Open Access Emergency Medicine最新文献

{"title":"Strangulated Posterior Rectus Sheath Hernia with Contained Small-Bowel Perforation and Abdominal Wall Necrotizing Infection: A Case Report.","authors":"Theobald Hatangimana, Herbert Butana, Desire Rubanguka, Glorieux Twizeyimana, Khadar Digaale Abdishakour, Deresse Tilahun","doi":"10.2147/OAEM.S629726","DOIUrl":"https://doi.org/10.2147/OAEM.S629726","url":null,"abstract":"<p><strong>Background: </strong>Posterior rectus sheath hernia is an exceptionally uncommon interparietal hernia and may be difficult to recognize because the herniated bowel remains between abdominal wall layers.</p><p><strong>Case presentation: </strong>A 49-year-old multiparous woman presented with acute severe pain, vomiting, fever, and inflammatory skin changes over a right paraumbilical swelling that had been present for six years. Ultrasound suggested a complicated abdominal wall cyst, whereas computed tomography demonstrated a right rectus sheath hernia. Emergency exploration revealed strangulated and perforated small bowel contained between rectus sheath layers, with enteric leakage into necrotic anterior abdominal wall tissues. Approximately 20 cm of gangrenous bowel was resected and a primary end-to-end anastomosis was performed. The small fascial defect was closed primarily without mesh because of the dirty infected field. The skin and subcutaneous wound were left open after debridement, managed with temporary packing and two further operative debridements, and closed secondarily after infection control. The patient recovered and was discharged in good clinical condition.</p><p><strong>Conclusion: </strong>Posterior rectus sheath hernia should be considered in atypical abdominal wall masses. Early computed tomography and urgent source control are essential when strangulation, perforation, or necrotizing infection is suspected.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"629726"},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184393","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":"Hemorrhage Control in a Facial Gunshot Wound: A Case Report.","authors":"Thomas R Knobl, Tyler N Carruth","doi":"10.2147/OAEM.S650049","DOIUrl":"https://doi.org/10.2147/OAEM.S650049","url":null,"abstract":"<p><p>Gunshot wounds (GSWs) to the head or face are among the most complex injuries secondary to a number of vital structures in a relatively small volume of space. Hemorrhage can be difficult to control with traditional techniques, and ongoing hemorrhage can further complicate securing the airway. We present the use of a hemostatic gel in a facial GSW. A 74-year-old male suffered a self-inflicted GSW to the submandibular region with significant hemorrhage in the setting of a suspected overdose of apixaban (Eliquis) and alprazolam (Xanax). Traditional methods were unable to control the bleeding, and a syringe of Traumagel, a hemostatic gel, was then deployed into the complex wound, which achieved hemostasis.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"650049"},"PeriodicalIF":1.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169386","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":"Evidence in the Age of Algorithms: Redefining Emergency Medicine Research.","authors":"Amado Alejandro Baez","doi":"10.2147/OAEM.S657506","DOIUrl":"https://doi.org/10.2147/OAEM.S657506","url":null,"abstract":"","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"657506"},"PeriodicalIF":1.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116144","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":"Left Without Being Seen: A Scoping Review of a Silent Crisis in Emergency Departments.","authors":"Andres Ramiro Ardila Jara, Catalina Barbosa Malagon, Laura Daniela Castillo Moreno, Fredy Alexander Rojas, Gabriel Camilo Beltrán Rojas, Alejandro Medina Adam, María José Romero Troya, Leonar Giovanni Aguiar Martinez","doi":"10.2147/OAEM.S604937","DOIUrl":"10.2147/OAEM.S604937","url":null,"abstract":"<p><strong>Background: </strong>Left Without Being Seen (LWBS) rates are widely recognized as a key quality indicator in Emergency Departments (ED) worldwide. Their clinical relevance is substantial, given the documented association between LWBS and increased morbidity and mortality among patients presenting to the ED. However, the available evidence is extensive and highly heterogeneous; therefore, a scoping review represents a more appropriate approach for synthesizing the evidence than a systematic review or meta-analysis.</p><p><strong>Objective: </strong>This scoping review aims to synthesize current evidence regarding population characteristics, underlying determinants, and potential interventions associated with LWBS rates, pondering the need to strengthen strategies for identifying and reducing these events.</p><p><strong>Design: </strong>Scoping review conducted according to PRISMA-ScR guidelines. We searched four databases (PubMed, Scopus, Oxford Academic, and EBSCO) between Jan 01, 2020 - Dec 31,2025. To meet the eligibility criteria, studies were required to be observational analytical, interventional, or evidence synthesis, given the limited evidence found, posters involving studies of human participants in ED settings.