Archives of Academic Emergency Medicine最新文献

{"title":"Comparison of Video Laryngoscope (VL) and Intubating Laryngeal Mask Airway (I-LMA) for Endotracheal Intubation in a Manikin with Restricted Neck Motion.","authors":"Welawat Tienpratarn, Methapat Boonyingsatit, Chaiyaporn Yuksen, Sittichok Leela-Amornsin, Parunchaya Jamkrajang, Thammanunt Chrunarm, Sumate Rienrakwong","doi":"10.22037/aaem.v12i1.2421","DOIUrl":"10.22037/aaem.v12i1.2421","url":null,"abstract":"<p><strong>Introduction: </strong>Intubating patients undergoing manual in-line stabilization (MILS) can make airway management more challenging. This study aimed to compare the outcomes of intubation with video-laryngoscope (VL) and Intubating Laryngeal Mask Airway (I-LMA) in manikin with restricted neck motion using MILS.</p><p><strong>Methods: </strong>In this comparative study, emergency medicine residents and paramedics were randomly allocated to two crossover sets. Then the intubation outcomes (success rate, time to successful intubation, and cervical spine movement) were compared between intubation with VL and I-LMA in a manikin model with restricted cervical spine mobility, achieved through MILS.</p><p><strong>Results: </strong>64 participants with a mean age of 28.86 ± 4.03 (range: 24-47) years and a mean duration of intubation experience of 3.63 ± 1.35 years were studied (43.75% male, 81.3% emergency medicine resident). The intubation success rate was 62 out of 64 (96.88%) in the VL method and 52 out of 64 (81.25%) in the I-LMA method (p = 0.008). The mean time to successful intubation was 33.03±16.94 seconds in the VL method and 55.03±17.34 seconds in the I-LMA method (p < 0.001). The mean cervical range of motion (CROM) in flexion-extension was 4.38±1.82 degrees in the VL method and 4.13±3.20 degrees in the I-LMA method (p = 0.158). The mean CROM in rotation was 4.27±2.62 degrees in the VL method and 4.65±2.47 degrees in the I-LMA method (p= 0.258) and the mean CROM in lateral bending was 5.35±4.45 degrees in the VL method and 7.71±6.14 degrees in the I-LMA method (p = 0.010).</p><p><strong>Conclusion: </strong>In a manikin model with restricted cervical spine mobility, the utilization of VL significantly improved intubation success rates, reduced time to successful intubation, and limited CROM.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e1"},"PeriodicalIF":2.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339958","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":"Piperonylbutoxide and the Necessity of Toxicological Assessment of Insecticide Mixtures; a Letter to Editor.","authors":"Dirk Habedank, Birgit Habedank","doi":"10.22037/aaem.v12i1.2434","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2434","url":null,"abstract":"","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e64"},"PeriodicalIF":2.9,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279647","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":"A Guide to Opportunities and Challenges of Developing a Virtual Reality Simulation for Disaster Medicine Courses: A Letter to Editor.","authors":"Mohsen Masoumian Hosseini, Seyedeh Toktam Masoumian Hosseini, Karim Qayumi","doi":"10.22037/aaem.v12i1.2388","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2388","url":null,"abstract":"","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e63"},"PeriodicalIF":2.9,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279626","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":"Stroke and COVID-19: An Umbrella Review.","authors":"Kavous Shahsavarinia, Nasim Hajipoor Kashgsaray, Morteza Ghojazadeh, Zahra Falaki, Maryam Soleimanpour, Hassan Soleimanpour","doi":"10.22037/aaem.v12i1.2385","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2385","url":null,"abstract":"<p><strong>Introduction: </strong>Acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) are among the acute cerebrovascular diseases (CVDs) that have been reported as a result of COVID-19. It will be a significant step forward if our research helps improve the compilation and analysis of existing data from other studies.</p><p><strong>Methods: </strong>The study is registered on PROSPERO with an ID of CRD42023464058. It encompasses articles published until December 2023 and involves searching databases such as PubMed, Scopus, Web of Knowledge, Embase, and Cochrane. Additionally, we conducted manual searches in respected publications within this discipline, utilized the Google Scholar search engine, and conducted reference checks, citation checks, and study of gray literature. The publications' reporting quality was assessed using the \"Assessment of Multiple Systematic Reviews\" (AMSTAR) checklist. The meta-analysis was conducted using Stata software (StataCorp, version 16).