Archives of Academic Emergency Medicine最新文献

{"title":"Challenging Dilemma regarding Cardiac Advanced Life Support in Patients with Minimally Invasive Cardiac Surgery: A Letter to Editor.","authors":"Mahmood Hosseinzadeh Maleki, Mohsen Yaghubi","doi":"10.22037/aaem.v14i1.2876","DOIUrl":"10.22037/aaem.v14i1.2876","url":null,"abstract":"<p><p>Cardiac Advanced Life Support (CALS) differs from conventional Advanced Cardiac Life Support (ACLS) in utilizing targeted resuscitation protocols designed explicitly for post-cardiac surgery patients. The hallmark of CALS is the performance of prompt re-sternotomy and internal cardiac massage within 5 minutes of cardiac arrest if the patient is unresponsive to external chest compressions and rapid defibrillation. The standardized algorithms for ACLS, fundamental to managing cardiac arrest, present a significant and potentially dangerous dilemma when applied to patients who have undergone minimally invasive cardiac surgery (MICS). While MICS offers benefits like reduced trauma and faster recovery, it creates a unique physiological landscape that conflicts with conventional resuscitation. This letter highlights the urgent need to re-evaluate the ACLS protocol for this growing patient population. We advocate for the immediate development of a specialized MICS-specific resuscitation guideline that moves beyond a one-size-fits-all approach to in-hospital cardiac arrest.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e5"},"PeriodicalIF":2.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148931","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":"Neutrophil to Lymphocyte Ratio as a Predictive Factor of Unfavorable Outcomes in Traumatic Spinal Cord Injury: A Systematic Review and Meta-analysis.","authors":"Amirreza Peyrovinasab, Hamed Zarei, Mahrokh Janmohamadi, Mehra Fekri, Farzin Tahmasbi Arashlow, Alireza Ghorbani, Pantea Gharin, Pardis Soroush, Saeed Safari, Mahmoud Yousefifard","doi":"10.22037/aaem.v14i1.2766","DOIUrl":"10.22037/aaem.v14i1.2766","url":null,"abstract":"<p><strong>Introduction: </strong>There are a number of biomarkers connected to inflammation that affect spinal cord injury (SCI) outcomes. This systematic review and meta-analysis was conducted to evaluate the prognostic value of the Neutrophil-to-lymphocyte ratio (NLR) in patients diagnosed with traumatic SCI.</p><p><strong>Methods: </strong>Observational studies evaluating the association between baseline NLR and severity or neurological improvement in traumatic SCI patients were systematically identified using Medline, Embase, Scopus, and Web of Science databases on March 4, 2025. The risk of bias among the included studies was assessed using the National Heart, Lung, and Blood Institute (NHLBI) tool. A random-effects model was employed for meta-analyses. Effects sizes were reported as odds ratios (ORs) or standardized mean difference (SMD), along with their 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Six retrospective cohort studies involving 1,564 participants were included, with five eligible for meta-analysis. Blood samples were collected within 72 hours of admission. Meta-analysis showed that patients without neurological improvement had significantly higher NLR values (SMD: 0.98; 95% CI: 0.08-1.87; I² = 94.36%). Additionally, elevated NLR was independently associated with no neurological improvement (adjusted OR: 1.12; 95% CI: 1.06-1.17; I² = 0.04%). Qualitative synthesis further indicated that higher NLR values were consistently associated with greater injury severity in acute traumatic SCI.</p><p><strong>Conclusion: </strong>Elevated NLR is associated with greater injury severity and poorer neurological recovery in patients with acute traumatic SCI. These findings suggest that NLR may serve as a useful early prognostic biomarker in the clinical assessment of mentioned patients.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e4"},"PeriodicalIF":2.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155888","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":"The Effects of Using Prehospital Calcium Gluconate During Cardiopulmonary Resuscitation: A Retrospective Study.","authors":"Thongpitak Huabbangyang, Agasak Silakoon, Suchanaree Soimongkolchai, Punyawee Dangsawasd, Siravit Phankhot, Piyada Yomklang, Chunlanee Sangketchon","doi":"10.22037/aaem.v13i1.2870","DOIUrl":"10.22037/aaem.v13i1.2870","url":null,"abstract":"<p><strong>Introduction: </strong>Calcium gluconate (CG) administration during cardiopulmonary resuscitation (CPR) has not been recommended in routine clinical practice. This study examined the impact of prehospital CG administration on outcomes of out-of-hospital cardiac arrest (OHCA) cases.