International Journal of Emergency Medicine最新文献

{"title":"Impact of telemedicine on mortality, hospital admissions, and length of stay in pediatric emergencies: a systematic review and meta-analysis.","authors":"Amani N Alansari, Mohamed Sayed Zaazouee, Marwa Messaoud, Salma Mani, Alaa Ahmed Elshanbary, Hanan Youssif Mohamed","doi":"10.1186/s12245-025-00968-3","DOIUrl":"10.1186/s12245-025-00968-3","url":null,"abstract":"<p><strong>Background: </strong>Pediatric emergencies pose significant challenges in healthcare. Telemedicine offers a promising solution by enabling remote assessments, improving specialist access, reducing unnecessary ER visits and admissions, optimizing resources, and enhancing patient satisfaction. This systematic review and meta-analysis uniquely aimed to quantify the effect of telemedicine on key outcomes in pediatric emergency and post-emergency care.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, the Cochrane Library, and Web of Science to identify studies focusing on the impact of telemedicine in pediatric emergency settings. Both single- and double-arm studies were included. Statistical analysis was performed using RevMan and CMA software, with a random-effects model applied to all analyses. We assessed differences in admissions, hospital length of stay (LOS), and mortality. Event rates were calculated for single-arm analyses, and risk ratios and mean differences were used for dichotomous and continuous outcomes in double-arm analyses.</p><p><strong>Results: </strong>A total of 23 studies were included. Telemedicine significantly reduced hospital LOS (MD = -1.01, 95% CI: -1.3 to -0.71) and overall mortality (RR = 0.17, 95% CI: 0.13 to 0.24). The admission rates to the emergency department, hospital ward, and pediatric intensive care unit (PICU) were comparable between both groups. Single-arm analysis revealed that telemedicine was associated with an ED admission rate of 18% (95% CI: 5.2-47%), a hospital ward admission rate of 16.7% (95% CI: 4.6-45.7%), and a pooled mortality rate of 1.8% (95% CI: 1-3.3%).</p><p><strong>Conclusions: </strong>Telemedicine appears to be an effective tool in pediatric emergency care. While our analysis suggests reductions in hospital length of stay and mortality, these findings should be interpreted with caution due to variability and potential confounding across studies. The impact on admission rates remains inconclusive. Nonetheless, telemedicine offers a promising approach to enhancing healthcare delivery and optimizing resource use in pediatric emergency and early post-emergency settings.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"160"},"PeriodicalIF":2.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953219","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":"Splenic infarction in a 12-year-old female leading to the diagnosis of systemic lupus erythematosus.","authors":"Melanie M Randall, Salomon H Alvarado, Andrew Gurewitz, Brian G Chen, Joel A Labha, Fairuz Despujos Harfouche","doi":"10.1186/s12245-025-00964-7","DOIUrl":"10.1186/s12245-025-00964-7","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus is an autoimmune inflammatory disease with extremely variable presentations. While a facial rash is the most common finding, other symptoms can include arthralgias, fatigue, and cytopenias. Abdominal symptoms are much less common presentations of lupus. Antiphospholipid syndrome is a related autoimmune disorder causing vascular thrombosis. Children with lupus frequently have antiphospholipid antibodies. We present a rare case of a 12-year-old female with a splenic infarction leading to a new diagnosis of lupus with associated antiphospholipid syndrome.</p><p><strong>Case presentation: </strong>A previously healthy 12-year-old female presented with prolonged and recurrent fever, nausea, body aches and left sided abdominal pain. Her evaluation revealed anemia, thrombocytopenia, and proteinuria. A computed tomography of the abdomen showed a splenic infarction. While admitted to the hospital, she underwent extensive oncologic and rheumatologic testing. This evaluation resulted in a diagnosis of systemic lupus erythematosus. The patient's hospital course was complicated by acute respiratory failure and myocarditis requiring intensive care unit transfer and care. Her symptoms and cytopenias gradually improved on oral steroids, hydroxychloroquine, and cyclophosphamide infusions.</p><p><strong>Conclusions: </strong>Splenic infarction is less a distinct entity, but rather a symptom of an underlying disorder. Common etiologies include hypercoagulable states, infection, and oncologic and rheumatologic diseases. Patients with splenic infarctions are more likely to have longer hospital stays and higher mortality. This case is a reminder that a practitioner should consider hospitalization and further evaluation when splenic infarction is diagnosed, as this can be a signal of serious systemic disease.