American Journal of Emergency Medicine最新文献

{"title":"Effect of real-time carbon dioxide sensing stylet-assisted endotracheal intubation: A case-crossover manikin simulation study","authors":"Yoonjic Kim MD ,&nbsp;Yoon Ha Joo PhD ,&nbsp;Ki Hong Kim MD, PhD ,&nbsp;Dong Hyun Choi MD ,&nbsp;Hyun Jeong Kang MS ,&nbsp;Ki Jeong Hong MD, PhD ,&nbsp;Kyoung Jun Song MD, PhD ,&nbsp;Sang Do Shin MD, PhD","doi":"10.1016/j.ajem.2025.05.047","DOIUrl":"10.1016/j.ajem.2025.05.047","url":null,"abstract":"<div><h3>Background</h3><div>Endotracheal intubation is an important emergency procedure, especially in critical care settings. Capnography-guided intubation (CGI) is a technology that may enhance procedural efficiency. This study aimed to compare the effectiveness of CGI with conventional intubation (CI) using a manikin simulation.</div></div><div><h3>Methods</h3><div>A case-crossover manikin simulation study was conducted with three clinical scenarios: normal airway, cervical immobilization, and cardiopulmonary resuscitation. A CO2-exhalation simulation manikin was developed for this purpose. Participants were randomly assigned to perform CGI or CI first, followed by the alternative method. The primary outcome was the first-attempt success rate, and the secondary outcome was the procedure time of intubation. A linear mixed-effects model with a random effect for each subject was applied.</div></div><div><h3>Results</h3><div>A total of 40 participants were enrolled, and 20 in each study group. The first-attempt success rate was higher with CGI than CI across all clinical situations, with statistically significant differences in the normal airway and cervical immobilization settings. Specifically, for the normal airway, the success rate was 40 (100.0 %) for CGI vs. 33 (82.5 %) for CI [abs diff: 17.5 %, 95 % CI: 5.7 %–29.3 %]; for cervical immobilization, 39 (97.5 %) vs. 32 (80.0 %) [abs diff: 17.5 %, 95 % CI: 4.2 %–30.8 %]; and for cardiopulmonary resuscitation, 40 (100.0 %) vs. 38 (95.0 %) [abs diff: 5.0 %, 95 % CI: −1.8 %-11.8 %]. The intubation time was shorter with CGI in the normal airway and cervical immobilization scenarios. The median [interquartile range (IQR)] time for normal airway was 23.5 (19.2–28.4) <em>sec</em> for CGI vs. 31.6 (22.2–59.7) sec for CI, and for cervical immobilization, 24.4 (20.4–30.8) sec for CGI vs. 28.6 (22.6–56.9) sec for CI. In cardiopulmonary resuscitation, the median [IQR] was 23.1 (19.6–31.4) sec for CGI vs. 25.1 (18.6–32.4) sec for CI.</div></div><div><h3>Conclusion</h3><div>In the manikin-based randomized crossover simulation, CGI achieved a higher first-attempt success rate and shorter intubation time than CI in the normal airway and cervical immobilization scenarios.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"95 ","pages":"Pages 124-128"},"PeriodicalIF":2.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community awareness of acoustic gunshot detection systems in Washington, DC.","authors":"Jesus Trevino, Aditya Loganathan, Ishan Abdullah, Andrew Meltzer","doi":"10.1016/j.ajem.2025.05.040","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.05.040","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gardening hazards to vision: Patterns of eye injuries in emergency care","authors":"Matthew J. Lee BA ,&nbsp;Sophia Dutton BA ,&nbsp;Philip R. Rizzuto MD","doi":"10.1016/j.ajem.2025.05.042","DOIUrl":"10.1016/j.ajem.2025.05.042","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the demographics and diagnoses of garden tool-related eye injuries presenting to United States emergency departments (EDs).</div></div><div><h3>Materials and methods</h3><div>Eye injuries associated with gardening tools from 2014 to 2023 were identified using the National Electronic Injury Surveillance System (NEISS). Cases involving the eyeball and relevant product codes were analyzed using descriptive statistics and linear regression.