International Journal of Emergency Medicine最新文献

{"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}

{"title":"Isolated oculomotor nerve palsy in Neisseria meningitidis meningitis: a case report and literature review.","authors":"Sadia Zafar, Hessa Al Delail, Mahmoud Ghanaim","doi":"10.1186/s12245-025-00980-7","DOIUrl":"10.1186/s12245-025-00980-7","url":null,"abstract":"<p><p>Bacterial meningitis remains a significant cause of morbidity and mortality worldwide, despite advances in prevention and treatment. Prompt diagnosis and appropriate management are crucial for optimal patient outcomes. This case report describes a 22-year-old Bangladeshi male who presented to the emergency department with headache, neck pain, vomiting, and left eye ptosis, ultimately diagnosed with Neisseria meningitidis meningitis. This case highlights the rare but significant complication of oculomotor nerve palsy associated with this infection. We also present a literature review discussing the incidence, pathophysiology, and clinical implications of cranial nerve involvement in bacterial meningitis, focusing on N. meningitidis, and explore the diagnostic challenges posed by overlapping clinical presentations of bacterial and tuberculous meningitis, particularly in resource-limited settings.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"188"},"PeriodicalIF":2.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212649","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":"Serial electrical cardioversion for refractory atrial fibrillation with rapid ventricular response post ablation.","authors":"Katherine Liu, Nofel Iftikhar, Latha Ganti","doi":"10.1186/s12245-025-01012-0","DOIUrl":"10.1186/s12245-025-01012-0","url":null,"abstract":"<p><p>The authors present the case of a man in his 50s who arrived at the ED with palpitations and persistent tachycardia a month after undergoing catheter ablation (CA) for atrial fibrillation with rapid ventricular response, and a week after electrical cardioversion in our ED. He was once again successfully cardioverted in our ED. The unique aspect of this case is how refractory his case was.This case highlights the limitations of current AF management strategies in achieving durable rhythm control, particularly following ablation. It underscores the importance of timely follow-up, individualized treatment planning, and consideration of additional interventions such as repeat ablation or atrioventricular nodal ablation with pacemaker placement in refractory cases. Serial ECV can provide temporary relief but should be viewed as a bridge to more definitive therapy. Serial Electrical Cardioversion for Refractory Atrial Fibrillation with Rapid Ventricular Response Post Ablation.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"184"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206459","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":"Skill progression models in emergency medicine training: a narrative review and the development of the OASIS framework.","authors":"Aaditya Katyal, Vimal Krishnan S","doi":"10.1186/s12245-025-00994-1","DOIUrl":"10.1186/s12245-025-00994-1","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"186"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206426","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":"Tattoo-associated toxic shock syndrome: a case report.","authors":"Takuya Kubo, Tetsuya Yumoto, Hideharu Hagiya, Koji Iio, Hiromichi Naito, Atsunori Nakao","doi":"10.1186/s12245-025-00993-2","DOIUrl":"10.1186/s12245-025-00993-2","url":null,"abstract":"<p><strong>Background: </strong>Toxic shock syndrome (TSS) is a rare but life-threatening complication occasionally reported after tattooing.</p><p><strong>Case presentation: </strong>A 29-year-old Japanese man was admitted to Okayama University Hospital, Okayama, Japan, in early spring 2025, one week after receiving a tattoo on his right shoulder and upper arm in Osaka. He presented with fever, gastrointestinal symptoms, hypotension, and multi-organ failure. Despite a failure to isolate a causative pathogen, he met clinical criteria for TSS. Supportive care and broad-spectrum antibiotics led to full recovery.</p><p><strong>Conclusions: </strong>TSS can occur after tattooing, even in individuals without apparent immunodeficiency. Pathogenic organisms may be unidentifiable; however, clinical diagnosis should not be delayed, and early therapeutic interventions are essential to improve outcomes.