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"157"},"PeriodicalIF":2.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953240","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":"Comparative analysis of emergency medical systems in the UK and Japan: recommendations for Japan based on on-site observations in the UK.","authors":"Kazuhiko Omori, Paul Vulliamy, Chris Aylwin, Hiroki Nagasawa, Shigenori Kan, Jiro Takahashi, Noriaki Yamada, Ross Davenport","doi":"10.1186/s12245-025-00956-7","DOIUrl":"10.1186/s12245-025-00956-7","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"155"},"PeriodicalIF":2.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953246","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 periscope-based, 3D printed indirect laryngoscope for resource limited settings: a non-randomized observational manikin trial.","authors":"Phillip R Schmitt, Samantha Maguire, Eliza Sternlicht, Austin M Quinn, Whit Fisher, Andrew Beck","doi":"10.1186/s12245-025-00962-9","DOIUrl":"10.1186/s12245-025-00962-9","url":null,"abstract":"<p><strong>Background: </strong>In the United States and other resource-rich settings, video laryngoscopy is often favored for emergency intubation over direct laryngoscopy due to ease of use and improved performance in difficult airways. Video laryngoscopes pose a significant cost barrier against adoption in low- and middle-income countries (LMICs). In this study, we designed and tested a low-cost, 3D printable, periscope-based laryngoscope that achieves an indirect view of the vocal cords without the use of a video camera. The absence of expensive video components allows this device to be manufactured for $4.41 USD, making it well-suited for resource-limited settings.</p><p><strong>Methods: </strong>The periscope-based laryngoscope was manufactured from polylactic acid (PLA) filament using a 3D printer. Manikin testing of the laryngoscope was performed by providers ranging from medical students to experienced physicians using the high fidelity Laerdal SimMan^®. The novel laryngoscope was compared to commonly available direct and video laryngoscopes, and intubation times and first-pass success rates were recorded.</p><p><strong>Results: </strong>A total of 121 trials were performed. In experienced intubators, faster intubation times were seen in the direct and periscope-based laryngoscopes compared to video laryngoscopes. Mean intubation times for experienced intubators were as follows: Direct Laryngoscope = 17.45 s, Video Laryngoscope = 23.34 s, and Novel Periscope-based Laryngoscope = 11.31 s, with statistical significance (p < 0.001) found between the Video and Periscope-based laryngoscope times. 100% of trials resulted in successful intubation of the trachea.</p><p><strong>Conclusion: </strong>The periscope-based laryngoscope yielded intubation times and first-pass success rates that compare favorably to direct and video laryngoscopes, and it can be readily manufactured in multiple environments at a low price point without proprietary industrial technology. Next steps include human clinical trials and regulatory approvals prior to clinical adoption of the novel device.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"156"},"PeriodicalIF":2.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953190","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 association between the severity of out-of-hospital cardiac arrest and the effectiveness of target temperature management: a retrospective study based on prediction models.","authors":"Zhenyu Shan, Rui Shao, Xingsheng Wang, Guyu Zhang, Luying Zhang, Chenchen Hang, Le An, Jingfei Yu, Ziren Tang","doi":"10.1186/s12245-025-00947-8","DOIUrl":"10.1186/s12245-025-00947-8","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to develop prediction models and conduct risk stratifications for patients with out-of-hospital cardiac arrest (OHCA) to identify patients who could benefit from targeted temperature management (TTM) at 33°C.</p><p><strong>Methods: </strong>A retrospective analysis was carried out on 368 patients and the primary outcome was the neurological outcome at discharge evaluated by the Cerebral Performance Categories (CPC) scale. Six variables were utilized to construct prediction models via six methodologies, and the Chi-square test or Fisher's exact test was used to analyze the efficacy of TTM at 33℃ under diverse risk stratifications.