International Journal of Emergency Medicine最新文献

{"title":"Aconitine accidental poisoning: two case reports and literature review.","authors":"Qian Zhao, Lei Wang, Feng Zeng, Xue-Bo Jiang, Yan-Xia Shao","doi":"10.1186/s12245-026-01339-2","DOIUrl":"10.1186/s12245-026-01339-2","url":null,"abstract":"<p><strong>Introduction: </strong>Chinese Herbal Medicine (CHM) is widely integrated into clinical practice across Asia and other regions for disease treatment and health maintenance. Aconitine, a potent diterpenoid alkaloid derived from plants of the Aconitum genus (e.g., Aconitum carmichaelii and Aconitum kusnezoffii), exhibits significant pharmacological activity but also considerable toxicity. While properly processed Aconitum herbs are prescribed for their analgesic and anti-rheumatic properties, inadequate detoxification during processing or improper clinical use can lead to accidental aconitine poisoning. This condition characterized by severe cardiotoxicity and neurotoxicity, which may progress to fatal outcomes. Recently, with the expanding clinical application of traditional medicines globally, the incidence of aconitine poisoning has risen, particularly in Asian populations.</p><p><strong>Case presentation: </strong>We present two cases of aconitine poisoning in middle-aged patients following ingestion of herbal preparations containing aconitine. Both patients developed significant cardiac arrhythmias of varying severity. Clinical management included gastric lavage, catharsis induced by mannitol, gastric mucosal protection, intravenous fluid resuscitation, and hemoperfusion. One patient experienced cardiac arrest and subsequently died after family members elected to withdraw life-sustaining therapy. The second patient was successfully weaned from mechanical ventilation and was eventually discharged following a short-term hospitalization.</p><p><strong>Conclusion: </strong>These cases emphasize the urgent need to enhance the awareness of healthcare professionals and the public regarding the risks of certain traditional Chinese medicines, especially those containing aconitine. Heightening vigilance and promoting their rational use are crucial for improving public health knowledge and preventing similar adverse events.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030522","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":"The perils of a \"hypertensive\" diagnosis.","authors":"Richard Lappin","doi":"10.1186/s12245-026-01367-y","DOIUrl":"10.1186/s12245-026-01367-y","url":null,"abstract":"<p><strong>Background: </strong>The current framework for approaching patients with severe hypertension assigns every patient with arterial pressure above an arbitrary threshold to a state of either \"hypertensive emergency\" or \"hypertensive urgency.\" By labeling every condition in these patients a \"hypertensive\" condition, this framework implies that elevated blood pressure is responsible for every vascular event. An extension of this idea holds that hypertension is even capable of causing symptoms directly, without any intervening pathology.</p><p><strong>Case presentation: </strong>A man in his early 60s presented to the Emergency Department with new hypertension, headache, vomiting and diplopia. His doctors confidently diagnosed his presentation as \"symptomatic hypertensive urgency\" - a direct hypertensive effect. However, when he reported back pain and leg weakness two days later, investigation resumed. Spinal MRI showed subacute hemorrhage extending along the spinal cord from T9-T12. Catheter angiography revealed a small fusiform aneurysm of the posterior spinal artery at T11. The aneurysm was surgically clipped. The patient made a complete recovery and his hypertension resolved.</p><p><strong>Conclusion: </strong>Subarachnoid hemorrhage from a spinal aneurysm is a rare entity. Typical presenting symptoms of back pain and leg weakness help localize the lesion, but when intracranial symptoms such as headache or confusion predominate the diagnosis can be challenging. In this case, misconceptions about hypertension led clinicians to anchor on a diagnosis of \"symptomatic hypertensive urgency.\" When clinicians attribute signs and symptoms directly to elevated blood pressure they may fail to search for real disease processes.