</p><p><strong>Results: </strong>Ninety-four publications were included with de eligibility criteria Most studies were interventional and conducted in North America; however, systematic reviews and additional studies from Europe, Asia, Australia, South America, and the Middle East were also identified. Reported LWBS rates varied widely across settings and were influenced by both community-level and individual-level factors, including demographic characteristics, EDs staffing, time of presentation, chief complaint, and facility resources, as well as contextual factors such as the COVID-19 pandemic. The available evidence demonstrated considerable heterogeneity in the definition and characterization of LWBS causes, largely due to differences in reporting practices, documentation, and descriptions of events related to this outcome. Numerous interventions aimed at reducing LWBS rates were described.</p><p><strong>Conclusion: </strong>LWBS is a key emergency care quality indicator driven by waiting times, crowding, and temporal factors. It predominantly affects low-acuity, socioeconomically vulnerable adults. Physician-in-triage reduces LWBS, while predictive models identify high-risk patients. Associated with revisits and mortality, LWBS requires flow optimization and context-adapted strategies. Standardized frameworks are needed to strengthen evidence.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"604937"},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065052","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":"Integrated Multidisciplinary and Digital Innovation in Polytrauma: Optimizing Whole-Process Emergency Models for Secondary Hospitals.","authors":"Jianhua Zhao, Zihui Zhao, Yanhui Li, Chunhua Fang, Jingdong Li, Wenliang Xiao, Jiaxi Dong","doi":"10.2147/OAEM.S625393","DOIUrl":"10.2147/OAEM.S625393","url":null,"abstract":"<p><p>Polytrauma, characterized by multi-system injuries and life-threatening complexity, poses significant challenges to healthcare systems, particularly in resource-constrained secondary hospitals. This narrative review synthesizes global research on polytrauma management, focusing on workflow optimization, digital innovation, and MDT adaptation tailored to secondary hospitals. Based on a systematic literature search of PubMed, Web of Science, CNKI, and Wanfang Data (January 2014 - December 2024), 63 studies were included and analyzed. We identify key barriers-including prolonged diagnostic intervals, insufficient inter-departmental coordination, and reliance on traditional emergency processes with redundant steps-that disproportionately delay door-to-CT times, time to definitive intervention, and contribute to preventable mortality in secondary hospital settings. Emerging solutions such as simplified MDT frameworks, telemedicine-enabled collaboration, and AI-assisted triage show promise, yet current literature lacks practical, context-sensitive frameworks addressing the unique constraints of secondary hospitals, including staffing shortages and limited surgical capabilities. To address these gaps, we propose a hybrid model centred on four core elements: (1) a core MDT team (emergency physicians, trauma nurses, and key specialists) for rapid assessment and damage control; (2) an optimized green-channel process with clear activation criteria and streamlined workflows; (3) digital decision-support systems (eg, 5G-based platforms, process mining algorithms) to enable real-time information sharing and coordination; and (4) regional referral linkages with higher-level trauma centres to ensure timely transfer of patients requiring specialized surgical interventions. Future research should prioritize validation studies-using both quantitative and qualitative approaches-of process optimization strategies, development of context-specific training programs, and cost-effectiveness analyses of technology-driven interventions. This synthesis provides actionable insights for advancing secondary hospital trauma systems, ultimately reducing preventable mortality and bridging disparities in global trauma care equity.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"625393"},"PeriodicalIF":1.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency CT KUB: Incidental Findings and Their Clinical Significance.","authors":"Mostafa Dayraki, Shahzad Anjum, Lolwa AlKhulaifi, Lara Miranda, Duha Adil Musa Mohmmad, Atika Jabeen, Zain Ali Bhutta, Yavuz Yigit","doi":"10.2147/OAEM.S620255","DOIUrl":"10.2147/OAEM.S620255","url":null,"abstract":"<p><strong>Background: </strong>Incidental findings (IFs) on computed tomography of the kidneys, ureters, and bladder (CT KUB) are increasingly common in emergency departments (EDs) due to the widespread use of advanced imaging. These findings, often unrelated to the primary diagnostic indication, present clinical and operational challenges, particularly in high-volume, demographically diverse settings.</p><p><strong>Objective: </strong>To evaluate the prevalence, classification, and clinical significance of incidental findings on CT KUB scans performed in the ED for suspected obstructive uropathy, and to identify factors associated with clinically significant IFs and evaluate their clinical outcomes.</p><p><strong>Methods: </strong>A retrospective single-center observational study was conducted at a national tertiary-care hospital in Qatar, including all adult patients who underwent non-contrast CT KUB for suspected renal colic between January 1 and November 30, 2024. Demographic, clinical, and radiological data were extracted. IFs were categorized as major, moderate, or minor based on clinical relevance. Outcomes included prevalence and distribution of IFs, subsequent management actions, and factors associated with major IFs.