{"title":"Letter to the Editor: Methodological and practice insights on emergency nurses’ experiences of caring for critically ill patients requiring intensive care in the emergency department","authors":"Oscar Fidel Antunez Martinez","doi":"10.1016/j.ienj.2025.101736","DOIUrl":"10.1016/j.ienj.2025.101736","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101736"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736967","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":"A response to “A systematic review of suction-based airway clearance devices for foreign body airway obstruction”","authors":"Simon John Gould","doi":"10.1016/j.ienj.2025.101707","DOIUrl":"10.1016/j.ienj.2025.101707","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101707"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616635","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}
Andrea Toews , Donna Martin , Wanda Chernomas , Kendiss Olafson
{"title":"Emergency nurses’ experiences following resuscitation care: When the adrenaline wears off","authors":"Andrea Toews , Donna Martin , Wanda Chernomas , Kendiss Olafson","doi":"10.1016/j.ienj.2025.101732","DOIUrl":"10.1016/j.ienj.2025.101732","url":null,"abstract":"<div><h3>Aim</h3><div>To explore emergency nurses’ experiences following in-hospital resuscitation events in an adult emergency department and their desired resources for coping. Limited research has been done in this area.</div></div><div><h3>Design</h3><div>Qualitative exploratory design using Lazarus and Folkman’s Transactional Theory of Stress and Coping as a guiding framework.</div></div><div><h3>Methods</h3><div>Digitally recorded, semi-structured interviews conducted by the first author with emergency nurses who volunteered to participate. Digital recordings were transcribed verbatim. Transcripts and the first author’s reflective journals were iteratively read and analyzed using content analysis. The research setting was an adult emergency department in a Western Canadian city.</div></div><div><h3>Data sources</h3><div>Short demographic survey, verbatim transcripts, and the first author’s reflective journals.</div></div><div><h3>Results</h3><div>Eight emergency nurses participated. Most participants were women, employed part-time with an average number of 20 resuscitation events in the previous six months. Three themes were identified: (1) emergency nurses’ experiences of resuscitation – ‘The adrenaline rush,’ (2) emergency nurses’ experiences post-resuscitation – ‘When the adrenaline wears off’ and (3) emergency nurses’ recommendations for policies and resources. Participants described psychological consequences of providing resuscitation care, with profound effects on their personal and professional lives. Moral distress and secondary trauma stress were discussed with recommendations for future policies and resources to support healthcare teams. Improved staffing resources, a mentorship program, and multidisciplinary education for resuscitation teams were recommended.</div></div><div><h3>Conclusion</h3><div>Participants experienced significant moral distress and secondary trauma stress following resuscitation care. Participants provided recommendations for organizational policies and resources to support emergency nurses and resuscitation teams.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101732"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710174","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":"Interventions to reduce overcrowding in emergency departments: An umbrella review","authors":"Eduardo Santos , Ana Carolina Brito , Luana Fonseca , Margarida Figueiredo , Matilde Esteves , Diana Santos","doi":"10.1016/j.ienj.2025.101729","DOIUrl":"10.1016/j.ienj.2025.101729","url":null,"abstract":"<div><h3>Objective</h3><div>To identify and evaluate the effectiveness of interventions and/or strategies to reduce overcrowding in Emergency Departments (EDs).</div></div><div><h3>Method</h3><div>An umbrella review was performed using the JBI method. Eight search resources were considered. Two independent reviewers carried out the selection of studies, quality assessment, data extraction, and synthesis.</div></div><div><h3>Results</h3><div>Twenty systematic reviews were included, which identified several interventions to reduce overcrowding in EDs, such as: joint triage (physicians and nurses); creation of fast tracks; introduction of Rapid Assessment Units; request for auxiliary diagnostic tests by nurses; streaming; collaboration with Primary Health Care (PHC) for referral of non-urgent cases; allocation of PHC units within or adjacent to EDs; triage by PHC professionals; extension of PHC hours; increase in hospital capacity; creation of full capacity protocols; hiring of specialist professionals; lean thinking; reverse triage. The most effective interventions and/or strategies were: joint triage; creation of fast-track routes; introduction of rapid assessment units; request for auxiliary diagnostic tests by nurses; streaming; and collaboration with PHC for referral of non-urgent cases.</div></div><div><h3>Conclusion</h3><div>The combination of effective triage, appropriate flow management, and proactive action by the team appears to be key to mitigating overcrowding in the EDs. Joint triage and fast-track routes are the most effective measures. The expanded role of nurses − including their ability to request examinations and manage rapid assessment units − is also crucial to speeding up care.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101729"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685138","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}
Jenni Hirvikallio , Pauliina Hackman , Ari Haaranen , Tarja Kvist
