Journal of Emergency Medicine最新文献

{"title":"Letter to Editor Response","authors":"Dr. Lauren Gould","doi":"10.1016/j.jemermed.2025.07.006","DOIUrl":"10.1016/j.jemermed.2025.07.006","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Page 180"},"PeriodicalIF":1.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Academy of Emergency Medicine","authors":"","doi":"10.1016/S0736-4679(25)00375-0","DOIUrl":"10.1016/S0736-4679(25)00375-0","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 185-186"},"PeriodicalIF":1.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metoclopramide, Whether I.M. or I.V., Should Not Be a Panacea for Primary Headaches in Emergency Departments","authors":"Josef Finsterer MD, PhD , Sinda Zarrouk PhD","doi":"10.1016/j.jemermed.2025.05.032","DOIUrl":"10.1016/j.jemermed.2025.05.032","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 178-179"},"PeriodicalIF":1.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter: Can GPT-4o Accurately Diagnose Trauma X-rays? A Comparative Study with Expert Evaluations","authors":"Ahmet Öztürk MD , Serkan Günay MD , Serdal Ateş MD , Yavuz Yiğit MD","doi":"10.1016/j.jemermed.2025.07.034","DOIUrl":"10.1016/j.jemermed.2025.07.034","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 183-184"},"PeriodicalIF":1.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: Can Gpt-4o Accurately Diagnose Trauma X-Rays? A Comparative Study with Expert Evaluations","authors":"Amnuay Kleebayoon PhD , Viroj Wiwanitkit MD","doi":"10.1016/j.jemermed.2025.07.033","DOIUrl":"10.1016/j.jemermed.2025.07.033","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 181-182"},"PeriodicalIF":1.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal Perforation due to Interstim® Sacral Neuromodulation Device Lead Migration.","authors":"Adam E Brown, Caden Lambie, Mouneeb M Choudry, Adri M Durant, Patricia G Lu, Douglas E Rappaport","doi":"10.1016/j.jemermed.2025.07.007","DOIUrl":"10.1016/j.jemermed.2025.07.007","url":null,"abstract":"<p><strong>Background: </strong>Sacral neuromodulation (SNM) implantable devices such as the InterStim® device by Medtronic carry a small risk of stimulatory lead migration. In very rare cases migrated leads can injure the rectal wall resulting in a full-thickness perforation. The sequela of rectal perforation by SNM leads may have varied clinical presentation, and can remain undiagnosed without appropriate suspicion, increasing the risk for further complications.</p><p><strong>Case report: </strong>A 43-year-old woman with a history of multiple SNM device revisions presented to our emergency department (ED) with rectal pain and gastrointestinal symptoms. SNM lead migration into the rectum and a full thickness perforation was visualized on computerized tomography (CT) imaging. A multidisciplinary evaluation was performed, and a subsequent management plan was developed for this patient's rare complication. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Rectal perforation is a rare event, and it is even more rare as a result of SNM lead migration. As emergency physicians, we should be aware of this rare complication, as the use of implantable SNM devices has risen over the last few decades. Based on the very few prior case reports, prognosis appears to be excellent, but prompt recognition of the complication is important to streamline proper management and prevent more serious downstream complications of untreated rectal perforation.</p>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"76 ","pages":"60-63"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Elastic Tourniquet and Blood Pressure Cuff for Peripheral Intravenous Access in Hypotensive Patients: A Randomized Single-Blind Study.","authors":"İlker Şirin, Şerife Büşra Uysal, Afşin Emre Kayıpmaz","doi":"10.1016/j.jemermed.2025.07.004","DOIUrl":"10.1016/j.jemermed.2025.07.004","url":null,"abstract":"<p><strong>Background: </strong>Peripheral intravenous catheterization (PIVC) is one of the most common invasive procedures performed in emergency departments (EDs). Elastic tourniquets (ET) and blood pressure cuffs (BPC) are most commonly used for venodilatation. Difficult vascular access can be predicted in some patients, and the rate of successful first-time PIVC placement in this group is low.</p><p><strong>Objective: </strong>In this study, we investigated which venodilatation method is most appropriate for hypotensive patients, a group in whom vascular access is predicted to be difficult.</p><p><strong>Methods: </strong>This was a prospective, single-blind, randomized controlled trial in the ED of a tertiary care hospital. Hypotensive patients were randomly assigned to two methods of administration. Patients' basilic vein diameters and venous collapsibility were measured before and after the intervention by a physician blinded to the intervention, followed by intravenous (IV) access. The primary outcome was the change in basilic vein diameter after the applied venodilatation method (ET or BPC), and the secondary outcomes were the change in vein collapsibility and initial access success rate.</p><p><strong>Results: </strong>In this study of 101 patients, basilic vein diameter increased from 4.05 to 5.4 mm in the BPC group and from 4.1 to 4.5 mm in the ET group. The change in diameter in the BPC group was greater than that in the ET group (p < .0001). In addition, IV access was successful in 33 (63%) of 52 patients in the BPC group on the first attempt and in 20 (41%) of 49 patients in the ET group. The change in collapsibility was greater in the BPC group after the procedure.