</div></div><div><h3>Results</h3><div>A total of 218 cases represented an estimated 9326 ED visits (95 % CI: 7001–11,652). Although injuries declined overall (Beta = −43.5), a 132.2 % increase occurred from 2020 to 2023, likely reflecting increased gardening post-pandemic. Adults (78.4 %) and males (61.0 %) were most affected. Common diagnoses included contusions/corneal abrasions (53.7 %), foreign bodies (13.3 %), and subconjunctival hemorrhage/hyphema (10.1 %). Environmental debris was the most frequent cause.</div></div><div><h3>Discussion</h3><div>Gardening tool-related eye injuries primarily affect adults and are often caused by debris, leading to largely preventable outcomes such as abrasions. Promoting protective eyewear and public education may help reduce these injuries.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"95 ","pages":"Pages 129-132"},"PeriodicalIF":2.7,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Norepinephrine versus epinephrine after cardiac arrest: A systematic review and meta-analysis","authors":"Caitlin A. Williams MD MS ,&nbsp;Ali Pourmand MD MPH ,&nbsp;Trager Hintze PharmD ,&nbsp;Jennifer A. Walker MD ,&nbsp;Madison Moran BS ,&nbsp;Khai Dinh BS ,&nbsp;Anna Shaw ,&nbsp;Samantha Camp BA ,&nbsp;Emily F. Gorman MLIS ,&nbsp;Quincy K. Tran MD PhD","doi":"10.1016/j.ajem.2025.05.038","DOIUrl":"10.1016/j.ajem.2025.05.038","url":null,"abstract":"<div><h3>Objectives</h3><div>Patients who obtain return of spontaneous circulation (ROSC) after cardiac arrest often experience post-resuscitation hypotension, typically managed with epinephrine (EPI). However, recent research suggests that norepinephrine (NE) may improve patient outcomes. This systematic review and meta-analysis evaluates the effectiveness of EPI versus NE in managing post-resuscitative shock in patients who achieve ROSC.</div></div><div><h3>Methods</h3><div>A systematic literature search in PubMed, Medline, Scopus, EMBASE, and Cochrane CENTRAL was performed. Observational or randomized studies on adults comparing EPI to NE after cardiac arrest were included in analysis. Outcomes were analyzed via random-effects meta-analysis and included rate of re-arrest during hospital stay, survival to discharge, and functional neurological outcome at discharge.</div></div><div><h3>Results</h3><div>After screening 1217 studies, we analyzed 6 studies, which involved 3458 patients, with mean (+/− SD) age of 64 (+/− 3) years, and 2188 (63 %) were male. The NE group consisted of 1833 (53 %) patients and 287 (41 %) of the total 703 re-arrest. Patients receiving NE were associated with 63 % lower odds of having recurrent arrest (OR 0.47, 95 % CI 0.24–0.92, <em>P</em> = 0.03, I² = 89 %). There was no statistical difference for rates of hospital survival (OR 2.04, 95 % 0.93–4.47) or discharge with unfavorable neurological outcome (OR 1.72, 95 % CI 0.92–3.22).</div></div><div><h3>Conclusions</h3><div>Among a small number of studies, norepinephrine use in post-cardiac arrest patients was associated with lower odds of recurrent cardiac arrest. However, high study heterogeneity highlights the need for well-designed future research to validate these findings.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"95 ","pages":"Pages 107-114"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric “lift-assist” EMS calls with transport refusal: Characteristics of short-term repeat calls and hospitalizations","authors":"Emily A. Moore BA ,&nbsp;David W. Schoenfeld MD, MPH ,&nbsp;Christie L. Fritz MD, MS ,&nbsp;Matthew J. Bivens MD ,&nbsp;Shan W. Liu MD, SD ,&nbsp;Stephen H. Thomas MD, MPH","doi":"10.1016/j.ajem.2025.05.041","DOIUrl":"10.1016/j.ajem.2025.05.041","url":null,"abstract":"<div><h3>Background</h3><div>Older patients who fall may call Emergency Medical Services (EMS) for assistance, then refuse transport to the Emergency Department (ED). We sought to describe the characteristics of such patients, and to identify predictors of the need within 30 days for a repeat EMS call, ambulance transport and/or hospitalization.</div></div><div><h3>Methods</h3><div>The records of a single urban EMS service were reviewed for one year concluding in October 2024 to identify cases where a geriatric patient (age &gt; 64) refused transport after a fall. Multivariable logistic regression was used to evaluate dichotomous endpoints of repeat EMS call and hospitalization.