Journal of the American College of Emergency Physicians open最新文献

{"title":"Out-of-Hospital Cardiac Arrest Survivors Without ST-Segment Elevation had Lower Coronary Artery Stenosis in an Asian Population.","authors":"Yaw-Ren Hsu, Chien-Hua Huang, Han-Lin Yao, Yi-Wen Wu, Wei-Ting Chen, Wen-Jone Chen, Wei-Tien Chang, Min-Shan Tsai","doi":"10.1016/j.acepjo.2024.100036","DOIUrl":"10.1016/j.acepjo.2024.100036","url":null,"abstract":"<p><strong>Objectives: </strong>Guidelines recommend emergent coronary angiography (CAG) for out-of-hospital cardiac arrest (OHCA) patients with ST-segment elevation (STE) and selective angiography for those without STE. However, real-world data reporting coronary artery status in OHCA patients without STE are scarce, especially in an Asian population. This study evaluated the coronary artery status and associated outcomes in Asian OHCA patients without STE, comparing the results with those of patients with STE.</p><p><strong>Methods: </strong>This retrospective study enrolled 345 OHCA survivors with presumed cardiogenic cause who underwent CAG. Based on electrocardiographic evidence of STE following return of spontaneous circulation, the patients were segmented into an STE group (<i>n</i> = 150) and a non-STE group (<i>n</i> = 195). The CAG findings and percutaneous intervention details for the non-STE group were compared with those of the STE group. Chi-squared tests were applied for categorical variables, whereas Mann-Whitney U tests were applied for continuous variables.</p><p><strong>Results: </strong>Compared with the STE group, the non-STE group had a lower but still high prevalence of coronary artery stenosis (69.7% vs 91.3%, <i>P</i> < .001) and multivessel involvement (50.8% vs 68.0%, <i>P</i> = .001), especially in the left anterior descending coronary artery (56.9% vs 79.3%, <i>P</i> < .001). No differences in survival-to-discharge and neurological outcomes were observed.</p><p><strong>Conclusion: </strong>In OHCA survivors with presumed acute coronary syndrome, there was a high prevalence of coronary artery stenosis and multivessel involvement in patients without STE. Moreover, patients without STE had comparable survival-to-discharge and neurological outcomes with patients with STE.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100036"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517372","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":"Elderly Woman With Extensor Lag.","authors":"Taylor Turner, Lindsay Tjiattas-Saleski","doi":"10.1016/j.acepjo.2024.100037","DOIUrl":"10.1016/j.acepjo.2024.100037","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100037"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517601","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":"Superiority of the Bag-Valve-Guedel Adaptor Over the Standard Face Mask for Preintubation Ventilation of Bearded Patients by Trainees With Limited Experience: Prospective Controlled Cross-Over Clinical Trial.","authors":"Lilach Gavish, Shimon Firman, Daniel Fernando Orjuela Cruz, Anat Tovim, S David Gertz, Roger Andres Gomez Barrantes, Dina Velitsky, Angelika Erport, Joel Shapiro, Chloe Mimouni, Arik Eisenkraft, Reuven Pizov","doi":"10.1016/j.acepjo.2024.100035","DOIUrl":"10.1016/j.acepjo.2024.100035","url":null,"abstract":"<p><strong>Objectives: </strong>Ventilation of bearded patients using the standard face mask (FM) is often difficult, particularly in field settings and mass casualty events. The current study compares the effectiveness of a novel Bag-Valve-Guedel Adaptor (BVGA) with the standard FM when applied to anesthetized patients by anesthesiology trainees with limited experience.</p><p><strong>Methods: </strong>Male patients scheduled for elective surgery (American Society of Anesthesiology physical score 1-2) were recruited for this prospective, randomized, cross-over trial. Beard length was categorized as <0.5 cm (none/stubble), 0.5 to 1 cm, 1 to 5 cm, or ≥5 cm. Anesthetized patients were ventilated by anesthesiology trainees using the BVGA and an FM. The main outcome included end-tidal CO₂, expiratory tidal volume (tidal volume of predicted body weight), and user evaluation (comfort, physical demand, and tiredness). The role of the level of expertise was evaluated by comparing data from the present study with those of a previous study performed by attending anesthesiologists.</p><p><strong>Results: </strong>Forty men (mean ± SD, age, 37 ± 17 years; body mass index, 25 ± 3 kg/m²), of whom 30 had beards, were enrolled. For the BVGA, ventilation parameters were found to be superior to the FM (BVGA vs FM: end-tidal CO₂ [mm Hg], 34.3 ± 4.9 vs 26.6 ± 5.8, <i>P</i> < .001; expiratory tidal volume [mL/kg predicted body weight], 7.9 ± 2.5 vs 6.3 ± 2.8, <i>P</i> = .003). The BVGA was graded as more comfortable and less physically demanding by 96% to 100% of trainees. The level of expertise of the anesthesiologist (trainee vs attending [additional n = 61 patients]) and the presence of a beard were found to be significant factors for ventilation with the FM but not with the BVGA.</p><p><strong>Conclusion: </strong>The BVGA provides more effective and convenient ventilation than the FM for ventilation even when applied by anesthesia trainees. Its use can be of particular value in bearded subjects or in a setting where the use of supraglottic airway devices is limited.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100035"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517279","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":"Severe Intracranial Infection.","authors":"Shinnosuke Fukushima, Takumi Fujimori, Koji Iio, Hideharu Hagiya","doi":"10.1016/j.acepjo.2024.100026","DOIUrl":"10.1016/j.acepjo.2024.100026","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100026"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517376","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":"Young Woman With Right Lower Quadrant Abdominal Pain.","authors":"Gökhan Yılmaz","doi":"10.1016/j.acepjo.2024.100033","DOIUrl":"10.1016/j.acepjo.2024.100033","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100033"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517287","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":"Qualitative Exploration of Health Care Professionals' Experiences Caring for Young People With Acute Severe Behavioral Disturbance in the Acute Care Setting.","authors":"Elyssia M Bourke, Ned Douglas, Ziad Nehme, Jonathan Knott, Simon S Craig, Franz E Babl","doi":"10.1016/j.acepjo.2024.100030","DOIUrl":"10.1016/j.acepjo.2024.100030","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the experience of health care professionals involved in the care of young people with acute severe behavioral disturbance across the acute care setting.