International Journal of Emergency Medicine最新文献

{"title":"Workplace violence as a predictor of missed nursing care in emergency departments: Findings from an analytical cross-sectional study.","authors":"Hamed Gholizad Gougjehyaran, Hossein Ebrahimi, Hadi Hasankhani, Reza Nematollahi Maleki","doi":"10.1186/s12245-026-01354-3","DOIUrl":"10.1186/s12245-026-01354-3","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence is a common and significant issue in healthcare settings, particularly against emergency nurses, which compromises the quality of nursing care and can lead to the omission or delay of patient care tasks in the emergency department. Therefore, this study was conducted to examine the relationship between workplace violence and missed nursing care among emergency department nurses.</p><p><strong>Methods: </strong>A cross-sectional correlational study was conducted with 221 nurses from emergency departments of Tabriz University of Medical Sciences, selected via stratified random sampling. Data were collected using a three-part questionnaire comprising demographic information, the MISSCARE questionnaire (Part A), and the Workplace Violence in the Health Sector questionnaire. Descriptive statistics, Pearson's correlation, and multiple regression were used to analyze the data.</p><p><strong>Results: </strong>Among 221 emergency nurses, 76.0% experienced verbal violence, 32.1% experienced physical violence, and 24.9% reported threatening behaviors during the previous six months. The most frequently missed nursing care activities were patient and family education (67.9%), monitoring patients' emotional status (57.0%), and assisting with patient mobility (52.9%). Pearson correlation analysis demonstrated significant positive associations between verbal violence (r = 0.52, p < 0.001), physical violence (r = 0.38, p < 0.001), and total workplace violence (r = 0.61, p < 0.001) and missed nursing care. In the multivariable regression model, total workplace violence (B = 0.536, standardized β = 0.580, p < 0.001), work experience (B = 0.284, standardized β = 0.197, p = 0.031), and working time (B = 0.327, standardized β = 0.229, p = 0.004) were significant positive predictors of missed nursing care. The model explained 48% of the variance in missed nursing care (R² = 0.48).</p><p><strong>Conclusions: </strong>WPV is significantly associated with increased missed nursing care in emergency departments, with verbal and physical violence contributing to higher care omissions. Interventions to reduce WPV, such as violence prevention protocols and support systems, are essential to improve nursing care quality and patient safety.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879993","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":"Epiploic-mesenteric knotting as a rare cause of small-bowel obstruction.","authors":"Imen Ben Ismail, Hakim Zenaidi, Marwen Sghaier, Saber Rebii, Ayoub Zoghlami","doi":"10.1186/s12245-026-01345-4","DOIUrl":"10.1186/s12245-026-01345-4","url":null,"abstract":"<p><strong>Background: </strong>Epiploic-mesenteric knotting is an exceptionally rare cause of acute small-bowel obstruction. The condition results from entanglement between the greater omentum and the small-bowel mesentery, creating a true knot that may rapidly progress to strangulation and bowel necrosis if unrecognized.</p><p><strong>Case presentation: </strong>A 56-year-old woman with no previous abdominal surgery presented with a 48-hour history of diffuse abdominal pain, distension, bilious vomiting, and cessation of stool and flatus. Examination revealed abdominal distension with diffuse tenderness and hyperactive bowel sounds. Laboratory tests were unremarkable except for a mild elevation of C-reactive protein. Contrast-enhanced computed tomography demonstrated dilated small-bowel loops with a transition point in the mid-jejunum and a whirl sign of the mesenteric vessels, consistent with a closed-loop obstruction but without an identifiable mechanical cause. Exploratory laparotomy disclosed a tight knot between the greater omentum and the jejunal mesentery, forming an epiploic-mesenteric knot. After gentle detorsion, the bowel regained normal color and peristalsis, and no resection was required. The postoperative course was uneventful, and the patient was discharged on postoperative day 5.</p><p><strong>Conclusions: </strong>Epiploic-mesenteric knotting should be considered in patients with small-bowel obstruction of unclear origin, particularly when imaging shows a closed-loop pattern or a whirl sign without an obvious cause. Because ischemia develops rapidly, early surgical exploration remains both diagnostic and lifesaving. Prompt recognition and detorsion can prevent bowel resection and ensure an excellent outcome.