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"185"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206479","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":"A real pain in the back…or maybe not- a case series of urosepsis due to obstructing calculi identified on ultrasound.","authors":"Aurora Jin, John Forrester, Nicholas Bielawa, Stephanie Jose, Vidhi Rao, James Napolitano, Elizabeth Young, Mathew Nelson, Sofie Nelson, Allison Cohen","doi":"10.1186/s12245-025-00958-5","DOIUrl":"10.1186/s12245-025-00958-5","url":null,"abstract":"<p><strong>Background: </strong>Urosepsis, due to obstructing urinary calculi, is a urologic emergency requiring surgical decompression to reduce mortality. Presenting symptoms include fevers, pain, and dysuria, however, symptoms may be difficult to assess in patients with shock and altered mental status. Point-of-care ultrasound (POCUS) is an invaluable tool to assess patients in the emergency department (ED) with undifferentiated shock. We present a case series of three patients presenting with septic shock, who were found to have hydronephrosis on POCUS, from an infected ureteral stone.</p><p><strong>Case presentation: </strong>Three elderly patients presented to the ED with sepsis secondary to an infected kidney stone. POCUS identified hydronephrosis leading to the diagnosis of infected ureteral stone as the nidus of the infection. These patients presented with atypical symptoms, and POCUS was essential to making the diagnosis and rapid source control.</p><p><strong>Conclusion: </strong>POCUS is a useful tool for evaluating patients with shock in the ED. Numerous ultrasonographic protocols have been created to evaluate patients with shock, however, none of these include the importance of evaluating for hydronephrosis. This case series highlights the importance of renal ultrasound in patients with undifferentiated septic shock.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"181"},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199235","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":"Does TXA reduce total volume of 24-hour blood products transfused in post-traumatic hemorrhage in a resource-constrained setting:Secondary analysis of a prospective cohort trauma study in South Africa.","authors":"Chelsea Dymond, Mengli Xiao, Lani Finck, Hendrick Lategan, George Oosthuizen, Shaheem de Vries, Janette Verster, Craig Wylie, EpiC Study Site Collaborators, Willem Stassen, Joseph Maddry, Steven Schauer, Julia Dixon, Nee-Kofi Mould-Millman","doi":"10.1186/s12245-025-00972-7","DOIUrl":"10.1186/s12245-025-00972-7","url":null,"abstract":"<p><strong>Background: </strong>Low- and middle-income countries bear a disproportionately large share of the global burden of trauma, with hemorrhage as a leading cause of preventable mortality. Tranexamic acid has been shown to reduce mortality in trauma, but no studies have investigated tranexamic acid's effect on blood product consumption in resource-constrained settings.</p><p><strong>Methods: </strong>A prospective secondary analysis was performed from data collected from 'The Epidemiology and Outcomes of Prolonged Trauma Care (EpiC)' study, a multicenter observational study of major trauma patients within the Western Cape of South Africa. Adult trauma patients with major hemorrhage who arrived at an EpiC study site within 24 h of injury between March 2021 and December 2024 were included. The primary outcome was total blood product administration within 24 h of injury. Treatment groups included patients who received tranexamic acid within 3 h compared to those who did not. Multiple regression with inverse probability weighting was performed to mitigate confounding. Subgroup analyses included patients with penetrating injuries, severe shock, presence of intracranial hemorrhage and patients without head injury who received large-volume blood products.</p><p><strong>Results: </strong>A total of 1630 patients were included. Median total blood product volume was 760 mL. There was no difference in blood volume between the two groups. There was no significant difference in blood product volumes observed in all subgroup analysis.</p><p><strong>Conclusion: </strong>In a cohort of adult trauma patients with major hemorrhage, there was no difference in total blood volume transfused within the first 24 h between patients who received tranexamic acid compared to those who did not.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"179"},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199238","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":"Unveiling gas in the bowel wall: the role of point-of-care ultrasound in diagnosing pneumatosis intestinalis.","authors":"Rida Jawed, Noman Ali","doi":"10.1186/s12245-025-00957-6","DOIUrl":"10.1186/s12245-025-00957-6","url":null,"abstract":"<p><strong>Background: </strong>Pneumatosis intestinalis (PI) is an infrequent but clinically significant finding that can be a surrogate indicator of underlying severe gastrointestinal conditions, particularly in pediatrics. Despite its typical association with necrotizing enterocolitis (NEC), PI can occasionally present without overt clinical signs, which presents a diagnostic dilemma.