</p><p><strong>Results: </strong>We analyzed the findings of 23 meta-analyses, which included 795 articles and encompassed 5,937 patients who had previously experienced a stroke. The average age of these patients was 62.3 years, and 68.3% were male. The findings indicated that the collective incidence of stroke among individuals with COVID-19 is roughly 1.75% [95% confidence interval (CI): 0.4%-3.03], with 1.59% for ischemic strokes and 0.3% for hemorrhagic strokes. 32.3% (95% CI: 27.8%-36.9%) of COVID-19 patients with stroke passed away, approximately 27% were discharged from the hospital with very mild or no complications, and around 28.1% (95% CI: 14.1%-42.1%) were referred for rehabilitation.</p><p><strong>Conclusions: </strong>The overall rate of stroke in COVID-19 patients was approximately 1.75%, with a higher incidence in males and those with an average age of 62.3 years. Almost 80% of the strokes were ischemic, and the mortality rate was approximately 32%. Finally, 27% of the patients were discharged without complications, and 28% required rehabilitation.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e65"},"PeriodicalIF":2.9,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279663","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":"Dengue Fever as a Re-emergent Priority of Public Health; a Letter to Editor.","authors":"Mostafa Alavi-Moghaddam","doi":"10.22037/aaem.v12i1.2268","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2268","url":null,"abstract":"","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e62"},"PeriodicalIF":2.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279631","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":"Consequences of Natural and Man-made Disasters on Pregnancy Outcomes and Complications: A Systematic Review.","authors":"Yousef Pashaei Asl, Solmaz Ghanbari-Homaie, Nasim Partash, Alireza Pakzad, Gholamreza Faridaalaee","doi":"10.22037/aaem.v12i1.2268","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2268","url":null,"abstract":"<p><strong>Introduction: </strong>Due to their unique circumstances, pregnant women face a heightened risk of experiencing pregnancy complications during and after catastrophic events. This study aims to investigate the consequences of both natural and man-made disasters on pregnancy outcomes.</p><p><strong>Method: </strong>This study is a systematic review. Searches were performed until May 31, 2024, in the electronic databases including Medline, Web of Science, Embase, and Scopus. Outcomes such as preterm birth, low birth weight (LBW), small for gestational age (SGA), stillbirth, spontaneous abortion, and pregnancy-related blood pressure complications were studied.</p><p><strong>Result: </strong>The search conducted in the databases yielded 3307 non-duplicate records. After reading the abstracts, 3204 articles were excluded based on inclusion and exclusion criteria. Full texts of 103 article were obtained. However, upon reading the full texts of articles, 13 of them did not meet the inclusion criteria for the study. Consequently, 90 articles were ultimately included.</p><p><strong>Conclusion: </strong>Natural and man-made disasters exert significant influence on adverse pregnancy outcomes. While it is impossible to prevent the incidence of natural disasters and often man-made disasters occur abruptly, the negative consequences of disasters, particularly natural ones, can be mitigated by enhancing prenatal care and avoiding detrimental elements such as smoking and alcohol.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e61"},"PeriodicalIF":2.9,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11408978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279630","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":"Diagnostic Accuracy of ChatGPT for Patients' Triage; a Systematic Review and Meta-Analysis.","authors":"Navid Kaboudi, Saeedeh Firouzbakht, Mohammad Shahir Eftekhar, Fatemeh Fayazbakhsh, Niloufar Joharivarnoosfaderani, Salar Ghaderi, Mohammadreza Dehdashti, Yasmin Mohtasham Kia, Maryam Afshari, Maryam Vasaghi-Gharamaleki, Leila Haghani, Zahra Moradzadeh, Fattaneh Khalaj, Zahra Mohammadi, Zahra Hasanabadi, Ramin Shahidi","doi":"10.22037/aaem.v12i1.2384","DOIUrl":"10.22037/aaem.v12i1.2384","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI), particularly ChatGPT developed by OpenAI, has shown the potential to improve diagnostic accuracy and efficiency in emergency department (ED) triage. This study aims to evaluate the diagnostic performance and safety of ChatGPT in prioritizing patients based on urgency in ED settings.