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812743","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":"Saudi expert consensus on the management of acute asthma and COPD exacerbations with algorithm of aerosol drug delivery device recommendations.","authors":"Zohair Al Aseri, Mohammed Zeitouni, Majdy Idrees, Imad Khojah, Waleed Al Sowayan, Badr Aldawood, Khaled Alawam, Thiagarajan Jaiganesh","doi":"10.1186/s12245-026-01350-7","DOIUrl":"https://doi.org/10.1186/s12245-026-01350-7","url":null,"abstract":"<p><strong>Objective: </strong>To develop a practical, expert consensus for the management of acute asthma and chronic obstructive pulmonary disease (COPD) exacerbations in Saudi Arabia's Emergency Departments (EDs), addressing gaps in triage, diagnostic certainty, and aerosol delivery.</p><p><strong>Methods: </strong>A modified expert consensus process with Delphi elements was employed. Eight multidisciplinary experts in pulmonary medicine, emergency medicine, and respiratory therapy, three of whom were affiliated with the Saudi Society of Emergency Medicine (SASEM), two of whom are authors of the Saudi initiative for Asthma (SINA) Guidelines, and three of whom are authors of the Saudi COPD guidelines, reviewed evidence-based presentations and formulated structured discussion questions before the meeting. The advisory board session (Riyadh, November 19, 2025) served as the formal consensus round, addressing ten predefined clinical questions across two moderated debate sessions, with formal voting on two key device-selection statements.</p><p><strong>Results: </strong>The panel adopted a dual-phase severity classification: a binary \"Non-Severe vs. Severe\" model for rapid ED triage, followed by the four-tier SINA classification for clinical management. Pharmacological algorithms were standardized, prioritizing early corticosteroid therapy and optimizing bronchodilator dosing to mitigate toxicity. The panel reached a unanimous consensus that aerosol delivery device selection significantly influences treatment success; A-VMN was recommended at escalating strengths across severity levels (Class IIb-I) and as a preferred option for severe and ventilated patients, based on superior lung deposition, infection control advantages, and improved discharge rates.</p><p><strong>Conclusion: </strong>This modified expert consensus aims to provide an up-to-date, organized, and action-oriented protocol for Saudi EDs. It advocates a stratified triage system and evidence-based selection of aerosol-delivery devices to improve patient outcomes, enhance safety, and optimize resource utilization.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792706","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":"Farmers, Forestry and First Aid (F3A) and farmers' preparation for traumatic injury in the field.","authors":"Fergus J M Wilkie, Isobel Scott, Imogen Allen, Sarah Batting, William Passmore","doi":"10.1186/s12245-026-01243-9","DOIUrl":"10.1186/s12245-026-01243-9","url":null,"abstract":"<p><strong>Background: </strong>Agriculture is a high-risk industry in the United Kingdom, with disproportionate rates of fatal and serious traumatic injury. Farm workers face hazards from machinery, livestock, chemicals, and transport incidents, often in remote settings where emergency care is delayed. Existing first aid training is usually generic and does not reflect the specific risks of agriculture.</p><p><strong>Objective: </strong>To describe the development of Farmers, Forestry and First Aid (F3A), a trauma-focused first aid training programme for agricultural workers, and to evaluate participant reactions to the course.</p><p><strong>Methods: </strong>F3A was developed by clinicians and farming professionals using experiential learning principles and scenario-based training. The course covers basic life support, cardiopulmonary resuscitation, automated external defibrillator use, and immediate management of severe trauma. Anonymous post-course feedback was collected from participants across 32 courses using a training evaluation form with Likert-scale and free-text responses.</p><p><strong>Results: </strong>Feedback was received from 344 participants. Overall satisfaction was very high, with median scores at the top of the scale for all Likert items and 97% of respondents recommending the course. Free-text comments indicated that participants found the course practical, relevant to farm work, and effective in increasing confidence in responding to traumatic emergencies.</p><p><strong>Conclusions: </strong>F3A aims to address an important gap in rural trauma preparedness by providing agricultural workers with context-specific first aid training. Participant reactions were strongly positive, supporting wider delivery of the course and further longitudinal evaluation to assess skill retention and real-world impact.