{"title":"Leadership in emergency medical services: An integrative literature review","authors":"Jenni Hirvikallio , Pauliina Hackman , Ari Haaranen , Tarja Kvist","doi":"10.1016/j.ienj.2026.101750","DOIUrl":"10.1016/j.ienj.2026.101750","url":null,"abstract":"<div><h3>Background</h3><div>Leadership style in nursing has been associated with job satisfaction and patient outcomes. However, leadership research in emergency medical services (EMS) is limited and often emphasizes clinical encounters rather than system-level leadership.</div></div><div><h3>Objective</h3><div>This integrative review aimed to explore how leadership in EMS has been described in scientific research, to provide an overview of key themes, and to generate a synthesis that supports leadership development.</div></div><div><h3>Methods</h3><div>Searches were conducted in CINAHL, Scopus, and PubMed. Studies focused on clinical leadership were excluded. Two independent reviewers screened and critically appraised 17 articles, synthesizing the findings using a structured, integrative, and inductive approach to identify key EMS leadership themes.</div></div><div><h3>Results</h3><div>The included studies were thematically heterogeneous. Five key themes emerged: leadership models and styles, personnel management, communication and interaction, employee competence development and quality assurance, and transition into leadership roles. The literature showed limited coherence, and few studies examined leadership styles in detail.</div></div><div><h3>Conclusions</h3><div>Leadership in EMS is complex and context dependent. The relationship between transformational leadership, employee well-being, and system or patient outcomes has not been sufficiently studied. Although transformational leadership appears well-suited to EMS’s dynamic and high-pressure environment, it remains underutilized and underexplored.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101750"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977039","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}
Dain Lee , Soyoung Kim , Jaehoon Kim , Joohee Chung , Sunhee Yun , Yeonhee Lee , Il Hyun Lee , Hanjong Park
{"title":"Interventions according to patient severity in an emergency department based short stay unit: Nursing intervention classification and social network analysis","authors":"Dain Lee , Soyoung Kim , Jaehoon Kim , Joohee Chung , Sunhee Yun , Yeonhee Lee , Il Hyun Lee , Hanjong Park","doi":"10.1016/j.ienj.2025.101730","DOIUrl":"10.1016/j.ienj.2025.101730","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the operational performance of a short stay unit (SSU) and emergency department (ED) and identify the patterns of nursing interventions provided simultaneously to critically ill patients according to the severity of illness in the SSU using the Nursing Intervention Classification System and social network analysis.</div></div><div><h3>Methods</h3><div>This is a retrospective descriptive study. Data were collected from the electronic medical records of critically ill patients admitted to the SSU and ED of a university-affiliated tertiary general hospital between 1 June 2020 and 31 May 2022.</div></div><div><h3>Results</h3><div>Among the 48,985 ED visits for medical treatment before the SSU was launched, 2,289 (4.7 %) were hospitalised with severe illnesses. Among the 50,650 ED visits for medical treatment after the launch of the SSU, 2820 (5.5 %) were hospitalised with severe illnesses. A total of 551 patients with severe illnesses were admitted to the SSU via the ED during the study period. The respective occupancy rates of the SSU and ED were 25.2 % and 111.3 %. The median length of stays in the ED before and after the launch of the SSU were 8.05 h and 8.75 h. The SSU helped buffer the ED from receiving 531 more patients with severe illnesses without meaningfully increasing ED crowding. As patient severity increased, so did the need for complex physiological care, increasing from 48.3% in Class I to 56.9% in Class IV. Meanwhile, safety and health system-related interventions were more frequently provided to less severe patients, rising from 11.8 % and 8.5 %. in Class IV to 17.6 % and 14.7 % in Class I, respectively. Social network analysis showed that the clustering of emergency care was consistently centralised, regardless of severity, with ventilatory support and metabolic interventions becoming more prominent as patient severity increased.</div></div><div><h3>Conclusions</h3><div>This study provided a comprehensive understanding of the evolving priorities of nursing interventions across patient severity levels at the SSU of a tertiary general hospital. This study can serve as a reference to enable nurses to efficiently provide complex and interrelated nursing interventions for patients, ultimately improving patient outcomes in acute care settings. These insights may help other general hospitals refine their acute care models and guide future research on best practices for managing critically ill patients outside traditional ICU settings<strong>.</strong></div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101730"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716381","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}
Moutasem A. Zakkar , Fariba Kolahdooz , Kate Kerber , Farzad Akbaryan , Adrian Wagg , Debbie DeLancey , André Corriveau , Sangita Sharma
