International Emergency Nursing最新文献

{"title":"Audit and re-audit regarding the current practice of ABCDE approach in the emergency department at selected university hospitals in Syria","authors":"Ahmad Batieh ,&nbsp;Nagham Alsaid Abdullah Altwer ,&nbsp;Abdulkader Mehli ,&nbsp;Mohamed Amsha ,&nbsp;Batoul Al Zoubi ,&nbsp;Zafer Hadaki ,&nbsp;Bayan Alsaid","doi":"10.1016/j.ienj.2025.101691","DOIUrl":"10.1016/j.ienj.2025.101691","url":null,"abstract":"<div><h3>Background</h3><div>The ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) is crucial for the initial assessment and treatment of critically ill patients. However, previous studies have shown suboptimal adherence to this protocol, highlighting the need for clinical audits.</div></div><div><h3>Aim</h3><div>To evaluate the extent of application of the ABCDE approach and to discover the obstacles that prevent them from being applied in internal emergency Department at selected university hospitals in Syria.</div></div><div><h3>Methods</h3><div>A clinical audit was conducted over two cycles at two university hospitals (hospital A and B), involving 160 patients. The first cycle took place from November 6 to November 19, 2023, and the second one from March 31 to April 9, 2024. Twenty-nine criteria based on World Health Organization guidelines were assessed using a checklist completed by a data collection group. The snapshot sampling method was used in determining the sample size and the convenient method to select patients. After the first cycle, findings were presented locally, leading to formulated recommendations.</div></div><div><h3>Results</h3><div>Both Hospitals showed improvement in compliance rates over the second cycle. Hospital A achieved 17.2% in the second cycle, while hospital B reached 20.6%. Hospital B had fewer declines and more criteria met, indicating a more favourable trend in patient care standards overall.</div></div><div><h3>Conclusion</h3><div>The audit also identified barriers to adherence, such as issues related to wearing gloves and ensuring patient privacy. The study concluded that regular clinical audits enhance the application of the ABCDE approach and improve healthcare delivery, emphasizing the need for ongoing research in this area.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101691"},"PeriodicalIF":1.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201454","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":"The impact of person-centered care on pain control and experiences of trauma patients in the emergency department: a clinical trial study","authors":"Nesa Khademi ,&nbsp;Mohammad Gholami ,&nbsp;Behzad Moradi ,&nbsp;Ayat Ghasemi ,&nbsp;Yaser Mokhayeri ,&nbsp;Hamid Taheri","doi":"10.1016/j.ienj.2025.101685","DOIUrl":"10.1016/j.ienj.2025.101685","url":null,"abstract":"<div><h3>Background</h3><div>Although person-centered care is a fundamental aspect of nursing, its effective implementation in acute healthcare settings remains challenging. The current study aimed to determine the impact of person-centered care on pain control and the experiences of trauma patients in the emergency department (ED).</div></div><div><h3>Methods</h3><div>This randomized clinical trial included 88 trauma patients admitted to the ED, who were allocated via block randomization into two groups: the intervention group (n = 44) and the control group (n = 44). The intervention group received person-centered care focusing on two components: 1) pain management and 2) therapeutic communication/trauma-informed care. The control group received routine emergency care. Outcomes were measured using the Numerical Rating Scale (NRS) for pain, the Pain Management Satisfaction Scale (PMSS), and the Accident and Emergency Department Questionnaire (AEDQ). Data were analyzed using STATA-14 software, with Repeated Measure and paired t-tests applied for statistical analysis.</div></div><div><h3>Results</h3><div>The results showed no statistically significant difference in pain intensity during triage between the two groups (P = 0.091). However, upon discharge from the ED, the mean scores for pain management satisfaction and patient experiences were significantly higher in the intervention group (22.61 and 20.88, respectively) compared to the control group (8.40 and 39.99, respectively) (P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The findings suggest that incorporating principles of person-centered care such as patient participation, attention to preferences, and nurse-led pain management during triage, can enhance satisfaction and foster positive experiences among trauma patients in the ED.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101685"},"PeriodicalIF":1.