</div></div><div><h3>Results</h3><div>Of 19,694 overall calls, there were 7329 for geriatric patients, 931 of whom refused transport. Of these 931 geriatric refusals, 433 were refusals after a fall. 142 (32.8 %, 95 % CI 28.4–37.4 %) had at least one same-month repeat EMS call and 101 of those (71.1 %, 95 % CI 62.9–78.4 %) were transported, with 65.9 % of transports resulting in hospitalization. Multivariable analysis identified no patient factors predictive of repeat EMS call. Admission was predicted by advancing age (OR 1.08 for each year, with 95 % CI 1.01–1.14, <em>p</em> = .016).</div></div><div><h3>Conclusion</h3><div>Nearly a third of falls with transport refusals are associated with a same-month repeat EMS call, a majority (71.1 %) of which result in transport to the ED, usually followed by hospital admission. We identified no predictors of repeat EMS call or hospitalization. Geriatric patients who refuse transport after a fall are at high risk for repeat EMS calls and hospitalizations, but predictors of such needs are elusive.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"95 ","pages":"Pages 77-82"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-channelled video laryngoscopy versus direct laryngoscopy for improving hemodynamics and intubation time in ASA 1 and 2 patients, a double blinded randomized controlled trial","authors":"Peter B. Ghattas MSc, EDPM EFIC,&nbsp;Samir E. Elansary MD,&nbsp;Ashraf M. Mohamed MD,&nbsp;Mahmoud S. Anwar MD","doi":"10.1016/j.ajem.2025.05.036","DOIUrl":"10.1016/j.ajem.2025.05.036","url":null,"abstract":"<div><h3>Background</h3><div>In 2022, the American Society of Anaesthesiologists (ASA) included indirect video laryngoscopy in their difficult airway algorithm to aid in difficult intubation. To determine the potential advantages of routinely using video laryngoscopy (VL) in nonchallenging cases, we conducted a study to examine its effects on hemodynamics, intubation time and fasting blood sugar (FBS) in comparison with direct laryngoscopy (DL).</div></div><div><h3>Methodology</h3><div>This was a double blinded, prospective, randomized, controlled trial in a university hospital included ASA I to II patients undergoing elective surgery. Patients were randomly assigned to either DL or VL with an endotracheal tube preshaped to the blade through a stylet. The primary outcome was the difference in the mean blood pressure (MBP) post intubation. Secondary outcomes included intubation time, Cormack–Lehane grade, FBS levels and other hemodynamic differences. The study was registered at (<span><span>pactr.samrc.ac.za</span><svg><path></path></svg></span>), number PACTR202305589924304.</div></div><div><h3>Results</h3><div>80 patients were enrolled and intubated with either DL (<em>n</em> = 40) or VL (n = 40), MBP, HR, DBP, intubation time and Cormack–Lehane grade were significantly better with indirect video laryngoscopy with pre-shaped stylet than with direct laryngoscopy, with mean values of 78.83 vs 90.50 mmhg, 84.78 vs 92.13, 78.83 vs 90.50 mmhg, 15.63 vs 17.28 s respectively, but the effects of direct laryngoscopy on FBS, SBP, and saturation were not significantly different.</div></div><div><h3>Conclusion</h3><div>Indirect video laryngoscopy is superior to direct laryngoscopy regarding patient's hemodynamics specially the MBP, intubation time with no significant difference regarding FBS.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"95 ","pages":"Pages 95-100"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating smartwatch-based detection of supraventricular tachycardia and atrial fibrillation in the emergency department","authors":"Süleyman Alpar ,&nbsp;Ali Cankut Tatlıparmak","doi":"10.1016/j.ajem.2025.05.037","DOIUrl":"10.1016/j.ajem.2025.05.037","url":null,"abstract":"<div><h3>Background</h3><div>In this study, we categorized smartwatches into two groups: those with electrocardiogram (ECG) capability and those utilizing photoplethysmography (PPG) sensors. The aim was to evaluate the diagnostic performance of these devices in differentiating atrial fibrillation (AF) from supraventricular tachycardia (SVT) among patients presenting to the emergency department (ED) with an irregular rhythm alert.