</p><p><strong>Methods: </strong>This retrospective cohort study collected data on adult patients aged >18 years who experienced non-traumatic OHCA and were transported by the emergency medical service (EMS) to the emergency department. Data on return of spontaneous circulation (ROSC) at the scene, survival to hospital admission, and survival to hospital discharge were obtained from EMS reports and electronic medical records and compared between OHCA cases who received or didn't receive CG.</p><p><strong>Results: </strong>In total, 215 adult patients with non-traumatic OHCA were enrolled in this study. Among them, 107 received CG and 108 didn't receive. In particular, CG administration was associated with a lower rate of ROSC at the scene compared with cases without its administration (8.6% lower). The likelihood of ROSC at the scene was 0.75 times that of those who did not receive CG. CG administration was associated with a lower survival to hospital admission (16.48% lower). The likelihood of survival to hospital admission was 0.42 times that of patients who did not receive CG. In addition, survival to hospital discharge was 7.37% lower in patients who received CG, and the likelihood of survival to hospital discharge was 0.21 times that of those who did not receive CG.</p><p><strong>Conclusions: </strong>Prehospital CG administration by the EMS team did not improve ROSC in the scene, survival to hospital admission, or survival to hospital discharge. The findings highlight the need for selective use of calcium based on guideline-recommended indications rather than empirical administration.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e81"},"PeriodicalIF":2.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155910","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":"Machine Learning-Based Prognostic Prediction Models in Calcium Channel Blockers Poisoning.","authors":"Babak Mostafazadeh, Sayed Masoud Hosseini, Shahin Shadnia, Mahdi Mehmandoost, Mahsa Taremi, Seyed Ali Mohtarami, Peyman Erfan Talab Evini, Mitra Rahimi, Pooya Eini, Amirreza Taherkhani, Nahal Babaeian Amini, Elmira Heidarli, Mohammad Meshkini, Leena Amine, Hafedh Thabet","doi":"10.22037/aaem.v13i1.2804","DOIUrl":"10.22037/aaem.v13i1.2804","url":null,"abstract":"<p><strong>Introduction: </strong>Calcium channel blocker (CCB) poisoning is a critical toxicological emergency that can result in severe complications, particularly cardiovascular effects. This study aimed to evaluate the accuracy of Machine learning (ML) models in predicting the outcomes of CCB poisoning.</p><p><strong>Methods: </strong>This retrospective cross-sectional study analyzed the medical records of patients diagnosed with CCB poisoning at Loghman Hakim Hospital between 2019 and 2024. The accuracy of machine learning (ML) models in predicting the outcomes of CCB poisoning and identifying its predictive factors was evaluated. Various ML models, including XGBoost, CatBoost, Random Forest, and AdaBoost, were trained on clinical and laboratory data. Then, feature selection was performed to identify the most relevant variables. The hold-out set was randomly selected to avoid selection bias. Model performance was assessed using accuracy, precision, recall, F1-score, and macro-averaged area under the receiver operating characteristic (ROC) curve (AUC).</p><p><strong>Results: </strong>274 CCB poisoning cases with the mean age of 31.99± 17.47 (range: 1.5 to 89) years were evaluated (70.4% female). Feature selection identified 18 key prognostic factors, including body temperature, whole bowel irrigation, need for cardiology consultation, arterial oxygen saturation, Glasgow coma scale (GCS)-eye response, electrocardiography (ECG) findings, serum level of alkaline phosphatase (ALP), pH-venous blood gas (VBG), HCO₃-VBG, serum level of lactate dehydrogenase (LDH), blood sugar, pulse rate, fraction of inspired oxygen (FiO2), time elapsed from ingestion to admission, troponin, serum level of alanine aminotransferase (ALT), serum level of creatinine, and serum level of potassium. Among the ML models, XGBoost and CatBoost demonstrated the highest predictive performance, with macro-averaged AUC values of 0.9899 (95%confidence interval (CI): 0.98-0.99) and 0.9983 (95%CI: 0.997-0.999), respectively. These models outperformed traditional statistical approaches, providing enhanced risk stratification for patients with CCB poisoning.