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159416","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":"Evaluation of an advanced nurse practitioner led emergency rapid assessment and treatment service","authors":"Doireann Deay ,&nbsp;Orla O’Keefe ,&nbsp;Mary Byrne ,&nbsp;Barry McBrien ,&nbsp;Aileen McCabe","doi":"10.1016/j.ienj.2025.101684","DOIUrl":"10.1016/j.ienj.2025.101684","url":null,"abstract":"<div><h3>Background</h3><div>Emergency Departments (EDs) globally face persistent challenges, including overcrowding and workforce shortages, which negatively impact care quality and efficiency. Advanced Nurse Practitioners (ANPs) have demonstrated value in improving patient satisfaction, reducing wait times, and delivering cost-effective care. In Ireland, the ANP role is well-defined and regulated, supporting autonomous clinical practice.</div></div><div><h3>Local problem</h3><div>At Tallaght University Hospital (TUH), a significant proportion of ED presentations—abdominal pain, and chest pain was found to consume disproportionate clinical hours. A new ANP-led Emergency Rapid Assessment and Treatment (ERAT) service was introduced to target these low-acuity, high-contact-hour cohorts and alleviate ED pressures.</div></div><div><h3>Method</h3><div>This service evaluation, conducted between September 2022 and April 2025, assessed ERAT’s feasibility, safety, impact on ED process times, and patient satisfaction.</div></div><div><h3>Results</h3><div>ERAT managed 2,518 patients, with no major adverse events or in-hospital deaths. Most patients (1,766, 74.8 %) were safely discharged. While overall ED length of stay did not differ, ERAT patients had significantly shorter clinician-to-discharge times (5.9 vs. 8.9 h, p &lt; 0.05). Of the 56 abdominopelvic CT scans ordered, 42 scans (75 %) showed acute pathology. Eighty of the 85 (94.1 %) patients who completed a patient satisfaction questionnaire reported strong agreement that care met their expectations.</div></div><div><h3>Conclusion</h3><div>The ERAT service is a feasible, safe, and patient-centred model for managing targeted ED presentations. Findings support ANP-led services as an effective strategy to enhance ED efficiency, optimize care delivery, and improve patient satisfaction in acute care settings.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101684"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159418","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":"Reasons for hospital admissions in children with chronic diseases during the COVID-19 pandemic: A retrospective study","authors":"Zehra Çapa ,&nbsp;Gülendam Karadağ","doi":"10.1016/j.ienj.2025.101689","DOIUrl":"10.1016/j.ienj.2025.101689","url":null,"abstract":"<div><h3>Background</h3><div>This study was conducted to investigate the reasons for hospital admissions in children with chronic diseases during the COVID-19 pandemic.</div></div><div><h3>Objective</h3><div>A descriptive and retrospective study design was employed.</div></div><div><h3>Methods</h3><div>The study included the records of children (1,018 children) who had been diagnosed with chronic diseases and had presented to the pediatric polyclinics, pandemic polyclinics, and emergency departments of a state hospital between April 1, 2020 and March 31, 2021. For the disease diagnoses of the children, the ICD 10 codes entered into the system for the most common diseases seen in children, like epilepsy, asthma, and cerebral palsy, were searched. Descriptive statistical methods (frequencies and percentages) were used to analyze the data; no statistical significance testing or group comparisons were conducted.</div></div><div><h3>Results</h3><div>The mean age was 8.74 ± 4.63 years. It was found that 32.58 % of the children with epilepsy and 19.77 % with asthma had presented to the pediatric emergency department with fever and 26.32 % of those with cerebral palsy had presented with nausea and vomiting. A total of 212 PCR samples had been taken from children, and PCR test results of 15.57 % were positive. The procedures applied to the children during outpatient clinic presentations were ‘examination’ for girls (38.88 %) and boys (37.41 %) with epilepsy, ‘examination and test requests’ for girls with asthma (23.35 %), and ‘examination and prescription’ for boys with asthma (22.35 %), and ‘examination’ for both girls (39.18 %) and boys (33.90 %) with cerebral palsy.</div></div><div><h3>Conclusion</h3><div>It was found that the majority of children diagnosed with epilepsy had presented to pediatric neurology, those with asthma to pediatric allergy, and those with cerebral palsy to pediatric neurology departments. The most frequently performed procedures in children with epilepsy, asthma, and cerebral palsy were physical examination, test requests, prescription issuance, disability report issuance, and preparation of medication reports.