</p><p><strong>Results: </strong>A total of 264 eligible patients were divided into the development cohort and test set. The identified predictors comprised bystander cardiopulmonary resuscitation (CPR), pupillary light reflex, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, lactate, serum calcium (Ca²⁺), and base excess (BE). The AUC of different prediction models in the test set ranged from 0.7592 to 0.9304. Patients with a predicted probability of 80-100%, 75-100%, and 67-100% in the Random Forest model, and 40-60% in the K-Nearest Neighbors model, can benefit from 33℃ TTM (OR [95% CI]: 3.21[1.44-7.19], 2.73[1.25-5.97], 2.18[1.09-4.36], 6.42[1.09-37.73], respectively). Among patients who had successfully undergone TTM at 33 °C, there was a higher prevalence of patients classified as CPC 3 and CPC 4 and a lower incidence of those classified as CPC 5 (OR [95% CI]: 3.90[1.12-12.58], 2.29[1.24-4.26], 0.31[0.19-0.51], respectively).</p><p><strong>Conclusion: </strong>Prediction models developed from early variables can predict the neurological prognosis of OHCA, and the efficacy of 33℃ TTM may be related to severity.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"154"},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882838","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":"Experience of carbon monoxide poisoning treated with hyperbaric oxygen therapy and steroid pulse therapy: a case report.","authors":"Soichiro Kano, Takahito Miyake, Hirotaka Asano, Yugo Wakayama, Erika Takada, Yoshinori Kakino, Kodai Suzuki, Tetsuya Fukuta, Shozo Yoshida, Hideshi Okada","doi":"10.1186/s12245-025-00966-5","DOIUrl":"10.1186/s12245-025-00966-5","url":null,"abstract":"<p><strong>Background: </strong>Delayed neurological sequelae (DNS) caused by carbon monoxide (CO) poisoning remain a significant problem.</p><p><strong>Case presentation: </strong>A 50-year-old man was admitted to his base hospital with an impaired consciousness level (day X). His Glasgow Coma Scale score was 3, and the fraction of carboxyhaemoglobin on arterial blood gas analysis was 51.2%. He was referred to our hospital for treatment with a diagnosis of CO poisoning. He was admitted to the intensive care unit, where he received hyperbaric oxygen therapy (HBOT) and steroid pulse therapy (SPT). On day X + 3, his level of consciousness noticeably improved. The patient was discharged on day X + 14. Outpatient follow-up was conducted, and the patient had no complications, including DNS, until day X + 49.</p><p><strong>Conclusion: </strong>This case suggests that the combination of SPT and HBOT may not only improve acute neurological recovery but also help prevent the development of DNS after CO poisoning.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"153"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873085","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":"Euglycemic diabetic ketoacidosis associated with a sodium-glucose co transporter 2 inhibitor use in a trauma patient: a case report.","authors":"Ophélie Dirand, Julie Dupont, Emmanuel Weiss, Myriam Lamamri","doi":"10.1186/s12245-025-00963-8","DOIUrl":"10.1186/s12245-025-00963-8","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose co-transporter 2 inhibitors (SGLT2i), like empagliflozin, are widely prescribed for managing type 2 diabetes mellitus. However, they carry a rare but serious risk: euglycemic diabetic ketoacidosis (EDKA). EDKA's atypical presentation, characterized by metabolic acidosis and ketosis despite normal blood glucose levels, often delays diagnosis, posing significant challenges in intensive care.</p><p><strong>Case presentation: </strong>We report the case of a 74-year-old female with type 2 diabetes on empagliflozin, gliclazide, and metformin. Admitted after severe trauma from a road traffic accident, she subsequently developed EDKA. This was fostered by septic shock due to methicillin-susceptible Staphylococcus aureus cellulitis. All home medications were discontinued. EDKA was successfully managed with fluid volume expansion, continuous intravenous insulin and dextrose infusions, resolving her metabolic derangements within five days.</p><p><strong>Conclusion: </strong>SGLT2i use is associated with a significantly increased risk of EDKA. Early diagnosis is critical due to its potential lethal consequences. Reintroducing SGLT2i in ICU patients, especially trauma patients at high sepsis risk, requires careful, daily reassessment given their unpredictable clinical course.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"152"},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835016","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 complex case of acute abdomen.","authors":"Mohammed Khalid Alageel","doi":"10.1186/s12245-025-00954-9","DOIUrl":"10.1186/s12245-025-00954-9","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"150"},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821392","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":"Climate change and the global food chain: a catalyst for emerging infectious diseases?","authors":"Courage Chandipwisa, Olivier Uwishema, Adisalem Debebe, Malaz M Abdalmotalib, Reem Barakat, Abdu Oumer, Mosopefoluwa John, Luboom Taa, Helen Onyeaka","doi":"10.1186/s12245-025-00901-8","DOIUrl":"10.1186/s12245-025-00901-8","url":null,"abstract":"<p><strong>Background: </strong>Climate change is disrupting the global food chain, affecting food production, delivery and safety. Extreme weather events disrupt the quality of food and water, while rising temperatures accelerate the spread of microbes. Habitat destruction also forces wildlife in close proximity to people, increasing the risk of zoonotic diseases. Threatening global health seriously, these disturbances also increase the probability of infectious and food-borne diseases.