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989812","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":"Matters arising: expanding the literature base on blunt trauma-induced abdominal wall hernia.","authors":"Mohamed Hajri, Lassad Gharbi, Zied Hadrich","doi":"10.1186/s12245-026-01387-8","DOIUrl":"10.1186/s12245-026-01387-8","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982705","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":"Correction: Intermittent upper limb cyanosis revealing Paget-Schroetter syndrome: the value of patient-provided photographs.","authors":"Marine Desjardins, Giulia Casutt, Marco Fresa, Jean Perentes, Adriano Alatri, Pierre-Nicolas Carron","doi":"10.1186/s12245-026-01384-x","DOIUrl":"10.1186/s12245-026-01384-x","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968028","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, management, and outcomes of polytraumatized children: a retrospective cohort study.","authors":"Lisa Fiona Roder, Soufian Ben Amar, Alberto Alfieri Zellner, Jonas Roos, Johanna Thiele, Lioba Bürvenich, Kristian Welle, Christian Prangenberg","doi":"10.1186/s12245-026-01371-2","DOIUrl":"10.1186/s12245-026-01371-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Pediatric polytrauma remains a major cause of morbidity and mortality worldwide. Owing to age-specific anatomical and physiological characteristics, children are particularly vulnerable to traumatic brain injury (TBI), which frequently represents the most severe component of polytrauma. This study aimed to evaluate injury mechanisms, injury patterns, treatment strategies, complications, and outcomes in pediatric polytrauma patients treated at a tertiary trauma center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective single-center cohort study was conducted including pediatric patients (&lt; 18 years) with polytrauma, meaning with an Injury Severity Score (ISS) ≥ 16, treated at the University Hospital Bonn between 2023 and 2025. Demographic data, injury mechanisms, injury patterns, ISS, Maximum Abbreviated Injury Scale (MAIS) scores, surgical interventions, intensive care unit (ICU) treatment, complications, and discharge outcomes were analyzed. Correlations between head MAIS, ISS, age, and length of hospital stay were assessed using Spearman's rank correlation coefficient, while differences in ISS between injury mechanisms were evaluated using the Kruskal-Wallis test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-two pediatric patients were included. The median age was 13.5 years (range 2-17 years), and 50% were female. Traffic accidents were the predominant mechanism of injury (75%), followed by falls from heights greater than 3 m (12.5%). Head trauma was the most common injury pattern, including skull fractures (34.4%), subarachnoid hemorrhage (28.1%), subdural hematoma (25.0%), and epidural hematoma (9.4%). Thoracic, abdominal, pelvic, and extremity injuries were also frequently observed. Fifteen patients (46.9%) required surgical intervention. The median ICU stay was 3 days (range 0-69 days). Complications occurred in five patients (15.6%) and included meningitis, aseptic bone necrosis, epidural rebleeding, soft tissue infection, and pulmonary complications. No in-hospital mortality was observed. Most patients (84.4%) were discharged directly home, while 6.3% required inpatient rehabilitation and 9.4% were transferred to another hospital. No significant correlations were found between head MAIS and length of hospital stay (ρ = 0.28, p = 0.127), head MAIS and ISS (ρ = 0.07, p = 0.714), ISS and hospitalization duration (ρ = 0.10, p = 0.581), or age and head MAIS (ρ = 0.03, p = 0.883).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;TBI represented the predominant injury burden and was associated with the most complex clinical courses. Despite the severity of injuries, outcomes were generally favorable, characterized by low complication rates, absence of in-hospital mortality, and a high proportion of patients discharged home. These findings emphasize the importance of specialized multidisciplinary trauma care, neurosurgical expertise, and pediatric intensive care management in severely injured children. Larger multicenter studies with","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929921","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":"\"Resuscitation on the go\"- Musculoskeletal discomfort, CPR quality and provider experiences in a transit ambulance setting: A simulated, mixed-methods study.","authors":"Caroline Ashritha Maben, Prithvishree Ravindra, Abraham Samuel Babu, Mohammad Khalid, B N Lavanya, Ankit Kumar Sahu, Vimal Krishnan S","doi":"10.1186/s12245-026-01365-0","DOIUrl":"10.1186/s12245-026-01365-0","url":null,"abstract":"<p><strong>Background: </strong>Performing high-quality cardiopulmonary resuscitation (CPR) in a moving ambulance poses biomechanical and ergonomic challenges. This pilot study aimed to evaluate musculoskeletal discomfort, CPR quality, and provider posture, while exploring the experiences of healthcare providers delivering CPR in a moving ambulance.