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101689"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159364","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":"Patterns of pediatric emergency department visits in a tertiary women’s and children’s hospital in China: A 2021 retrospective analysis","authors":"Jing Zhao ,&nbsp;Juan Hu ,&nbsp;Liqing He","doi":"10.1016/j.ienj.2025.101690","DOIUrl":"10.1016/j.ienj.2025.101690","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the pediatric ED visits in a hospital in China.</div></div><div><h3>Methods</h3><div>This was a retrospective cross-sectional study of 198,628 pediatric ED visits to a women’s and children’s hospital in China from January 1 to December 31, 2021. Data concerning patient name, gender, age, registration number, home address, chief complaints, medical history, date of visit, time of visit, triage levels, wait time for treatment, physician name, diagnosis, and disposition were obtained from the hospital information system.</div></div><div><h3>Results</h3><div>There were more male patients (55.128 %) than female patients (44.872 %). The patients aged ≥3 years but &lt;6 years accounted for the largest proportion (33.235 %). The numbers of patients triaged to levels 1, 2, 3, and 4 were 128 (0.06 %), 1164 (0.59 %), 14,560 (7.33 %), and 182,776 (92.02 %), respectively. Patients with diseases of the respiratory system accounted for 66.45 %. Pediatric diseases originating in the perinatal period were the primary ones in patients triaged to levels 1, 2, and 3.</div></div><div><h3>Conclusions</h3><div>Non-urgent patients accounted for a large proportion of pediatric ED patients. Dissemination of information concerning the prevention and treatment of common symptoms of pediatric diseases should be strengthened.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101690"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159419","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":"When do emergencies happen? Exploring circadian, weekly, and seasonal trends in ambulance calls in Cyprus","authors":"Andreas Protopapas ,&nbsp;Ioannis Mamais ,&nbsp;Riana Constantinou ,&nbsp;Stelios Iordanou ,&nbsp;Maria Prodromou ,&nbsp;Stelios Mappouras ,&nbsp;Efthyvoulos Kyriacou","doi":"10.1016/j.ienj.2025.101686","DOIUrl":"10.1016/j.ienj.2025.101686","url":null,"abstract":"<div><h3>Objectives</h3><div>The demand for ambulances has steadily risen over the past few decades, straining Emergency Medical Services (EMS) and emergency departments (EDs). Understanding the temporal patterns of emergency calls can improve ED patient flow. The aim of this study was to analyze the overall demand for emergency ambulance calls in Cyprus focusing on call reasons, time of day, day of the week, and year season.</div></div><div><h3>Method</h3><div>This retrospective descriptive study analyzed emergency call data from the Cyprus Ambulance Service (2018–2022). Descriptive statistics summarized emergency call distributions by priority level, year season, weekday, and time of day. Frequencies and percentages were reported, and chi-square tests assessed differences (p &lt; 0.05). Statistical analysis was performed using STATA v14, with results presented in tables and figures.</div></div><div><h3>Results</h3><div>A total of 148,043 emergency calls were analyzed, with RED (32.5 %) (high priority) and BLACK (11.1 %) (lowest priority – dead patient) cases peaking in winter (27.9 %), followed by spring (27.7 %). Monday recorded the highest overall demand (14.9 %), while RED emergencies peaked on Fridays and Sundays (14.7 %). The highest call volume occurred between 8 am and 12 pm (25.1 %), reflecting increased daytime activity. The most common emergency categories were unwell patients (25 %), falls (11 %), respiratory problems (10 %), and road traffic accidents (9 %), with their frequency varying throughout the day. Notably, traffic accidents were most frequent between 1 pm and 7 pm, particularly on Mondays and Fridays, while other medical emergencies exhibited peak demand in the late morning and early evening hours.</div></div><div><h3>Conclusion</h3><div>Emergency ambulance calls in Cyprus peaked in winter, especially severe cases (despite the fact that Cyprus population is more than double during summer due to tourism). Weekly trends showed highest demand on Mondays, while life-threatening cases increased on Fridays and Sundays. The most frequent call reasons displayed distinct daily and weekly patterns.