</p><p><strong>Method: </strong>A narrative review of literature data from WHO publications, Google Scholar and PubMed. The review examines the impacts of climate change on agriculture, food supply systems, and the associated transmission of infectious disease - specifically zoonotic and food-borne diseases.</p><p><strong>Results: </strong>As temperatures increase, the germs multiply easily - and the risk of E. coli and Salmonella goes up. Waterborne diseases such as Norovirus and Hepatitis A are more likely to spread in typified extreme weather conditions such as floods. Ecosystem changes push humans and animals into a closer relationship that can lead to zoonotic spillovers, such as the Nipah virus and COVID-19. The growth of animal production and international trade exacerbates antimicrobial resistance (AMR) issues, imposing challenges to disease control.</p><p><strong>Conclusion: </strong>Climate change is a critical public health emergency with risks of zoonotic and food-borne illnesses alarmingly on the rise. This is an important step toward a One Health approach, which also addresses the integration of human, animal, and environmental health, as well as strengthens food safety regulations and enhances disease surveillance. It needs immediate international cooperation to construct a robust and sustainable food system that reduces health hazards.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"149"},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821393","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":"Quantitative effects of mechanical cardiopulmonary resuscitation devices in rural American emergency medical services: a retrospective cohort study.","authors":"Peter H King, Esmaeil Bahalkeh","doi":"10.1186/s12245-025-00920-5","DOIUrl":"10.1186/s12245-025-00920-5","url":null,"abstract":"<p><strong>Background: </strong>Emergency medical service agencies increasingly utilize medical devices which perform external chest compressions during cardiac arrest. Due to the unique staffing and budget considerations of the rural emergency medical services environment, an investigation of mechanical cardiopulmonary resuscitation in this setting is warranted. Studying the effects of new technologies in the rural environment promotes improvement of the standard of rural prehospital care. This study evaluated the effect of mechanical cardiopulmonary resuscitation use on rural out-of-hospital cardiac arrest performance measures.</p><p><strong>Methods: </strong>Five hundred eighty-five rural cardiac arrests were assessed from National Emergency Medical Services Information System 2017-2019 data. Using both linear and logistic multivariate regression analysis, the effect of mechanical cardiopulmonary resuscitation on the incidence of a return of spontaneous circulation, the first defibrillation interval, and the first cardiac epinephrine administration interval was assessed.</p><p><strong>Results: </strong>In rural cardiac arrest with initial presentation of a shockable rhythm, the use of mechanical cardiopulmonary resuscitation devices delayed initial defibrillation by 21.5% (p < 0.05). A 15.1% (p < 0.05) delay in first administration of epinephrine was also found when mechanical cardiopulmonary resuscitation was used. Incidence of return of spontaneous circulation was unchanged between manual and mechanical cardiopulmonary resuscitation conditions.</p><p><strong>Conclusions: </strong>Current rural mechanical cardiopulmonary resuscitation device use can have a negative effect on prompt delivery of vital interventions. Our findings suggest that improvements to equipment training may help remedy improper utilization of mechanical cardiopulmonary resuscitation devices. Delaying application of mechanical cardiopulmonary resuscitation devices until time-sensitive interventions are complete may result in a better standard of care. Proper use of mechanical cardiopulmonary resuscitation devices may help to overcome inherent difficulties faced by rural prehospital clinicians.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"151"},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821395","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}