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines. Comprehensive literature searches were performed in Scopus, Web of Science, PubMed, and Embase. Studies evaluating ChatGPT's diagnostic performance in ED triage were included. Quality assessment was conducted using the QUADAS-2 tool. Pooled accuracy estimates were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic.</p><p><strong>Results: </strong>Fourteen studies with a total of 1,412 patients or scenarios were included. ChatGPT 4.0 demonstrated a pooled accuracy of 0.86 (95% CI: 0.64-0.98) with substantial heterogeneity (I² = 93%). ChatGPT 3.5 showed a pooled accuracy of 0.63 (95% CI: 0.43-0.81) with significant heterogeneity (I² = 84%). Funnel plots indicated potential publication bias, particularly for ChatGPT 3.5. Quality assessments revealed varying levels of risk of bias and applicability concerns.</p><p><strong>Conclusion: </strong>ChatGPT, especially version 4.0, shows promise in improving ED triage accuracy. However, significant variability and potential biases highlight the need for further evaluation and enhancement.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e60"},"PeriodicalIF":2.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279641","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":"Key Features in Designing an Integrated Recall System for Dispatch in Mass Casualty Incidents; a Systematic Review.","authors":"Negar Mazaheri, Mohammad Reza Khajehaminian, Saeed Fallah-Aliabadi, Omid Yousefianzadeh","doi":"10.22037/aaem.v12i1.2330","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2330","url":null,"abstract":"<p><strong>Introduction: </strong>Following Mass Casualty Incidents (MCIs), the sudden surge in demand for essential services disrupts the balance between available and required resources. This study aimed to systematically identify and categorize existing systems employed for dispatching professional or lay rescuers during emergencies.</p><p><strong>Methods: </strong>Adhering to the PRISMA 2020 Checklist, the research scrutinized international databases (PubMed, Scopus, and Web of Science) using formulated search strategies. Additionally, a manual search was conducted on Google Scholar and prominent journals employing specific keywords. Original articles introducing systems for dispatching rescuers to incident sites were included.</p><p><strong>Results: </strong>Thirty-one of the 23051 initially identified documents were included for data extraction and quality assessment. The comprehensive analysis revealed twenty-two dispatch systems worldwide, contributing to life-saving efforts in emergencies. Additionally, an evaluation of the articles' quality using the Mixed Methods Appraisal Tool (MMAT) with five scores, indicated that more than two-thirds of the identified articles scored four or higher. Summarizing the data extracted from these systems, four distinct categories of recall system characteristics were identified: general, dispatcher, responder, and other features.</p><p><strong>Conclusion: </strong>Technology has the potential to revolutionize the delivery of healthcare services. This study highlights four key elements necessary for the development of dispatch systems that can effectively mobilize healthcare providers to the incident scene. These elements include general characteristics, dispatcher roles, responder requirements, and additional features, which equip researchers with the knowledge for designing effective systems to recall healthcare providers during MCI.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e58"},"PeriodicalIF":2.9,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279644","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":"Impact of Inspiratory Muscle Training and Positive Expiratory Pressure on Lung Function and Extubation Success of ICU Patients: a Randomized Controlled Trial.","authors":"Mohammad Kazemi, Razieh Froutan, Ahmad Bagheri Moghadam","doi":"10.22037/aaem.v12i1.2331","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2331","url":null,"abstract":"<p><strong>Introduction: </strong>Preparing patients for extubation from mechanical ventilation (MV) necessitates focused respiratory muscle strengthening. This study aimed to evaluate the effect of threshold inspiratory muscle training (IMT) and positive expiratory pressure (PEP) exercises on outcomes of patients who underwent MV in intensive care unit (ICU).