released the largest number of articles written about ocular melanoma.</p><p><strong>Conclusion: </strong>Ocular melanoma is a rare type of cancer affecting people worldwide. As medicinal research advances over time, the ability to prevent and treat ocular melanoma steadily improves. Over the past years (1990-2024), there has been a general increase in the number of publications regarding ocular melanoma. There have been gaps in the research in South Asian and African demographics, showing that these communities have not brought enough attention to this disease.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"195"},"PeriodicalIF":2.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IFEM model framework for the accreditation of training sites for emergency medicine specialists.","authors":"Andrew Singer, Simon Chu, Anantharaman Venkataraman, Nicholas Jouriles, Arif Alper Cevik, James Kwan","doi":"10.1186/s12245-025-01001-3","DOIUrl":"10.1186/s12245-025-01001-3","url":null,"abstract":"<p><p>The International Federation for Emergency Medicine (IFEM) has developed model curricula for undergraduate education, graduate education and continuing professional development in Emergency Medicine. Graduate education is delivered in various settings, including training sites based in a clinical Emergency Department. In order to ensure the quality of the training that is delivered at these sites, mature training systems have a system that accredits these sites for training purposes. This paper presents a model framework for this accreditation process that may be used by national societies to develop their own process. This paper also includes a comparison of this framework with the accreditation standards of established programs in IFEM member societies.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"196"},"PeriodicalIF":2.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the pentraxin-3 as a prognostic biomarker in paraquat poisoning: a systematic-narrative hybrid review.","authors":"Deepu Mathew, Ambika Prasad Patra","doi":"10.1186/s12245-025-01003-1","DOIUrl":"10.1186/s12245-025-01003-1","url":null,"abstract":"<p><strong>Purpose: </strong>Paraquat is a commonly used pesticide that is highly toxic to humans and leads to fatal lung fibrosis upon consumption. Due to its rapid clearance from the bloodstream, there are no reliable biomarkers for the diagnosis and prognosis of paraquat intoxication. Pentraxin 3 (PTX3), an acute-phase inflammatory mediator, has emerged as a potential biomarker, particularly in the context of lung injury and fibrosis. This review aimed to assess the prognostic value of the level of PTX3 in predicting clinical outcomes in patients with paraquat poisoning and to evaluate the correlation between PTX3 levels and the severity of poisoning.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, MEDLINE (Ovid), EMBASE (Ovid), Web of Science, Scopus, CROSSREF, and Google Scholar. The included studies were observational (cohort or case-control), involving human subjects with confirmed paraquat poisoning, and reported PTX3 levels related to clinical outcomes. Data on PTX3 expression, disease severity, and prognostic correlations were extracted.</p><p><strong>Results: </strong>Two primary studies were performed. PTX3 levels were significantly elevated in non-survivors compared to survivors and were positively correlated with serum paraquat levels and disease severity. PTX3 levels peaked between 12 and 24 h post-ingestion and maintained a prognostic value over subsequent days. A PTX3 cut-off of 8.9 ng/mL was associated with higher mortality, with moderate sensitivity and specificity.</p><p><strong>Conclusion: </strong>PTX3 is a promising prognostic biomarker for paraquat poisoning, particularly in cases where traditional markers are unreliable. Due to the limited sample size, a multicenter study is recommended to validate the role of PTX3 in clinical and forensic settings.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"193"},"PeriodicalIF":2.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical presentation and management outcome of abdominal stab wounds in a low-resource setting: experience of a central hospital in Sudan.","authors":"Mohamed Soud Mohamed Saadeldien, Mohamed Daffalla Awadalla Gismalla, Adam Mohamed Ibrahim Adam, Aimen Elsheikh Khalil Abuelnour, Mustafa Abdullah Alhamed","doi":"10.1186/s12245-025-01022-y","DOIUrl":"10.1186/s12245-025-01022-y","url":null,"abstract":"<p><strong>Background: </strong>Abdominal stab injuries are a major public health concern worldwide, especially in African countries. This study aimed to examine the presentation patterns and management outcomes of abdominal stab wounds.</p><p><strong>Methods: </strong>This descriptive, prospective, cross-sectional, hospital-based study was conducted at Wad Medani Teaching Hospital, including all patients with abdominal stab wounds from January 2022 to December 2022. Patient characteristics and clinical presentations were documented. Factors influencing management outcomes were analyzed and correlated.</p><p><strong>Result: </strong>The total number of patients admitted to the hospital with abdominal stab wounds is 47. The most common age group is between 20 and 29 years (38.3%), with the majority being male (97.9%). They are mainly from Gezira State (61.7%) and live in rural areas (38.3%). The most common occupation among them is labor, making up 51.1%. Patients were admitted within the first two hours in 57.5% of cases. The organs most often involved in this study include the small bowel, large bowel, and mesentery, affecting 27.7%, 23.4%, and 17.0% of patients, respectively. Additionally, 25.4% of patients sustained associated injuries. Of the 40 patients treated, 30 (60.8%) underwent a laparotomy. From a total of 30 laparotomies, 14 patients (46.6%) underwent resection and anastomosis, while 7 patients (23.3%) had their small bowel injuries repaired. Most patients recovered, while four (8.5%) developed complications.</p><p><strong>Conclusion: </strong>In our setting, abdominal stab wounds predominantly affect young males in their productive years. The small intestine is the most frequently injured organ, and most patients require an exploratory laparotomy as part of their treatment.