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101686"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159417","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":"Factors influencing triage competence in emergency nurses: The role of resilience, social support, and work-related factors","authors":"JianMei Chen ,&nbsp;JiaHui Ma ,&nbsp;Ao Zhao ,&nbsp;XueHuan Huang","doi":"10.1016/j.ienj.2025.101681","DOIUrl":"10.1016/j.ienj.2025.101681","url":null,"abstract":"<div><h3>Aims</h3><div>This multi-center cross-sectional correlational study examined whether psychological resilience, perceived social support, and work-related factors were independently associated with triage competence among emergency nurses.</div></div><div><h3>Background</h3><div>Triage nurses play a vital role in emergency care, yet factors shaping their competence remain underexplored. Psychological resilience and social support may significantly impact performance. Understanding these influences is crucial for targeted interventions. <em>Design:</em>A cross-sectional study was conducted from May to December 2024, involving 291 emergency triage nurses from 30 hospitals across China.</div></div><div><h3>Methods</h3><div>Data were collected via self-administered questionnaires using multi-center convenience sampling. Instruments included the Triage Competence Scale, Psychological Resilience Scale, and Perceived Social Support Scale. Analyses comprised descriptive statistics, ANOVA, t-tests, and multiple linear regression.</div></div><div><h3>Results</h3><div>In the multivariable model including 14 candidate predictors, career development prospects (<em>p</em> = 0.001), work environment (<em>p</em> = 0.040), internal resilience (<em>p</em> &lt; 0.001), and family support (<em>p</em> = 0.040) were independently associated with higher triage competence. The model explained 66.6 % of the variance (adjusted R² = 0.666; F (14, 276) = 42.219, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div><strong>Career</strong> prospects, a supportive work environment, resilience, and family support significantly influence triage competence. Improving triage competence requires targeted interventions, including resilience training, career development programs, and supportive work environments, to enhance nurse performance and ultimately improve patient outcomes.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101681"},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119007","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":"Evaluation of the effect of Z-track technique training on emergency nurses: A single-group pretest–posttest study","authors":"Nadiye Barış Eren","doi":"10.1016/j.ienj.2025.101683","DOIUrl":"10.1016/j.ienj.2025.101683","url":null,"abstract":"<div><h3>Aim</h3><div>This quasi-experimental single-group pretest–posttest study aimed to evaluate the effect of Z-track technique training on emergency nurses.</div></div><div><h3>Methods</h3><div>The study was conducted among 75 nurses working at a state hospital in Türkiye from July to October 2023. Participants completed a descriptive characteristics form, a knowledge suggestions form, a Z-track technique skill checklist, and a Z-track technique usage frequency form. Descriptive statistics and within-group changes in repeated measurements were analyzed using a dependent-samples <em>t</em>-test. The significance level was set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Prior to training, the participants’ mean knowledge suggestions score was 5.720, which increased to 11.880 after training (p &lt; 0.001). The mean Z-track technique skill checklist score also increased from 1.960 pre-training to 7.520 post-training (p &lt; 0.001). In addition, the mean Z-track technique usage frequency increased from 0.150 before training to 3.670 1 month after training (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This study demonstrated that training improved the nurses’ knowledge and skills related to the Z-track technique, leading to increased usage frequency 1 month later. Retention of knowledge and skills was supported by applying the technique in clinical practice. Since theoretical and practical training is often forgotten without regular application, implementing evidence-based standard procedures and in-service training programmes is essential to keep nurses’ competencies up to date. These programmes should focus on critical steps for safe injection practices, include hands-on training, and utilize positive reinforcements to enhance professional competence and ensure patient safety.