</p><p><strong>Results: </strong>Of 2786 CT KUB scans analyzed, 1531 (54.9%) revealed at least one incidental finding. Most incidental findings were classified as minor (63.2%), whereas 6.1% were major and 30.8% were moderate according to the highest-severity incidental finding per scan. Major IFs (e.g, suspected malignancy, aortic aneurysm) accounted for most urgent interventions and admissions. Multivariable analysis identified that older age, nationality, fever, desaturation, and abdominal tenderness were independently associated with major IFs (all p<0.05). Management of the primary condition was delayed due to IFs in only 0.6% of cases. The most frequent IFs were vascular calcifications, bone lesions, and hernias.</p><p><strong>Conclusion: </strong>Incidental findings on CT KUB are common in the ED, with a significant proportion requiring further intervention or specialist referral. The high prevalence in a younger, multi-ethnic population underscores the need for context-specific protocols, structured reporting, and robust follow-up systems.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"620255"},"PeriodicalIF":1.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963854","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":"Strengthening Prehospital Emergency Care in Somalia: Current Barriers and Priorities for System Reform.","authors":"Hassan Adan Ali Adan","doi":"10.2147/OAEM.S630944","DOIUrl":"10.2147/OAEM.S630944","url":null,"abstract":"<p><p>Effective prehospital emergency care is a core component of an emergency care system because assessment, initial stabilization, communication, and transport begin before definitive hospital treatment. In Somalia, prehospital services remain fragmented, with substantial reliance on informal transport and limited access to trained responders, standardized protocols, dispatch, and coordinated referral. Somalia-specific reports have documented major gaps in organized prehospital care, including limited ambulance capacity and a lack of a unified national system. This Perspective examines these barriers and proposes a pragmatic pathway for reform that prioritizes governance, workforce development, community first response, dispatch and communication, ambulance standards, and linkage with receiving hospitals. Rather than proposing an expensive high-resource model, the paper advocates phased development beginning with context-appropriate first-responder and basic ambulance-provider training, followed by regulated expansion of advanced prehospital care as workforce, financing, and clinical governance mature. Existing Somali experience with WHO-supported emergency-care training provides a foundation for local capacity building, while regional experience from Kenya illustrates the value of policy, regulation, data, and coordinated dispatch. Mobile communication technologies may offer a feasible bridge where conventional dispatch infrastructure is limited. The immediate priority should be to establish a nationally coordinated, measurable, and sustainable prehospital system that connects communities, responders, ambulances, and hospitals.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"630944"},"PeriodicalIF":1.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Parotitis Following a Cheek Slap: A Case Report and Clinical Implications.","authors":"Ahmad A Oqlat, Ammar A Oglat, Mohammad K Alsuleiman, Saad A Saidan, Anas Isawi","doi":"10.2147/OAEM.S638560","DOIUrl":"10.2147/OAEM.S638560","url":null,"abstract":"<p><strong>Background: </strong>Parotitis, inflammation of the parotid gland, is most commonly attributed to infection, salivary duct obstruction, or autoimmune disease; trauma-induced parotitis is uncommon, and blunt-trauma cases are reported less frequently than penetrating injury.</p><p><strong>Case presentation: </strong>We describe a 4-year-old boy who presented to the emergency department with left-sided facial swelling one day after a low-velocity slap to the cheek during play. Examination showed tender left parotid swelling without bruising, pain-limited trismus, and no facial nerve, otologic, oral cavity, or temporomandibular joint abnormalities; a whole-body skin survey and a formal social-work assessment for non-accidental injury were unremarkable. Computed tomography, obtained because the mechanism of injury required clarification and mandibular fracture could not initially be excluded on clinical grounds, showed parotid enlargement with adjacent fat stranding and no fracture. Markedly elevated serum amylase, with normal inflammatory markers and negative viral serology, supported a diagnosis of traumatic parotitis after systematic exclusion of infectious, obstructive, and suppurative causes. The child was managed conservatively and recovered fully within two weeks.</p><p><strong>Conclusion: </strong>This case adds to the limited literature on post-traumatic parotitis by illustrating that even a low-velocity, everyday mechanism such as a slap can produce isolated parotid swelling in children, an association not previously emphasized outside higher-energy blunt trauma. It highlights the value of a structured differential work-up, judicious imaging, and routine safeguarding assessment in this presentation.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"638560"},"PeriodicalIF":1.