</div></div><div><h3>Methods</h3><div>This retrospective, single-center observational study was conducted in the ED of a tertiary hospital over a two-year period. The study included adult patients (≥22 years) who presented to the ED following an irregular rhythm alert generated by their smartwatch. Smartwatches were classified as either ECG-capable devices or PPG-based devices. Final rhythm diagnoses were confirmed by two independent emergency physicians based on 12‑lead ECG findings obtained during the ED evaluation.</div></div><div><h3>Results</h3><div>A total of 424 patients were included. Of these, 63.7 % (<em>n</em> = 270) used ECG-capable smartwatches, and 66.3 % (<em>n</em> = 281) received an AF alert. Among all alerts, 60.8 % (<em>n</em> = 258) were ECG-based and 39.2 % (<em>n</em> = 166) were PPG-based. Common presenting symptoms included palpitations (56.1 %), dizziness (21.7 %), and dyspnea (23.6 %), while 8.5 % of patients were asymptomatic. In total, 44.6 % (<em>n</em> = 189) required pharmacologic or electrical interventions. Smartwatches demonstrated moderate accuracy for AF and SVT detection. PPG-based detection showed higher sensitivity than ECG-based detection (AF: 54.3 % vs. 44.9 %; SVT: 83.6 % vs. 79.2 %). Agreement with final ECG diagnoses was poor (Cohen's Kappa = 0), with significant misclassification for both arrhythmias (McNemar's <em>p</em> &lt; 0.001), except for PPG-based SVT (<em>p</em> = 0.072). No significant predictors of false-positive AF alerts were found (area under the curve [AUC] = 0.538). False-positive SVT alerts were more common in younger patients (odds ratio [OR] = 0.92, <em>p</em> = 0.039), females (OR = 0.55, <em>p</em> = 0.048), and less frequent in diabetic patients (OR = 0.24, <em>p</em> = 0.001; AUC = 0.685).</div></div><div><h3>Conclusion</h3><div>Among patients presenting to the ED with smartwatch-reported irregular rhythm alerts, PPG-based detection demonstrated higher sensitivity for SVT compared to ECG-based methods; however, the overall diagnostic agreement for both AF and SVT was limited.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"95 ","pages":"Pages 101-106"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Found down, pulseless and cold: Outcomes following unwitnessed hypothermic cardiac arrest","authors":"Christopher R. Wyatt MD ,&nbsp;Aaron S. Perez DO ,&nbsp;Matteo P. Garofalo MD ,&nbsp;Lawrence H. Brown PhD","doi":"10.1016/j.ajem.2025.05.035","DOIUrl":"10.1016/j.ajem.2025.05.035","url":null,"abstract":"<div><h3>Objective</h3><div>Hypothermic out-of-hospital cardiac arrest (OOHCA) without an apparent abrupt cause for hypothermia presents a dilemma for emergency physicians. This study compared outcomes among hypothermic and normothermic OOHCA arrest patients “found down” following unwitnessed arrest who required ongoing chest compressions in the emergency department (ED).</div></div><div><h3>Methods</h3><div>This secondary analysis of Resuscitation Outcomes Consortium (ROC) Epistry 3 data included OOHCA patients ≥15 years old transported to hospital by EMS who required continued or recurrent chest compressions in the ED. Per current resuscitation guidelines, patients with initial core temperatures &lt;30 °C were considered hypothermic; temperatures between 35 °C and 38 °C were classified as normothermic. We excluded patients with initial temperatures recorded &gt;30 min after arrival. We compared survival to hospital admission, survival to hospital discharge and survival with good neurologic status (i.e., Modified Rankin Scale ≤2) for hypothermic and normothermic patients. Sensitivity analyses explored alternate hypothermia cut-points (&lt; 35 °C; 28 °C).