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"194"},"PeriodicalIF":2.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and mortality risk factors in polytrauma patients with pelvic fractures: a retrospective study based on an integrated multidisciplinary treatment approach.","authors":"Haixiang Ding, Wenwen Wang, Wei Sun, Li Liu, Ming Huang, Dong Han, Yaozhong Lu, Jianhong Zhou, Jingshi Pan","doi":"10.1186/s12245-025-00990-5","DOIUrl":"10.1186/s12245-025-00990-5","url":null,"abstract":"<p><strong>Purpose: </strong>Pelvic fractures in polytrauma patients represent complex injuries associated with substantial mortality rates. This study examined clinical characteristics, multidisciplinary collaborative management approaches, and mortality risk factors in these patients to establish clinical references for optimizing comprehensive treatment strategies.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical data from 32 polytrauma patients with pelvic fractures managed under an integrated multidisciplinary treatment protocol in our trauma center's Emergency Intensive Care Unit (EICU). This protocol incorporated expedited prehospital transport, trauma team activation before patient arrival, \"resuscitation in the operating room\" strategy, and collaborative intervention from emergency surgery, trauma surgery, interventional radiology, and EICU teams. We collected patient demographics, injury characteristics, therapeutic interventions, and outcome data. Univariate and correlation analyses were employed to identify mortality risk factors.</p><p><strong>Results: </strong>The study cohort (n = 32) had a mean age of 51.2 ± 18.3 years, with female predominance (62.5%). Motor vehicle accidents constituted the primary injury mechanism (75.0%). Thoracic injuries were the most prevalent concomitant injuries (87.5%). Under the multidisciplinary collaborative approach, 37.5% of patients underwent early external pelvic fixation, and 6.3% received transcatheter arterial embolization (TAE). Surgical interventions significantly reduced pain scores (p < 0.001). The overall mortality rate was 9.4% (3/32). Correlation analysis demonstrated a negative association between mortality and Glasgow Coma Scale (GCS) scores (-0.710) and a positive correlation with Injury Severity Score (ISS) (0.547).</p><p><strong>Conclusion: </strong>Polytrauma with pelvic fractures carries substantial mortality risk. Initial GCS scores and ISS were identified as independent mortality risk factors. Optimization of integrated multidisciplinary treatment protocols with early identification of mortality risk factors and timely interventions appears essential for reducing mortality in this complex patient population.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"192"},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genital burns caused by cell phone combustion following a motorcycle accident: a case report.","authors":"Koshi Ota, Saki Mizutani, Akinori Asaka, Yuri Yae, Kanna Ota, Takashi Nuri, Akira Takasu","doi":"10.1186/s12245-025-01002-2","DOIUrl":"10.1186/s12245-025-01002-2","url":null,"abstract":"<p><strong>Background: </strong>Thermal injuries are common in emergency departments, but rarely involve isolated genital burns. However, burns caused by electronic devices, particularly cell phones, represent an emerging concern.</p><p><strong>Case presentation: </strong>A 47-year-old man presented with third-degree burns to the left anterior thigh, penis, and scrotum, covering 2% of the total body surface area, accompanied by facial fractures. These injuries had been sustained in a collision. A burned cell phone was discovered in clothing adjacent to the perineum, leading to the suspicion that it had ignited in his trouser pocket, causing burns in addition to trauma from the collision. He underwent surgical debridement and split-thickness skin grafting on hospital day 14. Despite the severity of the injury, the patient achieved complete epithelialization and recovered pre-injury urological and sexual function by the 3-month follow-up. To our knowledge, this represents the first report of deep dermal and full-thickness genital burns caused by cell phone combustion.</p><p><strong>Conclusions: </strong>This case highlights the potential for severe thermal injuries from cell phones, possibly exacerbated by trauma, and underscores the importance of patient education regarding the safe handling and storage of cell phones, particularly during activities like cycling or motorcycling.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"191"},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a structured triage system in improving timeliness of emergency care in a resource-limited rural hospital in Uganda.","authors":"Lucrezia Rovati, Samuel Otim, Sara Ottolenghi, Maurice Okao, Fausto Fazzini, Alex Ojera, Giovanni Carpani, Sandro Di Domenico, Laura Ferrari, Marco Bettina, Daniele Privitera, Nicolò Capsoni, Godfrey Smart Okot, Carmen Orlotti, Michele Bombelli","doi":"10.1186/s12245-025-01005-z","DOIUrl":"10.1186/s12245-025-01005-z","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"190"},"PeriodicalIF":2.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful management with hemoperfusion and antidotal therapy of severe combined dichlorvos and rodenticide poisoning: a case report.","authors":"Huiying Li, Xue Li, Biao Du, Hongzhi Yu, Shasha Fu, Yu Guo, Hongxia Shao, Huaiyong Chen, Wanjie Yang, Longyan Ma","doi":"10.1186/s12245-025-01004-0","DOIUrl":"10.1186/s12245-025-01004-0","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"189"},"PeriodicalIF":2.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular access for initial treatment of adult emergency patients in the resuscitation room: short summary of recommendations from the German national S1 guideline.","authors":"Manuel Florian Struck, Dan Bieler, Anett Henck, Carsten Hermes, Michael Kegel, Matthias Klein, Philipp Kümpers, Dominik Michalski, Michael Bernhard","doi":"10.1186/s12245-025-01015-x","DOIUrl":"10.1186/s12245-025-01015-x","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"187"},"PeriodicalIF":2.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}