</p><p><strong>Methods: </strong>A mixed-methods study involving 30 Emergency Medical Service (EMS) providers and students aged 18-40 years trained in Basic Life Support was conducted. Participants performed CPR simulation in an in-hospital stationary setting and a moving ambulance using a Little Anne^® QCPR mannequin (Laerdal Medical, Stavanger, Norway). Musculoskeletal discomfort was assessed before and after CPR in the moving ambulance using the Numerical Pain Rating Scale. CPR quality parameters, including compression score, depth, rate, recoil, and chest compression fraction, were recorded using the QCPR^® app. Body posture was assessed using mean trunk and elbow angles during compression and recoil. Semi-structured interviews explored participants' experiences.</p><p><strong>Results: </strong>Median pain scores increased significantly after CPR in the moving ambulance [0 (0, 2.75) before vs. 4 (0, 6) after; p < 0.001]. The most common pain sites were the lumbar region and wrists. Chest compression score and good rate percentage were lower in the moving setting. Trunk and elbow angles showed greater flexion in the moving ambulance, with changes observed across consecutive CPR cycles. Qualitative analysis revealed themes of physical fatigue, balance issues, safety concerns, and ergonomic limitations. Participants recommended simulation-based training, improved ambulance design, and mechanical CPR devices.</p><p><strong>Conclusion: </strong>CPR in a moving ambulance was associated with increased musculoskeletal discomfort and lower CPR quality metrics. Ergonomic modifications, provider training, and mechanical aids may help address these challenges. Further studies with larger and more diverse populations and real-world transport conditions are warranted.</p><p><strong>Trial registration: </strong>Prospectively registered in Clinical Trial Registry India (CTRI/2024/09/073482) on September 5th, 2024.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955798","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":"Artificial intelligence applications in out-of-hospital cardiac arrest: an analysis of emerging research trends.","authors":"Selina Fee, Ethan Nichols, Latha Ganti, Paul Banerjee","doi":"10.1186/s12245-026-01376-x","DOIUrl":"10.1186/s12245-026-01376-x","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge despite advances in emergency medical services (EMS) and resuscitation systems. Artificial intelligence (AI), including machine learning (ML), deep learning (DL), and artificial neural networks, is increasingly being investigated for applications spanning cardiac arrest recognition, rhythm analysis, prognostication, and clinical decision support. This study characterized the growth, geographic and institutional structure, collaboration patterns, influential sources, and emerging themes of the AI-OHCA literature.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science (WoS) Core Collection. The search identified 290 publications related to AI applications in OHCA, spanning 1996-2026. Publication and citation trends, countries, institutions, authors, journals, subject categories, and keyword co-occurrence were evaluated. VOSviewer was used to construct bibliometric networks, and Microsoft Excel was used for descriptive analyses and publication-trend visualization.</p><p><strong>Results: </strong>A total of 290 publications were identified. Research output increased sharply beginning in 2019 and reached 53 publications (18.3% of the corpus) in 2025; 21 publications were indexed in 2026 at the time of data collection, representing an incomplete year. The United States (85 publications) and Spain (39) were the leading contributing countries, and the University of the Basque Country was the most productive institution (31 publications; 10.69%). Resuscitation was the most frequent publication source (40 publications; 13.79%), followed by Circulation (23) and Resuscitation Plus (16). Emergency Medicine, Critical Care Medicine, and Cardiac & Cardiovascular Systems were the dominant WoS subject categories. Keyword mapping emphasized machine learning, survival, out-of-hospital cardiac arrest, cardiac arrest, and resuscitation, while author-level analyses demonstrated a concentrated, highly collaborative research network.