Open Access Emergency Medicine最新文献

{"title":"Consumer Products Nerve Injuries Among Patients Products Presenting to United States Emergency Departments Between 2012 and 2021: A Nationwide Cohort.","authors":"Arjun Ganga, Taif Mukhdomi, Eric J Kim, Eric Ly, Yash Patel, Korinne N Dankievitch, Mark C Kendall","doi":"10.2147/OAEM.S486863","DOIUrl":"10.2147/OAEM.S486863","url":null,"abstract":"<p><strong>Introduction: </strong>Nerve injuries and resultant pain are common causes of emergency department (ED) visits in the United States. Injuries often occur either due to activity (ie sports related injury) or due to consumer products such as stairs or bedframes. We investigated the incidence of consumer product-related nerve injuries (CPNIs) in patients who presented to the ED in the United States.</p><p><strong>Materials and methods: </strong>The National Electronic Injury Surveillance System was queried to identify patients presenting to US EDs between 2012 and 2021 with CPNIs. The cohort was categorized by age: 1) 0-17-year-olds, 2) 18-64-year-olds, 3) and 65+ year-olds. The primary outcomes were the type of injury and the location of injury.</p><p><strong>Results: </strong>A total of 14,410 CPNIs were reported. There was an increase in yearly CPNIs (β = 4763, (95% confidence interval 1940-7586); P = 0.004). The majority (11,547/14,410, 80.1%) of injuries were among adults. Elderly females encountered more CPNIs than males (52.5% vs 47.8%, P = 0.002). Stairs were most involved in nerve injuries among adults (8.21%) and children (3.96%) whereas beds or bedframe injuries were most frequent (12.0%) among the elderly. Sciatica was the most common diagnosis (≥60%) followed by radiculopathy (≥20%) in adults >18 years of age. Among adults aged 18 to 29, the upper trunk, lower arm, and wrist was more frequently involved, while these areas were less commonly involved in adults aged 40 to 49. Compared to adults, the pediatric and elderly patients presented with more traumatic spinal cord injuries.</p><p><strong>Conclusion: </strong>Sciatica, radiculopathy, and traumatic spinal cord injury were the most common diagnoses following CPNIs. Children and the elderly tended to present with more severe CPNIs than the general adult population. Further investigations exploring interventions to lower the burden of CPNIs, improve consumer product safety, and reduce potentially chronic and debilitating injuries are necessary.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"31-41"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061223","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":"Peculiarities of in-Stent Thrombosis and Restenosis in Coronary Arteries Post-COVID-19: A Systematic Review of Clinical Cases and Case Series.","authors":"Lyudmila Pivina, Gulnara Batenova, Nazarbek Omarov, Diana Ygiyeva, Assylzhan Messova, Galiya Alibayeva, Ulzhan Jamedinova, Ruslan Kurumbayev, Maksim Pivin","doi":"10.2147/OAEM.S470523","DOIUrl":"10.2147/OAEM.S470523","url":null,"abstract":"<p><strong>Background: </strong>One of the most serious complications of coronary artery stenting is restenosis and in-stent thrombosis; their prevalence can reach 20-25%. Stent thrombosis can be acute (up to 24 hours), subacute (24 hours to 30 days), late (30 days to 1 year), and very late (> 1 year after previous stenting). In the patients with COVID-19 in intensive care units, the proportion of those with elevated troponin levels reached 25%.</p><p><strong>Objective: </strong>Evaluation of the association between COVID-19 and the development of in-stent thrombosis and restenosis of the coronary arteries based on the analysis of clinical cases and case series.</p><p><strong>Materials and methods: </strong>We searched the PubMed and Scopus databases for relevant case reports and case series of stent restenosis and in-stent thrombosis associated with coronavirus infection (CVI) published between 2020 and the present. Thirty-eight full-text publications were screened and manually checked for analysis. We found 10 publications describing cases of thrombosis and restenosis of stents associated with coronavirus infection, of which only 2 were case series. In total, we analyzed 22 cases.</p><p><strong>Results: </strong>In the structure of in-stent restenosis and thrombosis, 59.1% were very late, 9.1% were late; 18.2% were considered subacute events, and 13.6% were acute events. All cases were angiographically confirmed. The main location of restenosis or thrombosis was the left coronary artery (LAD) (51.1%), thrombosis of the right coronary artery (RCA) occurred in 27.3%, and location in circumflex artery was in 22.7%. All patients had COVID-19 confirmed by a PCR test or the presence of immunoglobulins G and M. In fourteen patients (54.5%), an X-ray examination showed the presence of bilateral polysegmental infiltration.