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792727","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":"Prehospital factors associated with return of spontaneous circulation after nonshockable out-of-hospital cardiac arrest: a retrospective analysis of the Polk County Fire Rescue CARES registry.","authors":"Hammad Elahi, Latha Ganti, Paul R Banerjee","doi":"10.1186/s12245-026-01347-2","DOIUrl":"https://doi.org/10.1186/s12245-026-01347-2","url":null,"abstract":"<p><strong>Background: </strong>Non-shockable out-of-hospital cardiac arrest (OHCA), including pulseless electrical activity (PEA) and asystole, is associated with poor outcomes. Identifying prehospital factors associated with return of spontaneous circulation (ROSC) may inform emergency medical services (EMS) quality-improvement priorities.</p><p><strong>Methods: </strong>We performed a retrospective analysis of a Polk County Fire Rescue Cardiac Arrest Registry to Enhance Survival (CARES) export. Patients whose first monitored rhythm was PEA or asystole were included. Outcomes were any documented ROSC and sustained ROSC through the end of EMS care. Unadjusted comparisons were followed by complete-case multivariable logistic regression evaluating age, sex, witnessed status, initial rhythm, epinephrine administration, time to first CPR, field hypothermia care, and AED application before EMS arrival.</p><p><strong>Results: </strong>Among 1,198 included patients, median age was 66 years (interquartile range [IQR], 53-78), 59.8% were male, 20.9% had PEA, and 79.1% had asystole. Any ROSC occurred in 166 patients (13.9%), and 146 (12.2%) had sustained ROSC. In complete-case models (n=893), witnessed arrest, PEA rather than asystole, field hypothermia care, and female sex were associated with both outcomes. For any ROSC, adjusted odds ratios (aORs) were 2.65 (95% CI, 1.80-3.90) for witnessed arrest, 1.90 (95% CI, 1.29-2.79) for PEA, 1.99 (95% CI, 1.37-2.90) for field hypothermia care, and 0.60 (95% CI, 0.42-0.86) for male sex. Shorter time to first CPR was additionally associated with sustained ROSC (aOR per minute, 0.989; 95% CI, 0.979-0.999). AED use was not associated with either outcome. Epinephrine was not associated with any ROSC after adjustment and was inversely associated with sustained ROSC.</p><p><strong>Conclusions: </strong>Witnessed arrest and PEA were the most consistent positive correlates of ROSC in this county registry. Earlier CPR was associated with sustained ROSC. Associations involving epinephrine and field hypothermia care should not be interpreted as treatment effects because of likely time-dependent confounding and selection bias.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792666","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":"Epidemiology and outcomes of trauma patients transported by helicopter emergency medical services: a descriptive-analytical study.","authors":"Mohamad Reza Rezaei, Bareza Rezaei, Mahsa Pornoor","doi":"10.1186/s12245-026-01343-6","DOIUrl":"https://doi.org/10.1186/s12245-026-01343-6","url":null,"abstract":"<p><strong>Objective: </strong>he present study was designed and carried out to investigate the epidemiology and estimate the consequences of trauma in trauma victims transported by helicopter emergency medical services (HEMS).</p><p><strong>Methods: </strong>The present study was a descriptive-analytical, cross-sectional census study conducted on all trauma patients (n = 25) transported by helicopter to the emergency department of Ayatollah Taleghani Hospital in Kermanshah province in 2022. Data on demographics, trauma mechanism, injury anatomical site, and outcomes were extracted from the hospital's trauma registry. Trauma severity was evaluated using the Injury Severity Score (ISS) and Revised Trauma Score (RTS). Categorical associations were analyzed using Chi-square and Fisher's exact tests in SPSS version 26, with significance set at P < 0.05.</p><p><strong>Results: </strong>A total of 25 trauma patients were examined (75% male, 25% female; 8% with underlying medical conditions). The mean (± SD) scene-to-hospital transfer time was 75.25 ± 22.52 min, and the mean length of stay was 15.5 ± 2.41 days. The most common trauma mechanisms were road traffic accidents (50%) and falls > 3 m (25%). Severe/very severe trauma was present in 25% of patients, and multiple injuries (polytrauma) accounted for 25% of transfers. The overall mortality rate was 8% (n = 2). Statistically significant associations were identified between female gender and higher trauma severity (P < 0.05), female gender and head/polytrauma anatomical sites (P < 0.05), and severe/very severe trauma and overall mortality (P < 0.05). No significant association was found between transfer time or dispatch type and outcome (P > 0.05).</p><p><strong>Conclusion: </strong>In this single-center observational study, the majority of HEMS-transported trauma patients were male, with road traffic accidents and falls (> 3 m) being the predominant mechanisms, and polytrauma the main presentation for air transfer. Due to the small sample size and descriptive nature of these findings, large-scale, multicenter prospective cohort studies are needed to evaluate the true impact of HEMS on clinical outcomes and to inform national pre-hospital protocol optimization.