Frontiers in Disaster and Emergency Medicine最新文献

{"title":"Advances and challenges in mechanical support for cardiogenic shock complicating acute myocardial infarct: a comprehensive review of the latest data","authors":"A. Papanikolaou, D. Chlorogiannis, A. Apostolos, Theodoros Mavridis, G. Tsigkas","doi":"10.3389/femer.2024.1374291","DOIUrl":"https://doi.org/10.3389/femer.2024.1374291","url":null,"abstract":"Cardiogenic Shock represents a life-threatening condition characterized by high mortality and a spectrum of clinical presentations, complicating ~5%−10% of patients presenting with Acute Coronary Syndromes. Despite advances in interventional cardiology and emergency medicine, mortality rates remain extremely high and evidence concerning its management is scarce. Consequently, the decision making relies heavily on a single operator's experience. This comprehensive review aims to provide a thorough update on the latest proof regarding mechanical circulatory support devices of the left ventricle and examines the role of the classification scores on the selection of the appropriate patient and timing for the initiation of the device. The five necessary steps to a successful mechanical circulatory support device's insertion. The picture was made by Pixlr AI Image Generator.","PeriodicalId":502453,"journal":{"name":"Frontiers in Disaster and Emergency Medicine","volume":"14 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141341388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and implementation of a rehabilitation triage algorithm for disasters in the subacute phase: an experience from the 2024 Noto peninsula earthquake","authors":"Shigehito Shiota, Naoya Orita, Yuma Tsubakita, Masaya Ichimoto, Noboru Shimada, Naoya Goto, Tomohiro Hirota, Shunsuke Taito, Kazuhiko Hirata, Yukio Mikami","doi":"10.3389/femer.2024.1387704","DOIUrl":"https://doi.org/10.3389/femer.2024.1387704","url":null,"abstract":"Early rehabilitation during disasters such as earthquakes is an important but often undervalued responsibility of medical teams. Both the development of simple tools for assessing the life functioning of evacuees and the standardization of intervention methods are urgent issues in disaster rehabilitation. The Japanese Rehabilitation Assistance Team (JRAT), an officially recognized organization consisting of 10 suborganisations, was established after gaining important experience with disaster rehabilitation in the aftermath of the Great East Japan Earthquake. We, the Hiroshima JRAT, were dispatched to the Monzen area of Wajima City to support disaster recovery after the 2024 Noto Peninsula Earthquake. Since disaster rehabilitation assistance was not well established in the Monzen area of Wajima City, the medical team consulted JRAT for guidance on triaging evacuees based on their life functioning. We developed a rehabilitation triage algorithm that classifies evacuees into four triage tags based on their ability to perform three simple movements: sitting up, standing up from the floor, and one-leg standing. In our triage algorithm, an inability to sit up is classified as a red tag (difficulty living in a shelter without assistance), an inability to stand up from the floor is classified as a yellow tag (individual intervention: introduction of beds and handrails), one-leg standing for < 2 s is classified as a green tag (group intervention: installation of toilets and bath rails and use of walkers to prevent falls), and standing on one leg for more than 2 s is classified as a white tag (independent in ADLs). We worked with medical teams to triage 922 evacuees in 27 evacuation centers, resulting in the extraction of four red and eight yellow evacuees in 1 day. Our rehabilitation triage system has the potential to be a simple assessment tool for classifying the life functioning of disaster victims and linking them to appropriate supports.","PeriodicalId":502453,"journal":{"name":"Frontiers in Disaster and Emergency Medicine","volume":"93 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141352728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with anxiety about handling contaminated patients during a nuclear disaster among disaster medical assistant teams in Japan: a cross-sectional study","authors":"Hisami Shibata, Takumi Yamaguchi, Yumiko Yamada, Tetsuko Shinkawa, H. Urata, Yuko Matsunari","doi":"10.3389/femer.2024.1361236","DOIUrl":"https://doi.org/10.3389/femer.2024.1361236","url":null,"abstract":"Japanese Disaster Medical Assistance Teams (DMATs) are pivotal in disaster response, especially during nuclear crises. The objective of this study was to identify factors associated with anxiety among Japanese DMAT personnel