</p><p><strong>Methods: </strong>This randomized controlled trial was conducted in 2023 at the ICUs of Imam Reza Hospital, Mashhad, Iran. Participants were allocated to either intervention or control group (each comprising 35 patients) through block randomization. The intervention group received standard daily chest physiotherapy as well as targeted inspiratory and expiratory muscle strengthening exercises using the threshold IMT/PEP device, administered twice daily over one week. The control group received standard daily chest physiotherapy alone. Finally, the outcomes (lung compliance, duration of intubation, extubation success rate, and diaphragmatic metrics) of the two groups were compared.</p><p><strong>Results: </strong>70 patients with the mean age of 56.10 ± 14.15 (range: 28.00-85.00) years were randomly divided into two groups (50% male). Significant improvements were observed in the intervention group regarding pulmonary compliance values (35.62 ± 4.43 vs. 30.85 ± 6.93; p= 0.001), peak expiratory flow (PEF) (55.20 ± 10.23 vs. 47.80 ± 11.26; p = 0.002), and maximum inspiratory pressure (MIP) (33.40 ± 4.25 vs. 30.08 ± 6.08; p = 0.01) compared to the control group. Diaphragm inspiratory thickness (0.29 ± 0.03 vs. 0.26 ± 0.04; p = 0.001), diaphragm expiratory thickness (0.22 ± 0.03 vs. 0.20 ± 0.04; p = 0.006) and motion (1.61 ± .29 vs. 1.48 ± .21; p = 0.04) also exhibited significant differences between the two groups. Extubation success rate was higher in the intervention group (68.60% vs. 40%; p = 0.01). The duration of mechanical ventilation was 15.14±7.07 days in the intervention group and 17.34±7.87 days in the control group (p = 0.20). The mean extubation time was 7.00 ± 1.88 days for the intervention group and 9.00 ± 2.00 days for the control (p < 0.001).</p><p><strong>Conclusion: </strong>Threshold IMT/PEP device exercises effectively enhance respiratory muscle strength, diaphragm thickness, and reduce ventilator dependency. These findings support their potential for inclusion in rehabilitation programs for ICU patients.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e59"},"PeriodicalIF":2.9,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279643","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":"Attitude and Behavior of Road Users Responding to EMS Ambulances in Developing Countries: a Cross-sectional Study.","authors":"Mahmoud T Alwidyan, Ahmad Alrawashdeh, Alaa O Oteir","doi":"10.22037/aaem.v12i1.2262","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2262","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency medical service (EMS) providers use ambulance lights and sirens (L&S) to expedite their travel and to warn road users. This study aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use.</p><p><strong>Methods: </strong>This was a cross-sectional survey distributed to road users in Northern Jordan. The questionnaire included 19 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants' responses and assessed the association between demographics and attitude statements using logistic regression.</p><p><strong>Results: </strong>A total of 1302 questionnaires were available for analysis. The mean age of participants was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) would perform inappropriate actions in response to EMS ambulances with L&S in use. The multivariate logistic regression model showed that being female (OR: 0.63; 95% CI = 0.48-0.81), more educated (OR: 0.68; 95% CI = 0.53-0.86), or public transport driver (OR: 0.55; 95% CI = 0.34-0.90) was significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as following the passing by EMS ambulances.</p><p><strong>Conclusions: </strong>A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances and many engage in risky driving behaviors, perhaps due to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e57"},"PeriodicalIF":2.9,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279628","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}