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792648","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":"Early adjunctive local block therapy improves pain and limb swelling after Gloydius envenomation: a propensity score-adjusted retrospective cohort study in the emergency department.","authors":"Liang Shan, Jian-Bo Zhang, Li Yan, Jun Yu, Li-Li Cheng, Hong-Sheng Liu","doi":"10.1186/s12245-026-01299-7","DOIUrl":"https://doi.org/10.1186/s12245-026-01299-7","url":null,"abstract":"<p><strong>Background: </strong>Snakebite envenomation remains a major neglected tropical disease worldwide and frequently results in substantial local tissue injury despite timely antivenom therapy. Effective adjunctive strategies for early local symptom control are still limited. We aimed to evaluate whether early local block therapy (LBT) is associated with improved pain and limb swelling outcomes in patients with Gloydius envenomation.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study including 203 adult patients with confirmed Gloydius envenomation between 2019 and 2024. Patients were categorized according to receipt of LBT (perilesional lidocaine, dexamethasone, and α-chymotrypsin) in addition to standard care. Primary outcomes were reduction in limb swelling (change in limb circumference from admission to Day 3) and pain relief (change in VAS score within 48 h). Secondary outcome was length of hospital stay (LOS). Multivariable linear regression and propensity score-based analyses were performed to adjust for potential confounders, including baseline wound infection.</p><p><strong>Results: </strong>Baseline wound infection was more frequent in the LBT group than in controls (41.3% vs. 25.2%, P = 0.015). After full adjustment, LBT remained independently associated with greater limb swelling reduction (adjusted β = 2.31 cm; 95% CI 2.08-2.54; P < 0.001) and greater pain relief (adjusted β = 2.13 points; 95% CI 1.83-2.43; P < 0.001). Findings were consistent across propensity score-matched and weighted analyses. LBT was not associated with prolonged hospitalization (adjusted β = -0.98 days; P = 0.066).</p><p><strong>Conclusions: </strong>In this real-world cohort, early adjunctive LBT was associated with clinically meaningful improvement in local symptoms without evidence of increased hospital stay. These findings support LBT as a potential adjunctive strategy for hemotoxic snakebite and warrant prospective validation in multicenter prospective studies.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792696","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":"Obstructive shock from delayed blunt cardiac injury after chest trauma.","authors":"Olivia Sosnoski, Jeffery Cloyd, Blake Briggs","doi":"10.1186/s12245-026-01326-7","DOIUrl":"https://doi.org/10.1186/s12245-026-01326-7","url":null,"abstract":"<p><strong>Background: </strong>Blunt cardiac injury (BCI) is a rare but serious presentation in emergency departments (EDs) nationwide. These injuries arise in trauma and may be accompanied by confounding injuries that complicate the clinical picture. Timely recognition is crucial, as BCI may lead to complications such as pericarditis or life-threatening cardiac tamponade. Notably, there are no current guidelines on approaches in evaluating BCI.¹ CASE PRESENTATION: We describe a patient who presents one week after a motor vehicle accident (MVA) with delayed BCI manifesting as pericarditis. After an extensive literature search, we found only one similar case-highlighting limitations in the current discussion. Importantly, our case is unique because the patient was initially unable to provide a medical history, and point of care ultrasound (POCUS) was pivotal in the initial evaluation.</p><p><strong>Conclusions: </strong>BCI remains challenging due to variable presentation and potential for delayed symptoms, as seen in this case. This case underscores the importance of maintaining a high index of suspicion for BCI, particularly in patients with chest trauma who delay seeking care or present with limited history. Further, early intervention is critical in preventing life-threatening sequelae. Utilizing a combination of physical examination, imaging, and laboratory findings can guide clinicians in accurate diagnosis of BCI. Our report contributes to a limited body of literature by documenting a delayed pericardial complication one week post-MVA, highlighting the need for broader awareness and more structured diagnostic pathways for BCI.