</p><p><strong>Conclusions: </strong>Research at the intersection of AI and OHCA has expanded rapidly since 2019 but remains concentrated within a relatively small number of countries, institutions, and collaborative research groups. The literature is primarily clinically oriented, with particular emphasis on recognition, resuscitation, survival prediction, and post-arrest outcomes. Future work should prioritize prospective and external validation, real-world EMS implementation, and evaluation across diverse patient populations and EMS systems. CLINICAL TRIAL #: Not applicable, this study is not a clinical trial.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929916","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":"Assessment of cardiopulmonary resuscitation skills using a clinical simulation approach among emergency medical personnel of the Kerman Emergency and Incident Management Center.","authors":"Tayebeh Jalali, Mohammad Aminizade, Mohadeseh Motamed-Jahromi, Ali Asadi, Vahid Faramarzpur, Golamreza Khademipur","doi":"10.1186/s12245-026-01372-1","DOIUrl":"10.1186/s12245-026-01372-1","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hospital cardiac arrest (OHCA) remains a major public health and emergency medical challenge worldwide, with generally poor survival outcomes. The quality of cardiopulmonary resuscitation (CPR) provided by prehospital emergency personnel plays a critical role in improving outcomes. This study aimed to assess basic and advanced CPR skills among operational staff of the Kerman Emergency and Incident Management Center using a clinical simulation-based approach.</p><p><strong>Methods: </strong>This descriptive cross-sectional study was conducted among 267 operational personnel, including emergency medical technicians (EMTs), nurses, and Red Crescent personnel, recruited using a census sampling method. CPR performance was assessed through a standardized adult cardiac arrest simulation using a newly developed 40-item CPR skills checklist based on the 2025 American Heart Association recommendations. The checklist covered key domains of basic life support (BLS) and advanced cardiac life support (ACLS). Data were analyzed using descriptive statistics, one-way analysis of variance (ANOVA), and multiple linear regression.</p><p><strong>Results: </strong>The overall mean CPR skill score was 85.67 ± 19.11 out of 120. A significant difference was observed among professional groups (F = 9.89, P < 0.001), with EMTs having the highest mean score (90.00 ± 19.08) and Red Crescent personnel the lowest (79.20 ± 18.58). EMTs scored significantly higher than Red Crescent personnel, whereas the difference between EMTs and nurses was not significant. Significant group differences were observed in airway opening, bag-valve-mask ventilation, arrhythmia recognition, defibrillation, and Alert, Voice, Pain, Unresponsive (AVPU) assessment. In the adjusted regression model, Red Crescent personnel had significantly lower CPR skill scores than nurses, while work experience was positively associated with CPR skill scores.</p><p><strong>Conclusion: </strong>CPR skill levels differed among professional groups. EMTs demonstrated higher overall performance than Red Crescent personnel, particularly in airway opening and BVM ventilation, while nurses demonstrated higher performance in arrhythmia recognition and defibrillation. These findings support the need for regular competency-based training, simulation-based assessment, and targeted reinforcement of CPR skills among prehospital emergency personnel.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919217","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":"Presumed left atrial myxoma presenting with seizures, massive stroke, and systemic embolization in an adolescent: a case report.","authors":"Ali Akbari, Maziyar Amiri, Radin Saed, Arvin Mirshahi, Sayeh Shaban, Forod Salehi","doi":"10.1186/s12245-026-01369-w","DOIUrl":"10.1186/s12245-026-01369-w","url":null,"abstract":"<p><strong>Background: </strong>Cardiac myxoma (CM) is the most common primary cardiac tumor and, despite its benign histology, may lead to severe and life-threatening complications, primarily due to systemic embolization and intracardiac obstruction. Neurological events, particularly ischemic stroke, can be the initial manifestation and may obscure the underlying cardiac origin, especially in pediatric patients.