</div></div><div><h3>Results</h3><div>The primary analysis included 22 hypothermic and 416 normothermic patients. Outcomes for hypothermic and normothermic patients did not significantly differ: survival to hospital admission was 13.6 % vs. 28.6 % (difference −15 %, CI: −30.0 %; +0.01 %); survival to hospital discharge was 4.6 % vs. 3.1 % (difference + 1.4 %, CI: −4.2 %; +13.3 %); survival with good neurologic status was 4.6 % vs. 1.2 % (difference + 3.4 %, CI: −5.4 %; +12.1 %). Using alternative cut-points to define hypothermia did not meaningfully alter the results.</div></div><div><h3>Conclusion</h3><div>In this analysis, outcomes did not differ for hypothermic and normothermic adult OOHCA patients “found down” following unwitnessed OOHCA who required continued chest compressions in the ED.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"95 ","pages":"Pages 83-88"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of dilated aortic root on point-of-care ultrasound with aortic aneurysm and dissection","authors":"Mina Hesami MD,&nbsp;Ryan Denkewicz MD,&nbsp;Zachary Boivin MD,&nbsp;Sonali Bhalodkar MD,&nbsp;Jia Jian Li MD,&nbsp;Christopher Moore MD","doi":"10.1016/j.ajem.2025.05.039","DOIUrl":"10.1016/j.ajem.2025.05.039","url":null,"abstract":"<div><h3>Objectives</h3><div>Thoracic aortic dissection (TAD) is a life-threatening condition with a mortality rate of 1–2 % per hour, highlighting the importance of prompt diagnosis. Thoracic aortic aneurysm (TAA) is associated with TAD and can be detected by point-of-care ultrasound (POCUS). We sought to evaluate the diagnostic accuracy of POCUS in detecting TAA and the prevalence of TAD in patients with TAA by POCUS. We hypothesized that a dilated aortic root on POCUS would be strongly associated with TAA and TAD.</div></div><div><h3>Methods</h3><div>Patients with a dilated aortic root measurement of ≥4.5 cm on transthoracic cardiac POCUS between 2013 and 2023 who received either chest CT or cardiology echocardiogram (c-echo) were retrospectively selected by querying a POCUS database (QpathE) from three EDs in our system. Comprehensive demographic, clinical, and imaging data were retrieved from electronic medical records. For both CT and c-echo, aortic measurements of ≥4 cm were considered aneurysmal, using the largest reported measurement. If both CT and c-echo were performed, the largest CT measure was used. We also investigated how many patients with TAA also had TAD. Statistical analysis was performed using IBM SPSS version 29.</div></div><div><h3>Results</h3><div>Our cohort included 304 patients with TAA (≥4.5 cm) on POCUS, with a median age of 67.5 years (IQR:58–80) of which 247 (81.3 %) were male. 227 (74.6 %) had CT performed, and 77 (25.3 %) had a c-echo without CT. There was a significant positive correlation between POCUS measurements and those of CT and c-echo (<em>r</em> = 0.62, <em>p</em> &lt; 0.001). Comparing the measurements on POCUS with those derived from our ground truths, the mean difference for the Bland-Altman plot was 0.13 cm (95 % confidence interval; −0.71 to 0.97), with the average POCUS measure being slightly higher. Overall, the positive predictive value (PPV) of POCUS for TAA was 96 % (95 % CI, 93.8 %–98 %). TAD was present in 45 (15.4 %) of patients with TAA.</div></div><div><h3>Conclusion</h3><div>Although POCUS measurement tended to be slightly higher than that of CT or c-echo on average, it demonstrated a high accuracy and predictive value for TAA. More than one in seven patients with TAA on POCUS had TAD. Our results underscore the efficacy of POCUS for the prompt detection of thoracic aortic aneurysm and dissection.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"95 ","pages":"Pages 89-94"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to comments on \"ChatGPT-Supported Patient Triage with Voice Commands in the Emergency Department: A Prospective Multicenter Study\".","authors":"Sinan Paslı, Esma Nilay Kırımlı, Metin Yadigaroğlu","doi":"10.1016/j.ajem.2025.05.033","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.05.033","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}