</p><p><strong>Conclusion: </strong>This study highlights the potential of ML-based models for predicting outcomes in CCB poisoning, offering a data-driven framework for early risk stratification. The superior performance of XGBoost and CatBoost suggests their clinical applicability. Future research should focus on external validation in multi-center settings and real-time integration into clinical decision-making systems.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e79"},"PeriodicalIF":2.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762018","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":"Mechanical versus Manual Chest Compressions for Cardiopulmonary Resuscitation in Emergency Department: A Comparative Study.","authors":"Ali Vafaei, Parvin Kashani, Amir Heidari, Abbas Hasanzadeh","doi":"10.22037/aaem.v13i1.2849","DOIUrl":"10.22037/aaem.v13i1.2849","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical chest compression devices provide consistent depth and reduced pauses during cardiopulmonary resuscitation (CPR), but their clinical impact on routine practice in emergency department (ED) remains uncertain. This study aimed to compare the outcomes of mechanical versus manual compressions among adults with in-hospital cardiac arrest managed in ED.</p><p><strong>Methods: </strong>A single-center, comparative study of consecutive adult cardiac arrests in the ED (n = 372) was carried out. Patients were allocated by time period to either manual CPR (n = 195) during the retrospective phase (September 2024 to January 2025) or mechanical CPR (n = 177) with LUCAS-3 during the prospective phase (January to June 2025). The primary outcome was return of spontaneous circulation (ROSC). Secondary outcomes were survival at 6 hours and 24 hours post-arrest. Baseline differences were summarized with standardized mean differences, and survival was described with Kaplan-Meier curves (0-24 h). Logistic regression estimated odds ratios (ORs) for ROSC and 6-hour survival.</p><p><strong>Results: </strong>Mechanical and manual chest compression groups comprised 177 and 195 patients, respectively. Unadjusted outcomes favored mechanical CPR. ROSC occurred in 54 (30.5%) versus 32 (16.4%), with an absolute risk difference of 14.1% and Six-hour survival was 25 (14.1%) versus 5 (2.6%). After adjustment, mechanical CPR remained associated with higher odds of ROSC (OR = 2.44, 95% confidence interval (CI): 1.18-4.42) and 6-hour survival (OR = 6.71, 95% CI: 2.94-18.94). By 24 hours, no patient survived in the mechanical group, whereas one patient (0.5) survived in the manual group (P>0.05). Kaplan-Meier curves showed early separation that narrowed by 24 hours.</p><p><strong>Conclusion: </strong>It seems that mechanical chest compression during CPR is associated with increased ROSC and better early survival, compared to manual compression. Due to the limited sample size, non-randomized design with time-based allocation, single-center setting, potential residual confounding, and absence of neurologic outcomes, these results should be interpreted with caution.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e3"},"PeriodicalIF":2.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148961","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":"Challenges Faced by Jordan's Search and Rescue Team in the 2023 Turkey Earthquake; A Qualitative Study from Readiness to Response.","authors":"Mahmoud T Alwidyan, Abdulhadi A Al Ruwaithi, Ahmad Alrawashdeh, Haitham Bashier, Marwan Al-Smeiat, Zuhair A Ikhwayleh, Abdullah S Alruwailli, Yousef S Khader","doi":"10.22037/aaem.v13i1.2846","DOIUrl":"10.22037/aaem.v13i1.2846","url":null,"abstract":"<p><strong>Introduction: </strong>Many international search and rescue teams were deployed to the devastating earthquake of Southeastern Turkey and Northern Syria on February 6^th, 2023, including the Jordan International Search and Rescue Team (JSAR). This study aims to explore the challenges faced by the JSAR team members during their deployment.</p><p><strong>Methods: </strong>We employed a qualitative face-to-face semi-structured interview approach. Eighteen respondents were interviewed using an interview guide. Interviews took between 25 and 60 minutes (mean 45 minutes). Data were transcribed verbatim and an inductive thematic approach was used to analyze data and develop codes, categories, and themes.