{"title":"Perception and experience of patients in the emergency department in Edmonton, Canada: A qualitative study","authors":"Moutasem A. Zakkar , Fariba Kolahdooz , Kate Kerber , Farzad Akbaryan , Adrian Wagg , Debbie DeLancey , André Corriveau , Sangita Sharma","doi":"10.1016/j.ienj.2025.101731","DOIUrl":"10.1016/j.ienj.2025.101731","url":null,"abstract":"<div><h3>Introduction</h3><div>Patient experiences in emergency departments (EDs) may be suboptimal due to increasing patient volumes and constrained hospital resources. This study explores patient experiences in EDs in Edmonton, Alberta, Canada.</div></div><div><h3>Methods</h3><div>This study reports findings from a qualitative descriptive study conducted as part of the CARE project. Individuals experiencing socioeconomic disadvantages and having visited an ED in Edmonton within the past 12 months were recruited from two distinct settings—one hospital ED and four community organizations—using purposive sampling.</div><div>Quantitative data from closed-ended questions were used to describe participant characteristics and healthcare access, while qualitative data were analyzed thematically. The study adhered to the Consolidated Criteria for Reporting Qualitative Research.</div></div><div><h3>Results</h3><div>The study included 192 participants: 120 were interviewed in a hospital ED (46.7% women, 37.5% Indigenous, 60% unemployed), and 72 were interviewed in community-based organizations (59.7% women, 68.1% Indigenous, 94.4% unemployed). While most participants reported satisfactory experiences, others described unsatisfactory encounters. Positive experiences were linked to perceptions of health needs being met, while negative ones were associated with racism, accessibility barriers, long wait times, and poor communication. Quantitative data also revealed limited availability of primary care services and access to needed healthcare professionals. Suggestions for improvement included enhancing communication and expanding primary care capacity.</div></div><div><h3>Conclusions</h3><div>Wait times, communication, service accessibility, availability, and discrimination are key challenges affecting ED experiences. Addressing these issues requires strategic investments in primary care, ED staffing, and culturally safe care practices to improve equity, responsiveness, and patient experience.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101731"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726758","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":"Oculocardiac reflex: An underrecognized indication for surgical orbital fracture repair","authors":"John Ramos","doi":"10.1016/j.ienj.2025.101740","DOIUrl":"10.1016/j.ienj.2025.101740","url":null,"abstract":"<div><div>The oculocardiac reflex, a variant of the trigeminocardiac reflex, is a brainstem-mediated vagal response to stimulation of the trigeminal nerve’s ophthalmic branch. In orbital trauma, particularly fractures with extraocular muscle entrapment, the oculocardiac reflex can present as bradycardia, arrhythmia, or asystole. While the oculocardiac reflex has an established association with “trapdoor” fractures in pediatric patients and is increasingly reported in adults. Entrapment-related oculocardiac reflex is an accepted but under recognized indication for urgent surgical release. This clinical practice update synthesizes current evidence on oculocardiac reflex and other indications for surgical consultation in adults with orbital fractures, as well as modern perspectives on the impact of surgery on diplopia resolution.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101740"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037182","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":"Unprepared and under pressure: Transitioning experiences to emergency nursing in rural and remote areas","authors":"Danielle Rogers , Pauline Calleja , Amy-Louise Byrne , Ashlyn Sahay","doi":"10.1016/j.ienj.2025.101733","DOIUrl":"10.1016/j.ienj.2025.101733","url":null,"abstract":"<div><h3>Introduction</h3><div>Access to quality healthcare in rural and remote Australia remains a significant challenge, with registered nurses (RNs) often the sole face-to-face healthcare provider. Emergency care in these settings requires adaptable, highly skilled RNs capable of managing critical and deteriorating patients with limited support. A gap remains in preparing RNs for these complex demands. The aim of this research was to explore the experiences and preparedness of non-emergency trained RNs, new to the rural and remote environment in managing emergency care.</div></div><div><h3>Methods</h3><div>A qualitative exploratory descriptive design was used to explore the experiences of non-emergency trained RNs in rural and remote settings. Semi-structured interviews were conducted and transcribed verbatim. Data was analysed using thematic analysis. COREQ guidelines were followed.</div></div><div><h3>Results</h3><div>23 RNs were divided into two cohorts: experienced rural and remote RNs and those new to the rural and remote context. Thematic analysis revealed three core themes: (1) It is more complex than preparedness, (2) Securing the future success of rural and remote RNs and (3) The good, the bad and finding the ‘in between’. Participants highlighted a disconnect between metropolitan and rural healthcare expectations and emphasised the need for context-specific training, ongoing professional growth, and a culturally responsive, community integrated approach. Findings indicate unpreparedness extends beyond clinical skills to include confidence, community engagement, and cultural competence. This lack of preparedness impacts job satisfaction, confidence, and the ability to manage rural healthcare complexities, ultimately influencing nursing retention rates globally.</div></div><div><h3>Conclusion</h3><div>Rural and remote RNs face challenges including limited resources and professional isolation. Findings underline the importance of tailored education, self-reflection and realistic recruitment strategies to support and retain RNs in rural and remote settings and ensure sustainable healthcare in rural and remote communities.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101733"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821791","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}