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921447","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":"Operational Characteristics and System Readiness of Advanced Water-Based EMS Units Along the Chao Phraya River in Bangkok: A Retrospective Descriptive Study.","authors":"Pattanun Kitchaisawad, Rapeeporn Rojsaengroeng, Phudit Buaprasert, Kaewwalee Kaewnil","doi":"10.2147/OAEM.S607338","DOIUrl":"10.2147/OAEM.S607338","url":null,"abstract":"<p><strong>Introduction: </strong>Water-related emergencies are a major urban public health concern, particularly along Bangkok's heavily trafficked Chao Phraya River. Between 2019 and 2023, Bangkok reported the third-highest drowning mortality rate in Thailand. Although advanced water-based emergency medical service (EMS) units have operated for more than three decades, their operational characteristics have not been systematically evaluated.</p><p><strong>Objective: </strong>To describe the operational characteristics and system structure of advanced water-based EMS units operating along the Chao Phraya River in Bangkok.</p><p><strong>Methods: </strong>A retrospective descriptive study analyzed operational data from January 1, 2021, to December 31, 2023, using mission report databases from the Bangkok Metropolitan Administration EMS Center and three designated advanced water-based EMS units. Key variables included annual incident notifications, mission characteristics, operational outcomes, and system structure.</p><p><strong>Results: </strong>Descriptive evaluation identified several system limitations across all units, including inadequate docking infrastructure, shortages of specialized medical equipment, and the absence of standardized clinical protocols and performance monitoring. Comprehensive quantitative analysis was not possible for Units 2 and 3 because of incomplete operational records. Unit 1 recorded 28, 71, and 52 incident notifications in 2021, 2022, and 2023, respectively, resulting in 11, 50, and 18 EMS missions. Medical assistance was provided in 1, 11, and 9 cases, respectively. These findings are presented descriptively and should not be interpreted as comparisons between units because comparable operational data were unavailable for Units 2 and 3.</p><p><strong>Conclusion: </strong>Available data indicate important gaps in infrastructure, documentation, standardized reporting, and performance monitoring within Bangkok's water-based EMS system. Strengthening the system will require improved docking infrastructure, standardized medical equipment, digitized reporting systems, and the implementation of continuous quality improvement processes.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"607338"},"PeriodicalIF":1.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867110","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":"Perceived Implementation of Prehospital Emergency Care Protocols by Emergency Medical Services Personnel in the Philippines: A Sequential Explanatory Mixed-Method Design.","authors":"Rock P Cordero, Benjamin Joel L Breboneria, Eligin Jumel H Sayson, Jon-Jon T Martinez, Dina Joksimovic, Yasir M Aslam, Paulo Carl G Mejia, Nathira Al Hmaimat","doi":"10.2147/OAEM.S612905","DOIUrl":"10.2147/OAEM.S612905","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated how emergency medical service personnel perceive the implementation of prehospital emergency care protocols in the Philippines, with particular attention to the discrepancy between self-reported adherence and reported operational barriers.</p><p><strong>Patients and methods: </strong>The research utilized a sequential explanatory mixed methods design. Quantitative data collection involved a 56-item questionnaire answered by 114 EMS personnel from four regions in the Philippines (Metro Manila, Luzon, Visayas, Mindanao). Data collection for the qualitative component involved 4 focus group discussions and 6 in-depth interviews. Statistical techniques for analyzing qualitative data include descriptive statistics and chi-square tests of independence, while thematic analysis according to Braun and Clarke's six-step model, with two independent coders (Cohen's k=0.87), was used to analyze qualitative data.</p><p><strong>Results: </strong>Results obtained from the quantitative analysis suggested consistent high levels of implementation in all five domains of pre-hospital care (safety on the scene: mean=3.71, primary survey: mean=3.64, secondary survey: mean=3.61, detailed physical examination: mean=3.58, ongoing assessment: mean=3.74, all considered as high implementation). Qualitative results, however, demonstrated significant challenges in terms of operation, including time pressure while managing the scene, lack of airway and breathing devices, lack of standardization in training, no reassessment, insufficient documentation, and lack of communication between facilities. The contrast found in these results constitutes the core finding of the research.</p><p><strong>Conclusion: </strong>System-level effectiveness cannot be assumed from these self-report perceptions. Instead, the Philippine EMS system maintains a high level of normative protocol awareness yet is structurally weak in its implementation. The \"paradox of implementation\" indicates that intervention must focus more on resource provision, standardization, and coordination than on protocol dissemination.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"18 ","pages":"612905"},"PeriodicalIF":1.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819992","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}