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764614","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":"Structured correction after difficult direct laryngoscopy during prehospital rapid sequence intubation: an eleven-year physician-staffed helicopter emergency medical service registry study.","authors":"Akos Soti, Peter Temesvari, Laszlo Hetzman, Robert Gebei, Bank G Fenyves, Csaba Varga","doi":"10.1186/s12245-026-01342-7","DOIUrl":"10.1186/s12245-026-01342-7","url":null,"abstract":"<p><strong>Background: </strong>Difficult laryngoscopy during prehospital rapid sequence intubation may lead to procedural failure and serious adverse outcomes. Evidence is limited regarding whether a structured correction bundle can convert an initial poor view into successful intubation before declaring failure. We evaluated the outcomes of a structured correction protocol used after a poor initial laryngoscopy view during physician-staffed helicopter emergency medical service rapid sequence intubation.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using prospectively collected data from the Hungarian Air Ambulance airway registry. Patients older than 14 years with maintained circulation who underwent a tracheal intubation attempt between 2012 and 2022 were included. The primary endpoint was the proportion of successful tracheal intubations after at least one corrective maneuver among cases requiring corrective maneuvers. Secondary endpoints included the success rates of individual maneuvers and associations between corrective maneuvers and prespecified covariates.</p><p><strong>Results: </strong>Among 2,431 included patients, 1,827 (75.2%) intubations were successfully performed without the need for any corrective maneuvers. The primary endpoint, frequency of successful intubations after at least one corrective maneuver, was achieved in 578 out of 604 cases (95.7%; 95% CI 98.4-99.3). First-pass success in the full cohort was 92.8% (2,255/2,431; 95% CI 91.7-93.8), and overall intubation success was 98.9% (2,405/2,431; 95% CI 98.4-99.3). In 63.7% (385 of 604) of the correction cases, only one maneuver was required. The most common single maneuvers were suction and backward-upward-rightward pressure, each associated with 100% success. The combination of multiple correction elements was also associated with a high success rate. Male sex, cricoid pressure, head-elevated laryngoscopy position, and non-anesthesiology operator specialty were all associated with a higher risk of requiring corrective maneuvers.</p><p><strong>Conclusion: </strong>In this standardized prehospital rapid sequence intubation system, a structured correction protocol after an initially poor direct laryngoscopy view was associated with high rates of subsequent intubation success.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722121","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":"Key components for responding to burn mass casualty incidents: a comprehensive systematic literature review.","authors":"Mohammad Mahdi Doust Mohammadi, Saeed Fallah, Mohammad Reza Khajehaminian, Hojjat Farahmandnia","doi":"10.1186/s12245-026-01338-3","DOIUrl":"10.1186/s12245-026-01338-3","url":null,"abstract":"<p><strong>Background: </strong>Effective management of burn mass casualty incidents (BMCIs) requires coordinated systems that include early stabilization, definitive burn care, surge capacity, and rehabilitation, supported by adequate infrastructure and workforce capacity. Although different countries have national guidelines, the full synthesis of the components of the health system needed by BMCIs response remains limited. This study aimed to systematically identify and classify the key components of the response to BMCIs.</p><p><strong>Method: </strong>A systematic literature review was conducted to identify and synthesize the key components required for effective response to BMCIs. A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42024625737). This research was conducted through a systematic review and searches of the databases PubMed, Scopus, Web of Science, and Google Scholar. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for systematic search, and a Mixed Methods Appraisal Tool (MMAT) was used for quality assessment of final extracted articles.</p><p><strong>Results: </strong>From an initial set of 7,975 articles, 27 studies were included for analysis. The key components for responding to BMCIs were analyzed in 5 categories and 36 subcategories. The primary themes and related main categories included: (1) Preparedness and Prevention; (2) Command, Control, Coordination, and Communication; (3) Prehospital and Transport Management; (4) Hospital and Surge Capacity Management; and (5) Clinical and Supportive Care.</p><p><strong>Conclusion: </strong>This review provides a comprehensive, evidence-informed framework outlining essential health system components for effective BMCIs response. The identified domains may guide the development of national and regional response models, strengthen disaster preparedness, and enhance health system resilience to BMCIs scenarios.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711872","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}