</p><p><strong>Conclusion: </strong>Analysis of publications demonstrates the association between restenosis and in-stent thrombosis in patients with coronary arteries disease (CAD) and coronavirus infection.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"15-30"},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053703","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":"Comparing the Prognostic Value of Lactate to the Neutrophil to Lymphocyte Ratio Among Sepsis Patients: A Prospective Cohort Study.","authors":"Ralphe Bou Chebl, Saadeddine Haidar, Nadim Kattouf, Mohamad Assaf, Joudie Sahar Alwan, Mohamad M Khamis, Karim Abdeldaem, Maha Makki, Hani Tamim, Gilbert Abou Dagher","doi":"10.2147/OAEM.S486966","DOIUrl":"10.2147/OAEM.S486966","url":null,"abstract":"<p><strong>Background: </strong>Lactate has long been recognized as a key prognostic biomarker in sepsis. Similarly, the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) has been investigated in various conditions, including sepsis. Previous studies have explored the optimal NLR cutoff to differentiate sepsis survivors from nonsurvivors, predict bacteremia, diagnose sepsis, and assess mortality. This study compares the prognostic value of lactate and NLR in septic patients.</p><p><strong>Methods: </strong>This prospective cohort study included 874 adult septic or septic shock patients presenting to a tertiary care center's Emergency Department between September 2018 and February 2021. The primary outcome was to compare the prognostic value of NLR and lactate regarding in-hospital mortality. Secondary outcomes compared their prognostic value in different septic subgroups.</p><p><strong>Results: </strong>Stepwise logistic regression showed NLR was not associated with in-hospital mortality (OR=1.003, p=0.544), while lactate was significantly associated with in-hospital mortality (OR=1.188, p<0.0001). There was no significant difference in the AUCs of NLR and lactate (0.552 vs 0.591, p=0.22). Lactate outperformed NLR in patients with albumin <30, those <65 years old, and those with sepsis from a urinary tract infection. No significant differences were found in AUCs between lactate and NLR in patients with septic shock, Lactate<2, Lactate≥2, diabetes, malignancy, chronic kidney diseases, other sources of infection, albumin ≥30 and age ≥ 65.</p><p><strong>Conclusion: </strong>In this study, lactate but not NLR was associated with in-hospital mortality. There was no significant difference in the AUCs between lactate and NLR among sepsis patients and among most of the subgroups. However, lactate outperformed NLR in the following subgroups: albumin<30 g/L, patients <65 years old and patients with sepsis due to a urinary tract infection. Our results advocate for the continued use of serum lactate rather than NLR, despite its limitations, as a predictor of mortality among septic patients and the different subgroups in this study.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"3-13"},"PeriodicalIF":1.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048212","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":"Impact of Traffic Patterns on Trauma Response Prenotification [Letter].","authors":"M Zaenul Muttaqin","doi":"10.2147/OAEM.S511311","DOIUrl":"10.2147/OAEM.S511311","url":null,"abstract":"","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013813","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":"Impact of the Implementation of a Low-Complexity Emergency Care Protocol in the Patient Experience at a Level 3 Academic Institution in Colombia.","authors":"German Devia Jaramillo, Juan Pablo Vargas Gallo, Nathalia Maria Esmeral-Zuluaga","doi":"10.2147/OAEM.S478196","DOIUrl":"10.2147/OAEM.S478196","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency department overcrowding is a universal problem. It is associated not only with poor clinical outcomes but also with a decrease in patient satisfaction, especially in patients with low complexity emergencies or triage 4 and 5, who tend to have a longer waiting time.</p><p><strong>Objective: </strong>This study aims to determine whether the implementation of a care strategy for patients with low complexity emergencies called \"The special Line\" in the emergency department of a third level academic institution in Colombia, has a positive impact on the level of satisfaction with the care received by the patient and the number of people who leave without being seen.