</p><p><strong>Case presentation: </strong>A 35-day-old preterm infant who presented to the emergency department with loose stools and vomiting. Although the clinical examination was unremarkable, point-of-care ultrasound (POCUS) revealed multiple intramural echogenic foci consistent with PI. Subsequent abdominal X-rays confirmed the diagnosis. The patient was managed conservatively with bowel rest, intravenous fluids, and antibiotics, leading to resolution of symptoms and discharge in stable condition.</p><p><strong>Conclusion: </strong>The case uniquely demonstrates the feasibility and potential diagnostic advantage of POCUS as a diagnostic tool for rapidly identifying PI, especially in the absence of classical clinical signs-highlighting its novel utility in emergency pediatric care.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"177"},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199213","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":"Emergency field amputation in a resource‑limited setting: a case report.","authors":"Sweta Khuraijam, Siddharth Shah, Jugindra Sorokhaibam, Kalpesh Ram, Nabakishor Haobijam, Praneetha Vijayan","doi":"10.1186/s12245-025-00986-1","DOIUrl":"10.1186/s12245-025-00986-1","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"178"},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199222","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":"Right ventricular dysfunction: a key predictor of post-intubation hypotension in the emergency department.","authors":"Pranav Prakash, Nisarg S, Jayaraj Mymbilly Balakrishnan, Sai Deepak Alli, Ravi G S, Siddhi Rajeev Naik","doi":"10.1186/s12245-025-00987-0","DOIUrl":"10.1186/s12245-025-00987-0","url":null,"abstract":"<p><strong>Background: </strong>Post-intubation hypotension (PIh) is a frequent complication following drug-assisted intubation, leading to increased morbidity, mortality, and healthcare costs. Pre-intubation hemodynamic factors, acid-base imbalances, and existing comorbidities, particularly right ventricular dysfunction, which is a lesser-known variable, have emerged as a critical predictor of PIh. Since RV systolic motion is predominantly longitudinal, TAPSE on POCUS provides a time-sensitive surrogate of RV function for high risk patients in the Emergency department.</p><p><strong>Methods: </strong>Aim: The study aimed to list hemodynamic predictors and their correlation with easily executable POCUS and point-of-care echocardiography variables, which can impact emergency decision-making and optimal management in PIh. This prospective observational study was conducted in the Department of Emergency Medicine at Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India. 172 patients aged ≥ 18 years undergoing drug-assisted intubation were observed. Baseline demographics, clinical parameters, hemodynamic indices, and pre-intubation echocardiographic values (TAPSE, EPSS) were recorded. Shock index and modified shock index were calculated. Point-of-care ultrasound (POCUS) assessed left and right ventricular function. PIh within 30 min was defined as SBP [Formula: see text] 90mmHg, ≥ 20% fall in SBP, MAP < 65mmHg or new vasopressor initiation. Associations were tested with logistic regression. TAPSE discrimination was obtained with ROC analysis and Youden's Index.</p><p><strong>Results: </strong>Of the 172 patients, 71 (41.2%) developed PIh. Patients with obstructive lung disease (59.3%, p = 0.039) and sepsis (66.7%) were significantly more likely to experience PIh. TAPSE values were significantly lower in those with PIh (17.66 ± 2.45 mm vs. 18.54 ± 2.15 mm, p = 0.014). The multivariate logistic regression revealed TAPSE as an independent predictor of PIh (OR = 0.81, 95% CI = 0.69-0.95, p = 0.009). ROC analysis of TAPSE showed moderate predictive power (AUC 0.584, 95% CI 0.497-0.672), with a cut-off of 17.6 mm (sensitivity 85.1% and specificity 29.6%).</p><p><strong>Conclusion: </strong>TAPSE measured pre-intubation emerged as a reliable predictor of post-intubation hypotension. Incorporating a rapid assessment of right ventricular function using POCUS into the airway management algorithm provides valuable insights in identifying patients at higher risk of PIh.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"183"},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199219","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}