</p><p><strong>Case presentation: </strong>We report the case of a 14-year-old Persian male who presented with progressive dyspnea on exertion followed by syncope, recurrent generalized tonic-clonic seizures, and rapid neurological deterioration. Initial evaluation at a local center was unrevealing on chest radiography. Following the onset of recurrent generalized tonic-clonic seizures, the patient was initially treated as having a primary seizure disorder before the underlying ischemic stroke and cardiac source of embolism were recognized. He was subsequently admitted to a tertiary pediatric intensive care unit in a critically ill state requiring ventilatory support. Brain computed tomography demonstrated a large right hemispheric infarction with cerebral edema and midline shift. Laboratory findings revealed elevated inflammatory and myocardial injury markers. Electrocardiography showed nonspecific ST-segment changes that were insufficient to establish a diagnosis of acute myocardial infarction. Transthoracic echocardiography identified a large, highly mobile left atrial mass measuring 22 × 55 mm, arising from the interatrial septum and highly suggestive of a left atrial myxoma. The mass intermittently prolapsed into the mitral valve, causing partial obstruction. Severe mitral and tricuspid regurgitation were also present. Doppler ultrasonography confirmed femoral and popliteal arterial thrombosis, indicating systemic embolization. Despite anticoagulation and intensive supportive care, the patient experienced sudden cardiac arrest and died before surgical excision and histopathological confirmation of the mass could be obtained.</p><p><strong>Conclusion: </strong>A cardiac source of embolism, including a left atrial mass highly suggestive of myxoma, should be considered in pediatric patients presenting with acute neurological deficits, particularly when accompanied by systemic embolic phenomena or unexplained cardiopulmonary symptoms. Early echocardiographic evaluation is critical for timely recognition and appropriate clinical decision-making. In the absence of surgical excision and histopathological confirmation, the diagnosis should remain presumptive. Delayed recognition may result in catastrophic neurological and systemic complications and may preclude definitive diagnosis and surgical management.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919228","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":"Virtual reality versus companion-delivered therapeutic touch for reducing pain and anxiety during suturing: a randomized controlled trial.","authors":"Tooba Khajehhasani-Rabori, Saiedeh Haji-Maghsoudi, Roghayeh Mehdipour-Rabori","doi":"10.1186/s12245-026-01360-5","DOIUrl":"10.1186/s12245-026-01360-5","url":null,"abstract":"<p><strong>Background: </strong>Wound suturing is a common procedure in emergency departments and can cause considerable pain and anxiety. Non-pharmacological approaches, such as virtual reality (VR) and therapeutic touch, may help improve patients' comfort during the procedure.</p><p><strong>Objective: </strong>This randomized controlled trial compared the effects of VR and companion-delivered therapeutic touch on pain and anxiety during emergency suturing.</p><p><strong>Methods: </strong>The trial was conducted in the emergency department of Shahid Bahonar Hospital in Kerman, Iran, between 2025 and 2026. In total, 87 patients were allocated to three groups: VR (n = 30), therapeutic touch (n = 27), and standard care (n = 30). Pain was assessed using the Visual Analog Scale (VAS), and state anxiety was measured using the State-Trait Anxiety Inventory-State scale (STAI-State) immediately before and after suturing. The data were analyzed using statistical methods that adjusted for baseline differences between the groups.</p><p><strong>Results: </strong>The groups differed significantly in age and baseline anxiety. After adjustment for baseline values and age, both the VR and therapeutic touch groups had significantly lower post-procedure pain scores than the standard-care group (P < 0.001), whereas the difference between the VR and therapeutic touch groups was not statistically significant. For state anxiety, both intervention groups had significantly lower adjusted post-procedure scores than the standard-care group, and the VR group had significantly lower anxiety scores than the therapeutic touch group (P < 0.001).</p><p><strong>Conclusion: </strong>Both VR and therapeutic touch were associated with lower pain and anxiety during emergency suturing than standard care. VR appeared to provide an additional advantage over therapeutic touch for reducing anxiety, but not pain. These non-pharmacological interventions may offer practical options for improving patients' comfort during stressful emergency procedures.</p><p><strong>Clinical trail: </strong>The trial was prospectively registered with the Iranian Registry of Clinical Trials (IRCT20260627069963N1) on July 3, 2026.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929939","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}