when handling contaminated patients during nuclear disasters.In this cross-sectional study, 609 Japanese DMAT members from Kyushu and Okinawa, Japan, were surveyed. Multivariate binomial logistic regression was used to determine anxiety predictors.Of the 276 respondents, 77.2% expressed anxiety about managing contaminated patients. Women and younger team members expressed the highest level of anxiety associated with handling contaminated patients during nuclear disasters.This study revealed heightened anxiety among female and younger Japanese DMAT personnel regarding the handling of contaminated patients during nuclear disasters. Targeted training addressing these concerns is essential for effective disaster response.","PeriodicalId":502453,"journal":{"name":"Frontiers in Disaster and Emergency Medicine","volume":" 71","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140692256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: Successful extracorporeal cardiopulmonary resuscitation despite severe metabolic acidosis after refractory out-of-hospital cardiac arrest","authors":"Loreta Kavaliukaite, Anca-Isabela Diaconescu, Doris Eis, K. Slankamenac","doi":"10.3389/femer.2024.1328502","DOIUrl":"https://doi.org/10.3389/femer.2024.1328502","url":null,"abstract":"Current guidelines suggest considering extracorporeal cardiopulmonary resuscitation (ECPR) in refractory cardiac arrest and provide some guidance for favorable prognostic factors. However, inclusion and exclusion criteria are not strictly defined. We describe a 60-year-old male who underwent extracorporeal life support (ECLS) following refractory out-of-hospital cardiac arrest and made a full neurological recovery despite severe metabolic derangements, including a pH of 6.6 and lactate of 29 mmol/l. The aim is to present a favorable neurological outcome after ECPR despite severe significant physiologic derangements and put relative contraindications for ECPR into perspective.","PeriodicalId":502453,"journal":{"name":"Frontiers in Disaster and Emergency Medicine","volume":"16 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139609479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient factors associated with survival after critical care interhospital transfer","authors":"Andrew P. Reimer, Wei Dai, N. Schiltz, Jiayang Sun, S. Koroukian","doi":"10.3389/femer.2023.1339798","DOIUrl":"https://doi.org/10.3389/femer.2023.1339798","url":null,"abstract":"To identify the factors that predict mortality post-transfer and develop a comprehensive mortality prediction model capable of supporting pre-transfer decision making.Electronic health record data from the Medical Transport Data Repository of a large health system hospital in Northeast Ohio that consists of a main campus and 11 affiliated medical centers. We retrospectively analyzed patient data from the referring hospital encounter prior to interhospital transfer. All patient data including diagnoses, laboratory results, medication, and medical and social history were analyzed to predict in-hospital mortality post-transfer. We employed a multi-method approach including logistic regression, gradient boosting, and multiple correspondence analysis to identify significant predictors of mortality as well as variables that are clinically useful to inform clinical decision support development. We identified all patients aged 21 and older that underwent critical care transfer in the health system between 2010 and 2017.We found that age, laboratory results (albumin, INR, platelets, BUN, leukocyte, hemoglobin, glucose), vital signs (temperature, respirations, pulse, systolic blood pressure, pulse oximetry), and ventilator usage are the most predictive variables of post-interhospital transfer mortality. Using structured data from the EHR we achieved the same performance as APACHE IV within our health system (0.85 vs. 0.85). Lastly, mode of transport alone was not a significant predictor for the general population in any of the outcome models.Our findings provide a foundation for the development of decision support tools to guide transport referrals and identified the need for further inquiry to discern the role of mode of transport to enable future inclusion in decision support approaches. Further inquiry is needed to identify factors that differentiate patients not triaged as time-sensitive transfers but still require helicopter intervention to maintain or improve post-interhospital transfer morbidity and mortality.","PeriodicalId":502453,"journal":{"name":"Frontiers in Disaster and Emergency Medicine","volume":"48 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139448115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}