</p><p><strong>Conclusion: </strong>BPC during PIVC insertion in hypotensive patients presenting to the ED showed both a greater increase in basilic vein diameter and superior initial access success than ET. Therefore, we recommend BPC as a method of venodilatation in hypotensive patients.</p>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"76 ","pages":"41-49"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Safety and Efficacy of Four Intraosseous Devices for Vascular Access in the Emergency Department: A Systematic Review and Network Meta-Analysis.","authors":"Swati Suman, Prakash Ranjan Mishra, Paulina Mishra, Shivam Pandey","doi":"10.1016/j.jemermed.2025.07.011","DOIUrl":"10.1016/j.jemermed.2025.07.011","url":null,"abstract":"<p><strong>Background: </strong>Intraosseous (IO) devices are increasingly being utilized for rapid vascular access in emergency departments (ED) and other time-sensitive conditions where intravenous access is challenging. In spite of their growing use, there is a paucity of literature addressing their safety and efficacy profiles, and it is needed to guide their current status in clinical practice and policy.</p><p><strong>Objectives: </strong>To compare the safety and efficacy of four different types of IO devices utilized in EDs: battery-powered drill, automatic, semi-automatic spring-loaded, and manual devices.</p><p><strong>Methods: </strong>A systematic review and network meta-analysis was conducted. Studies on human subjects (excluding neonates) requiring IO access were included. Risk of bias and network meta-analysis was performed, with risk ratios (RR) and 95% confidence intervals (CI) calculated. Pairwise analysis of studies and surface under cumulative ranking curve (SUCRA) ranking of all devices were done.</p><p><strong>Results: </strong>Ten studies (783 participants) were included. Battery-powered drill device (RR 1.30, 95% CI 1.10-1.54), followed by manual device (RR 1.27, 95% CI 0.99-1.62) and automatic device (RR 1.20, 95% CI 0.99-1.44), showed higher incidence of success rates when compared with semi-automatic spring-loaded device. The SUCRA ranking also showed the highest cumulative probability of battery-powered drill (RR 1.30, 95% CI 1.10-1.54). Safety data were pooled in a tabular form.</p><p><strong>Conclusion: </strong>This meta-analysis provides insights that, although battery-powered drill device showed the best outcomes, the wide confidence intervals and lack of statistically significant differences between devices highlight the need for further research with larger sample sizes and standardized safety reporting protocols, to establish conclusions regarding optimal IO device for EDs.</p><p><strong>Research question: </strong>What are the comparative safety and efficacy profiles of four different intraosseous devices, that is, battery-powered drill device, automatic device, semi-automatic spring-loaded device, and manual device, used for vascular access during resuscitation in the ED?</p><p><strong>Registration: </strong>PROSPERO No.: CRD42024602219, url: https://www.crd.york.ac.uk/prospero/export_details_pdf.php.</p>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"76 ","pages":"64-78"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental Persistent Left Superior Vena Cava and Other Anatomic Anomalies During Emergent Central Line Placement in the Emergency Department: A Case Report","authors":"Maritza Kelesis MD ,&nbsp;Monica Deadmond ,&nbsp;Kahra Nix MD","doi":"10.1016/j.jemermed.2025.08.027","DOIUrl":"10.1016/j.jemermed.2025.08.027","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"78 ","pages":"Pages 37-40"},"PeriodicalIF":1.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Care for Patients with Cancer on Immune Checkpoint Inhibitors: A Retrospective Analysis of Immune-Related Adverse Events","authors":"Alice Ferrua ,&nbsp;Jacopo Davide Giamello ,&nbsp;Chiara Fulcheri ,&nbsp;Michela Milanesio ,&nbsp;Giulia Bernardi ,&nbsp;Elena Fea ,&nbsp;Salvatore D’Agnano ,&nbsp;Nicoletta Artana ,&nbsp;Daniela Caruso ,&nbsp;Giovanna Greco ,&nbsp;Tiziana Ponza ,&nbsp;Enrico Lupia ,&nbsp;Luigi Fenoglio ,&nbsp;Giuseppe Lauria ,&nbsp;Gianmauro Numico","doi":"10.1016/j.jemermed.2025.08.025","DOIUrl":"10.1016/j.jemermed.2025.08.025","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, but can lead to immune-related adverse events (irAEs), some of which require emergency care.</div></div><div><h3>Objective</h3><div>To evaluate the prevalence, clinical features and outcomes of emergency department (ED) visits related to irAEs among patients receiving ICIs.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed ED visits from 2013 to 2021 among patients with solid tumors treated with ICIs at a single tertiary cancer center in Italy. Each visit was independently reviewed and classified as definitely, potentially, or not related to irAEs.</div></div><div><h3>Results</h3><div>Of 457 ED visits from 216 patients, 27 (5.9%) were definitely and 15 (3.3%) potentially related to irAEs. The most frequent irAEs were pneumonitis (<em>n</em> = 19), colitis (<em>n</em> = 5), and hepatitis (<em>n</em> = 3). Dyspnea was more common in irAE-related visits (28.6% vs 13%, <em>p</em> = 0.006). 74.1% of irAE-related visits resulted in hospital admission and 30-day mortality was 14.3%. The median time from ICI initiation to ED presentation for irAEs was 21 weeks.</div></div><div><h3>Conclusions</h3><div>irAEs account for a significant portion of ED visits in patients receiving ICIs, with pneumonitis being the most frequent. Emergency clinicians should be aware of this delayed toxicity spectrum, especially in patients presenting with respiratory symptoms.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"78 ","pages":"Pages 235-240"},"PeriodicalIF":1.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}