</p><p><strong>Methods: </strong>This is a retrospective analytical observational study that looks at the effect on the rate of patients who leave without being seen and the net promoter score (NPS) of the entire emergency department of establishing a protocol for the care of patients with low complexity emergencies.</p><p><strong>Results: </strong>Of a total of 22,743 patients divided into the two comparison groups, it was found that after the implementation of the care protocol, a non-significant reduction in the median rate of patients without care from 2.35% to 1.85% was documented, as well as a significant improvement in the median value of the NPS from 44 to 53, p: 0.001.</p><p><strong>Conclusion: </strong>The implementation of a protocol for the care of patients with low-complexity emergencies demonstrated a significant improvement in the experience of care for all users in the emergency service, additionally, indirectly influencing the leave without being seen of the entire emergency service.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"329-336"},"PeriodicalIF":1.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878081","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":"Variability of Prehospital Pain Management Protocols: A Review of Prehospital Care Protocols in the United States.","authors":"Timmy Li, Daniel Koloden, Jonathan Berkowitz, Dee Luo, Howard Luan, Charles Gilley, Gregory Kurgansky, Devin M Howell, Paul Barbara","doi":"10.2147/OAEM.S480680","DOIUrl":"10.2147/OAEM.S480680","url":null,"abstract":"<p><strong>Purpose: </strong>We describe emergency medical services (EMS) protocols for pain management in the United States to elucidate systemic variability in protocols. We describe types of pain medications included in protocols, routes of administration, indications for use, standing orders for dosing, and use in pediatric patients.</p><p><strong>Methods: </strong>We performed a review of all publicly accessible EMS protocols from the website http://www.emsprotocols.org, supplemented with internet searches. Data were abstracted into a data collection form from June 2021 to January 2022. We developed categories of responses to summarize the data, using frequencies and proportions to describe outcome measures.</p><p><strong>Results: </strong>We reviewed 104 EMS protocols, spanning 43 states. The most common pain management medications include fentanyl (94.2%), morphine (70.2%), ketamine (61.5%), ketorolac (40.4%), oral acetaminophen (36.5%), oral ibuprofen (22.1%), and nitrous oxide (19.2%). The most common route of administration across all protocols and medications is intravenous. Severe pain, without a specified level, is the most common indication for fentanyl (65.3%), morphine (61.6%), ketorolac (50.0%), and nitrous oxide (40.0%). Musculoskeletal injuries and burns are the most common indications for morphine, 15.1% and 19.2% of protocols, respectively. The majority of protocols dictate the weight-based dosing of fentanyl (74.5%), morphine (64.4%), ketamine (87.3%), oral acetaminophen (56.8%), and oral ibuprofen (59.1%). However, 97.6% and 100.0% of protocols dictate a fixed dose of ketorolac and nitrous oxide, respectively. Fentanyl, morphine, oral acetaminophen, and oral ibuprofen can be administered to pediatric patients based on standing orders among >90.0% of protocols. However, only 46.2% and 75.0% of protocols allow the use of ketorolac and nitrous oxide in pediatric patients, respectively.</p><p><strong>Conclusion: </strong>We found variability in EMS pain management protocols including the types of allowed medications, routes of administration, dosing, and indications for use. Further studies may assess whether standardized protocols across EMS systems could improve patient safety and quality of care.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"337-345"},"PeriodicalIF":1.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878087","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":"An Atypical Presentation of Acute Cholecystitis with Left Sided Chest Pain and ST Elevation - A Case Report.","authors":"Helene G Meyer, Kristina Fäh, Michael Christ","doi":"10.2147/OAEM.S478102","DOIUrl":"10.2147/OAEM.S478102","url":null,"abstract":"<p><strong>Background: </strong>ST elevation combined with typical chest pain is an indication for acute coronary vascularization and is usually associated with acute myocardial infarction. Herein, we present an unusual case of ST elevation.