</p><p><strong>Methods: </strong>We used purposive and snowball sampling to recruit paramedics, nurses, doctors, and mental health clinicians caring for young people with acute severe behavioral disturbance in the prehospital and/or emergency department environments. We conducted one-to-one telephone-based semistructured qualitative interviews with each staff member. The audio recordings were transcribed verbatim, and participant pseudonyms were assigned. We iteratively developed a thematic coding structure. Data collection continued until thematic saturation was reached.</p><p><strong>Results: </strong>We interviewed 31 health care professionals-12 doctors, 5 nurses, 7 mental health clinicians, and 7 paramedics. Participants outlined factors they felt contributed to the young person's behavioral disturbance. They detailed the management strategies used. Participants spoke about their exposure to physical violence while managing these young people and the challenges of balancing patient and staff safety. There was a significant personal impact on participants through providing care to this cohort. Participants acknowledged the workflow, staff resource, and bystander impacts of these presentations.</p><p><strong>Conclusion: </strong>Based on participant's experiences, health care staff aim to provide high-quality care to young people with behavioral disturbance in circumstances that present risks to their safety. There is variability in the way staff are currently managing these young people likely because of the limited high-quality evidence currently available, highlighting key areas for future research.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100030"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517373","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":"Self-Resolving Pulsatile Frontal Mass Following Blunt Head Trauma.","authors":"Yoshihiro Aoki, Koichi Hayakawa, Kazuhiko Suyama","doi":"10.1016/j.acepjo.2024.100025","DOIUrl":"10.1016/j.acepjo.2024.100025","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100025"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517375","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":"Mapping Emergency Medicine Data to the Observational Medical Outcomes Partnership Common Data Model: A Gap Analysis of the American College of Emergency Physicians Clinical Emergency Data Registry.","authors":"Inessa Cohen, Zihan Diao, Pawan Goyal, Aarti Gupta, Kathryn Hawk, Bill Malcom, Caitlin Malicki, Dhruv Sharma, Brian Sweeney, Scott G Weiner, Arjun Venkatesh, R Andrew Taylor","doi":"10.1016/j.acepjo.2024.100016","DOIUrl":"10.1016/j.acepjo.2024.100016","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to conduct a gap analysis to determine the feasibility of mapping electronic health record data from the Clinical Emergency Data Registry (CEDR) to the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM).</p><p><strong>Methods: </strong>We employed a structured approach using a custom-built comparison matrix. This matrix facilitated the alignment of CEDR data fields with the corresponding elements in the OMOP-CDM schema. Each field was evaluated for compatibility, with categorization into 3 distinct types: direct matches, fields requiring transformation, and fields with no OMOP-CDM equivalent. The mapping process was informed by consultations with the Observational Health Data Sciences and Informatics community forums and was guided by existing documentation and best practices in data harmonization. We performed descriptive analyses, quantifying the extent of direct matches and identifying the specific transformations needed for each CEDR-CDM field to ensure compliance with the OMOP-CDM model.</p><p><strong>Results: </strong>Our analysis indicates a high degree of compatibility between CEDR and OMOP, with over 90% (244/269) of CEDR fields being successfully mapped. Specifically, 173 fields had direct matches, whereas 71 required transformations. Challenges identified include addressing fields unique to CEDR with no OMOP-CDM equivalent and managing the transformations required for proper alignment.</p><p><strong>Conclusion: </strong>The OMOP-CDM presents a promising framework for standardizing emergency medicine data, thereby enhancing future query automation, analytics, and cross-institutional collaboration. Despite the potential challenges in capturing unique CEDR fields and addressing necessary transformations, most emergency department data can be standardized within the OMOP-CDM, fostering broader insights and applications in research and public health.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100016"},"PeriodicalIF":1.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517351","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":"Man With Chest Pain 5 Months After Having Abdominal Pain.","authors":"Tomislav Tokic, Lea Hasnas, Ivica Safradin, Dubravka Sipus, Daniel Lovric, Hrvoje Gasparovic, Drazen Belina","doi":"10.1016/j.acepjo.2024.100012","DOIUrl":"10.1016/j.acepjo.2024.100012","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100012"},"PeriodicalIF":1.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517343","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":"Shortness of Breath After Heart Surgery.","authors":"Savannah Pocquette, Katelyn Levy, Jeffrey Gardecki","doi":"10.1016/j.acepjo.2024.100005","DOIUrl":"10.1016/j.acepjo.2024.100005","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 1","pages":"100005"},"PeriodicalIF":1.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517377","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}