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101683"},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109322","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":"Effectiveness of AI-assisted ESI triage on accuracy and selected outcomes in emergency nursing: A systematic review","authors":"Aekkachai Fatai ,&nbsp;Chakrit Sattayarom ,&nbsp;Wiwat Laochai ,&nbsp;Ekkalak Faksook","doi":"10.1016/j.ienj.2025.101680","DOIUrl":"10.1016/j.ienj.2025.101680","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the effectiveness of artificial intelligence (AI) assisted Emergency Severity Index (ESI) triage systems in improving triage accuracy, selected outcomes including under-triage and over-triage, waiting time and patient workflow, and barriers to implementation in emergency nursing.</div></div><div><h3>Design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>A narrative synthesis was used to evaluate findings from eligible studies. The Mixed Methods Appraisal Tool (MMAT) was applied for quality assessment. Studies were included if they examined AI-assisted ESI triage systems involving emergency nurses and reported on triage performance and implementation challenges.</div></div><div><h3>Data Sources</h3><div>Search was performed in CINAHL, Medline, PsycINFO, PubMed, and Google Scholar for English-language articles published between 2018 and 2025.</div></div><div><h3>Results</h3><div>Ten studies met the inclusion criteria. AI-assisted ESI triage systems improved accuracy, demonstrating higher AUC, F1 score, sensitivity, and specificity compared to traditional triage nursing. These systems also reduced rates of over-triage and under-triage, minimized long waiting times, and enhanced patient flow. However, barriers included reliance on retrospective data, the need for model validation, and potential resistance from nurses.</div></div><div><h3>Conclusion</h3><div>AI-assisted ESI triage systems demonstrate promising benefits in enhancing triage accuracy and efficiency in emergency nursing. While AI can be a valuable decision-support tool, it should complement rather than replace clinical judgment. Integrating AI into emergency triage may streamline workflows, reduce workload, and improve the accuracy of patient assessments.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101680"},"PeriodicalIF":1.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097130","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":"“Are prehospital shock, modified shock, age-adjusted shock indices and some scoring systems effective in predicting the prognosis of high-energy trauma Patients?”","authors":"Melih Yüksel,&nbsp;Mehmet Oğuzhan Ay,&nbsp;Fatma Betül Çalışkan,&nbsp;Ayşe Kılıç,&nbsp;Mustafa Tolga Özdal,&nbsp;Atakan Aydoğan,&nbsp;Yeşim İşler,&nbsp;Halil Kaya","doi":"10.1016/j.ienj.2025.101678","DOIUrl":"10.1016/j.ienj.2025.101678","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to investigate whether prehospital shock index (SI), modified shock index (MSI), age-adjusted shock index (ASI), Rapid Emergency Medicine Score (REMS), and Triage in Emergency Department Early Warning Score (TREWS) are effective in predicting the need for blood replacement, emergency surgical intervention, and first 24 h and 28 days mortality in high-energy trauma patients.</div></div><div><h3>Methods</h3><div>Patients brought to a single-center, tertiary care emergency department by ambulance due to high-energy trauma between 01.08.2023 and 31.01.2024 were prospectively analyzed.</div></div><div><h3>Results</h3><div>A total of 209 patients meeting the study criteria were included. In blood replacement estimation in the emergency department, the area under the curve (AUC) value of MSI was found to be 0.789 (p &lt; 0.001), SI was 0.783 (p &lt; 0.001), and ASI was 0.688 (p = 0.016). For the prediction of emergency surgical intervention, the AUC value of SI was 0.784 (p &lt; 0.001), MSI was 0.760 (p &lt; 0.001) and TREWS was 0.641 (p = 0.043). As for the first 24 h mortality prediction, the AUC value of ASI was 0.872 (p &lt; 0.001), MSI was 0.768 (p = 0.007), TREWS was 0.980 (p &lt; 0.001), and REMS was 0.831 (p = 0.001). Finally, in the first 28-day mortality prediction, the AUC value of ASI was 0.759 (p = 0.001), TREWS was 0.942 (p &lt; 0.001), and REMS was 0.826 (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In high-energy trauma patients, prehospital SI and MSI indicated the best performance in predicting both blood replacement in the emergency department and emergency surgical intervention. We found that the prehospital TREWS showed the best performance in predicting mortality in the first 24 h and 28 days.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101678"},"PeriodicalIF":1.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087952","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}