</p><p><strong>Case presentation: </strong>A 57-year-old male patient presented to the emergency department with chest pain radiating to both arms and the back. Typical clinical presentation and inferolateral ST elevations were suggestive of ST elevation myocardial infarction. Interestingly, coronary occlusion was excluded by coronary angiography. Despite extensive diagnostic workup, no underlying diagnosis was made. Four days later, the patient returned and reported pain in the right upper abdomen. Clinical presentation, laboratory analysis, and imaging features led to a diagnosis of calculous acute cholecystitis. Laparoscopic cholecystectomy was performed, and the diagnosis was confirmed. Electrocardiographic changes and pain resolved completely.</p><p><strong>Conclusion: </strong>Acute calculous cholecystitis is initiated by gallbladder distension due to biliary duct occlusion caused by gallstones. ST elevations in response to gallbladder distension have been demonstrated in animal models. We hypothesize that the ST elevations observed in this patient with chest pain were linked to stone-mediated distension of the gallbladder, leading to reflex coronary vasoconstriction.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"323-328"},"PeriodicalIF":1.5,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829558","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":"Reliability Evaluation of Temnography for Early Detection of Intracranial Lesions in Mild Traumatic Brain Injury Patient: A Preliminary Report of a New Portable, Non-Invasive Device.","authors":"Sara Montemerani, Cosimo Fabrizi, Cecilia Sacchi, Antoine Belperio, Lorenzo Moriani, Samuele Pacchi, Cinzia Garofalo, Giovanni Sbrana, Duccio Venezia, Maurizio Zanobetti, Simone Nocentini","doi":"10.2147/OAEM.S475328","DOIUrl":"10.2147/OAEM.S475328","url":null,"abstract":"<p><strong>Purpose: </strong>Mild Traumatic brain injury is classified based on Glasgow Coma Scale (GCS 13-15), it also involves transient alteration of brain function, which may lead to severe short- and long-term sequelae. When treating a patient with a mild head injury outside the hospital, it is of crucial importance to decide whether to transport him to a center without neurosurgery or to a center equipped with neurosurgery (primary centralization). Recent decades have seen exploration of portable, non-invasive devices for intracranial injury and stroke detection, with microwave frequency electromagnetic field technology showing promising clinical outcomes. This clinical investigation aims to assess the diagnostic accuracy of the TES HT100 medical device, utilizing electromagnetic fields for endocranial lesion screening.</p><p><strong>Patients and methods: </strong>Patients with mild traumatic brain injury were randomly enrolled according to inclusion criteria. Twenty-three patients recruited from the Intensive Short-Term Observation (ISTO) unit at San Donato Hospital in Arezzo. The sensitivity and specificity of the TES HT were evaluated statistically against cranial computed tomography (CT), the gold standard.</p><p><strong>Results: </strong>A preliminary analysis shows a sensitivity of 100% and a specificity of 100%. Based on these results, there is maximum concordance between the two examinations, and the AUC is 1. No adverse events related to the use of TES HT100 or the examination.</p><p><strong>Conclusion: </strong>The device's ability to differentiate patients with intracranial lesions from those without can streamline the diagnostic and therapeutic process, potentially leading to improved patient outcomes. If Temnography will maintain high standards of sensitivity and specificity with the expansion of the enrolled population, it could be considered as a stable screening tool in the Emergency Room (ER). We could think to apply this technology to reduce the length of stay that patients with mTBI have to spend in ER for observation. Temnography could also be useful in special categories of patients such as pregnant women or the pediatric population. Moreover, another front of future development of this technology could be extending the study to include Territorial Emergency. In this context, Temnography could aid centralized decision-making in patient care.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"313-321"},"PeriodicalIF":1.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808218","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 Retrospective Study of Patiromer as Adjunct to Insulin Therapy for Acute Hyperkalemia in the Emergency Department.","authors":"Pavel Goriacko, Ladan Golestaneh, Katherine E Di Palo","doi":"10.2147/OAEM.S478693","DOIUrl":"10.2147/OAEM.S478693","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical utility of administering patiromer as an adjunct to insulin for potassium reduction in patients presenting to the emergency department (ED) with hyperkalemia.