</p><p><strong>Results: </strong>The challenges were categorized into three main themes; logistical, coordination, and environmental. Logistical challenges included delays in deployment due to government and flight arrangements, difficulties in transporting excess equipment, and a lack of fuel upon arrival that led to delays in setting up camp and heating. Coordination challenges involved disruption in operation schedule and difficulties working with local volunteer responders. Environmental challenges encompassed extreme cold temperatures, which affected personnel comfort and performance, and recurrent aftershocks, which complicated rescue operations and posed safety risks.</p><p><strong>Conclusion: </strong>The JSAR experience highlights that technical readiness alone is insufficient for effective disaster response. Findings from this study underscore significant gaps in logistics, coordination, and environmental adaptation. These gaps can be addressed through improved pre-deployment coordination, context-specific resource planning, and better collaboration mechanisms between host countries and international teams, which would be crucial for enhancing the effectiveness of international search and rescue operations. Host governments, International Search and Rescue Advisory Group (INSARAG) stakeholders, and emergency management bodies can build on these lessons to better integrate specialized teams, reduce procedural delays, and enhance global disaster response systems.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e80"},"PeriodicalIF":2.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761978","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":"Characteristics of 76,113 Acute Poisoning Cases Registered in Emergency Medical System of Tehran Province; A Cross-sectional Study.","authors":"Ahmad Reza Baghernezhad, Fereydoon Khayeri, Mohamad Esmaeel Tavakoli, Sayna Sheikh Navaz Jahed, Fatemeh Solgi, Mohaddese Gholamrezai","doi":"10.22037/aaem.v13i1.2833","DOIUrl":"10.22037/aaem.v13i1.2833","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding the epidemiological patterns of poisoning cases in specific regions is essential for health authorities to implement preventive measures and strategic planning. This study aimed to describe the epidemiologic characteristics of acute poisoning cases registered in Tehran province's emergency medical services (EMS).</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted on all registered acute poisoning cases from 2022 to 2024 in the Asayar database of Tehran Province's EMS. The cases were included through census sampling and descriptive analysis was used for evaluating the epidemiologic characteristics of registered cases.</p><p><strong>Results: </strong>76,113 acute poisoning cases were registered by Tehran Province EMS during the study period. The mean age of cases was 34.3 ± 15.0 years (59.1% male). The most frequent method of poisoning was oral, with 71,521 (94.0%) cases, and inhalational, with 3,236 (4.2%) cases. The highest number of cases was reported in the eastern region of Tehran with 15,058 cases. Seasonal distribution of poisonings was as follows: 20,201 (26.6%) cases in summer, 21,322(28.0%) cases in winter, 21,105 (27.7%) cases in autumn, and 13,485 (17.7%) cases in spring. Most poisonings occurred in residential settings, accounting for 72,194 (94.9%) cases. The most frequent used antidote was naloxone, in 12,662 (16.6%) cases, and atropine, in 961 (1.3%) cases.</p><p><strong>Conclusion: </strong>Based on the findings of this study, the most vulnerable population groups to the poisoning were young individuals, males, and those with a history of psychiatric illness and substance abuse, predominantly affected by oral route. The geographical and temporal distribution of poisonings highlights the need for targeted preventive interventions, public education, and enhancement of prehospital emergency service infrastructure in high-risk areas.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e78"},"PeriodicalIF":2.0,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762001","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":"Prevalence and Predictors of Stroke Among Patients Presenting to the Emergency Department with Dizziness: A Retrospective Cohort Study.","authors":"Abdulelah A Alzahrani, Abdullah A Alzahid, Qasem A Almulihi, Mohammad I Assiri, Abdulrahman T Subaih, Rayan N Al Muhanna, Yasir Y Khan, Manal M Alabdullah, Jood J Alkallaf, Eyad S Alhashim, Abdulmonem A Alsaleh, Sukainah Y Al Khalaf, Deena A Aldossary, Mohannad A Alghamdi","doi":"10.22037/aaem.v13i1.2764","DOIUrl":"10.22037/aaem.v13i1.2764","url":null,"abstract":"","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e76"},"PeriodicalIF":2.