</p><p><strong>Methods: </strong> This retrospective cohort study used electronic health record data to identify adults treated with at least one intravenous dose of regular insulin for hyperkalemia within the ED. Patients who were administered patiromer within one hour before or after their insulin dose were categorized as the intervention group. Matching was performed at a 1:1 ratio. The primary outcome, mean change in potassium from baseline to the latest value within the 4-12 hour interval, was compared. Secondary outcomes included net clinical benefit, defined as the mean difference in the number of potassium-lowering interventions minus the change in potassium.</p><p><strong>Results: </strong>The final analysis included 133 patients treated with patiromer plus insulin and 133 patients treated with insulin alone. Participants had a mean age of 71 years; 43% were female, 31% self-identified as Black, and 38% self-identified as Latinx. No significant changes were observed in potassium from baseline (mean levels 6.2 mEq/L in each group) to the 4-12 hour time frame (patiromer: -0.90 mEq/L, n=78 vs insulin-only: -0.98 mEq/L, n=81; p = 0.51). The calculated net clinical benefit of potassium reduction was -0.25 in favor of the patiromer plus insulin group; however, this difference did not reach statistical significance. In the subgroup of eGFR >30 mL/min, patiromer group received numerically less potassium-lowering interventions (0.63 vs 1.12, p = 0.057).</p><p><strong>Conclusion: </strong>In this study of patients with acute hyperkalemia in the ED setting, concurrent administration of patiromer did not result in more sustained potassium reduction compared to insulin alone in the overall cohort. The trend in favor of adjunct patiromer in the subgroup with adequate renal function warrants further investigation.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"305-312"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802754","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":"Traffic Patterns and Emergency Medical Services Prenotification Transport Estimates in Trauma Activations.","authors":"Sophia Gorgens, Ella R Rastegar, Manuel Beltran Del Rio, Cristy Meyer, Daniel M Rolston, Maria Sfakianos, Eric N Klein, Timmy Li, Rashmeet Gujral, Matthew A Bank, Daniel Jafari","doi":"10.2147/OAEM.S480081","DOIUrl":"10.2147/OAEM.S480081","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether traffic patterns affect the accuracy of emergency medical services (EMS) prediction of transport interval to the emergency department (ED).</p><p><strong>Methods: </strong>Using a retrospective study, we examined all trauma activations at a level one, urban trauma center in Manhasset, New York, between 5/22/2021 and 3/30/2022. Inclusion criteria included patients ≥18 years and arrival by EMS. Field trauma activations involve prenotification communication through a government intermediary. Transport during \"peak hours\" was defined as hospital arrival of EMS between 06:00-10:00 and 16:00-20:00, Monday through Friday. ETI and actual transit interval (ATI) were extracted from the recorded prenotification calls and hospital records respectively. In instances with a time range, the arithmetic mean was used. ATI was defined as the time from prenotification call to arrival at the hospital. A 25% difference between EMS ETI and ATI was chosen to categorize each arrival as overestimated (ATI/ETI < 0.75), accurate (ATI/ETI within 0.75-1.25), and underestimated (ATI/ETI > 1.25). Fisher's exact and Wilcoxon Rank Sum tests were used for comparative analysis as appropriate.</p><p><strong>Results: </strong>Of the 369 trauma transports, 117 had prenotification reports with an ETI and were included in our analysis. Of those, 29 (25%) occurred during peak hours. Overall, EMS more often underestimated ETI (55%) than exactly (32%), or overestimated ETI (12%) (p<0.0001). This was true during peak and off-peak hours with underestimated, accurate, and overestimated arrivals being 59%, 31%, 10% (p<0.01); and 54%, 33%, 12% (p<0.001), respectively. There was no statistically significant difference between peak vs off-peak hours when comparing the proportion of under vs over-estimated times of arrival (p=0.263).</p><p><strong>Conclusion: </strong>While our hypothesis was not borne out, further research on the antecedents of underestimated transport intervals in traumas is warranted. This will allow for targeted solutions to best support EMS clinicians in communicating transport times back to the ED.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"297-303"},"PeriodicalIF":1.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773425","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}