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761979","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":"Inferior ST-Segment Elevation Pattern as a Result of a Small Bowel Obstruction: A Case Report.","authors":"Andrew Ryu, Andrew J Jacobs, Andrew Mastanduono, Daniel Frank, Gregory Garra, Christopher C Lee","doi":"10.22037/aaem.v13i1.2843","DOIUrl":"10.22037/aaem.v13i1.2843","url":null,"abstract":"<p><p>ST segment elevation patterns on Electrocardiogram (ECG) are a crucial finding in the diagnosis and treatment of acute coronary syndrome. An ST segment elevation pattern can be a sign of acute myocardial ischemia requiring immediate intervention. However, ST elevation patterns have been reported to occur due to obstructive intraabdominal pathology, a diagnosis often confirmed by cardiac catheterization. Here we report a 75-year-old female who presented to the emergency department with worsening chest and epigastric abdominal pain. ECG demonstrated ST-segment elevations in inferior leads (II, III, and aVF) with reciprocal changes in the lateral leads (I and aVL). Physical exam was suggestive of a bowel obstruction at the site of a large incarcerated ventral hernia, which was later confirmed by imaging. Due to the lack of typical chest pain symptoms and a strong suspicion of obstructive intraabdominal pathology, activation of the catheterization laboratory was deferred. Decompression of the bowel obstruction was achieved with a nasogastric tube, which resulted in immediate resolution of ST-segment elevations. During her admission, her ventral hernia was repaired, and left heart catheterization was deferred per cardiology recommendations. While an ST-segment elevation due to occlusive myocardial infarction is a diagnosis that cannot be missed and requires an emergent workup, it is important to be aware that it is possible for a small bowel obstruction (SBO) to present with ECG changes consistent with an ST-segment elevation myocardial infarction (STEMI). We also found that ST-segment elevations due to obstructive intraabdominal pathology are more reportedly seen in the literature in the inferior leads than any other contiguous leads, which is a novel pattern not discussed in past literature.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e77"},"PeriodicalIF":2.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761988","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":"Effectiveness of ISBAR Protocol Implementation by Emergency Medicine Residents in Pediatric Handovers; A Pre-post Intervention Study.","authors":"Negin Mousaeinejad, Forugh Charmduzi, Shaqayeq Khosravi, Kiana Khosravi, Shabahang Jafarnejad, Zahra Mahyapourlori, Ahmad Moayedfard, Sayed Mahdi Marashi","doi":"10.22037/aaem.v13i1.2835","DOIUrl":"10.22037/aaem.v13i1.2835","url":null,"abstract":"<p><strong>Introduction: </strong>Effective information transfer between healthcare providers is essential for patient safety. This study aimed to evaluate the impact of ISBAR (Identify, Situation, Background, Assessment, Recommendation) framework on the quality of clinical handovers in emergency department (ED).</p><p><strong>Methods: </strong>This prospective, pre- and post-intervention study was conducted at Hazrat Ali Asghar Pediatric Hospital in Tehran, Iran, from May to September 2023. A total of 428 clinical handovers were recorded (214 pre-intervention and 214 post-intervention) following a 90-minute training session and the introduction of a standardized ISBAR checklist. Handover quality was measured using the completeness of a 16-item ISBAR checklist. Data analysis employed descriptive statistics, the Mann-Whitney U test, and Chi-square tests.</p><p><strong>Results: </strong>Implementation of the ISBAR protocol significantly improved the overall quality of information conveyed during handovers. Total handover scores increased from a mean rank of 127.55 pre-intervention to 301.45 post-intervention (P < 0.001). All five ISBAR domains showed significant enhancements; Identify (from 145.41 to 283.59, P=0.001), Situation (from 129.64 to 299.36, P=0.001), Background (from 136.40 to 292.60, P=0.001), Assessment (from 156.00 to 273.00, P< 0.001), and Recommendations (from 198.14 to 230.86, P=0.03). In addition, the completeness of individual items such as patient diagnosis, admission date, and vital signs improved markedly.</p><p><strong>Conclusions: </strong>Adopting a standardized ISBAR handover protocol in a high-stakes pediatric environment ED significantly enhances the accuracy and completeness of patient handovers, thereby reducing the potential for errors and strengthening patient safety.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e75"},"PeriodicalIF":2.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762023","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}