Annals of emergency medicine最新文献

{"title":"Cybersecurity in Virtual Observation Units","authors":"Fredrik Granholm MD, Derrick Tin MBBS, Gregory Ciottone MD","doi":"10.1016/j.annemergmed.2024.08.568","DOIUrl":"10.1016/j.annemergmed.2024.08.568","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Pages 196-197"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grace on the Other Side of the Gown","authors":"Jason T. Kolb MD","doi":"10.1016/j.annemergmed.2024.07.025","DOIUrl":"10.1016/j.annemergmed.2024.07.025","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Pages 191-192"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic Acid for Children With Traumatic Brain Injuries: Progress Made and Important Evidence Gaps","authors":"Nathan Kuppermann MD, MPH , Daniel K. Nishijima MD, MAS","doi":"10.1016/j.annemergmed.2024.09.014","DOIUrl":"10.1016/j.annemergmed.2024.09.014","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Pages 109-110"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Research Highlights","authors":"","doi":"10.1016/j.annemergmed.2024.12.007","DOIUrl":"10.1016/j.annemergmed.2024.12.007","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Page A10"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of a Novel Resuscitation Teamwork Model for Out-of-Hospital Cardiac Arrest in the Emergency Department","authors":"Kah Meng Chong MD ,&nbsp;Eric Hao-Chang Chou MD ,&nbsp;Wen-Chu Chiang MD, PhD ,&nbsp;Hui-Chih Wang MD ,&nbsp;Yeh-Ping Liu MD, LLM ,&nbsp;Patrick Chow-In Ko MD, MsC ,&nbsp;Edward Pei-Chuan Huang MD, MsC ,&nbsp;Ming-Ju Hsieh MD, PhD ,&nbsp;Hao-Yang Lin MD ,&nbsp;Wan-Ching Lien MD, PhD ,&nbsp;Chien-Hua Huang MD, PhD ,&nbsp;Cheng-Chung Fang MD ,&nbsp;Shyr-Chyr Chen MD, EMBA ,&nbsp;Farhan Bhanji MD, MsC ,&nbsp;Chih-Wei Yang MD, PhD ,&nbsp;Matthew Huei-Ming Ma MD, PhD","doi":"10.1016/j.annemergmed.2024.09.008","DOIUrl":"10.1016/j.annemergmed.2024.09.008","url":null,"abstract":"<div><h3>Study objective</h3><div>Cardiopulmonary resuscitation (CPR) is critical for out-of-hospital cardiac arrest patients but is prone to rapid changes and errors. Effective teamwork and leadership are essential for high-quality CPR. We aimed to introduce the Airway-Circulation-Leadership-Support (A-C-L-S) teamwork model in the emergency department (ED) to address these challenges.</div></div><div><h3>Methods</h3><div>The study comprised 2 phases. The development phase involved reviewing CPR videos, categorizing problems, and formulating strategies using the Systems Engineering Initiative for Patient Safety model. Resuscitation tasks were organized into A-C-L-S domains using hierarchical task analysis. Equipment and environmental deficits were optimized ergonomically with a pit-crew style arrangement. Mnemonics enhanced teamwork and leadership. The evaluation phase assessed postimplementation ED resuscitation team performance, focusing on adherence, timeliness, and quality of A-C-L-S tasks.</div></div><div><h3>Results</h3><div>The development phase produced a structured teamwork model, assigning tasks, tools, mnemonics, and positions based on A-C-L-S domains. The A-team manages the airway and optimizes end-tidal CO₂ levels; the C-team focuses on high-quality chest compressions and defibrillation. Leadership coordinates resuscitation efforts using goal-directed mnemonics (DABCD²E³), whereas the S-team handles medications, timekeeping, and recording. The evaluation phase showed improvements in adherence and timeliness of A-C-L-S tasks, with sustained increases in chest compression fraction before mechanical CPR, from 67.2% preimplementation to 83.0% postimplementation, 89.1% after 1 year, and 86.1% after 2 years. Overall, chest compression fraction also improved from 81.7% to 88.6%, peaking at 92.2% after 1 year and maintaining 90.8% after 2 years.</div></div><div><h3>Conclusion</h3><div>The A-C-L-S teamwork model is feasible, applicable, and effective. Further research is needed to assess its influence on patient outcomes.</div></div>","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Pages 163-178"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department","authors":"Robert Ohle MSc, MBBCh ,&nbsp;David W. Savage MD, PhD ,&nbsp;Danielle Roy BSc ,&nbsp;Sarah McIsaac Med, MBBCh ,&nbsp;Ravinder Singh MD ,&nbsp;Daniel Lelli MD ,&nbsp;Darren Tse MD ,&nbsp;Peter Johns MD ,&nbsp;Krishan Yadav MSc, MD ,&nbsp;Jeffrey J. Perry MSc, MD","doi":"10.1016/j.annemergmed.2024.06.003","DOIUrl":"10.1016/j.annemergmed.2024.06.003","url":null,"abstract":"<div><h3>Study objective</h3><div>Identify high-risk clinical characteristics for a serious cause of vertigo in patients presenting to the emergency department (ED).</div></div><div><h3>Methods</h3><div>Multicentre prospective cohort study over 3 years at three university-affiliated tertiary care EDs. Participants were patients presenting with vertigo, dizziness or imbalance. Main outcome measurement was an adjudicated serious diagnosis defined as stroke, transient ischemic attack, vertebral artery dissection or brain tumour.</div></div><div><h3>Results</h3><div>A total of 2,078 of 2,618 potentially eligible patients (79.4%) were enrolled (mean age 77.1 years; 59% women). Serious events occurred in 111 (5.3%) patients. We used logistic regression to create a 7-item prediction model: male, age over 65, hypertension, diabetes, motor/sensory deficits, cerebellar signs/symptoms and benign paroxysmal positional vertigo diagnosis (C-statistic 0.96, 95% confidence interval [CI] 0.92 to 0.98). The risk of a serious diagnosis ranged from 0% for a score of &lt;5, 2.1% for a score of 5 to 8, and 41% for a score &gt;8. Sensitivity for a serious diagnosis was 100% (95% CI, 97.1% to 100%) and specificity 72.1% (95% CI, 70.1% to 74%) for a score &lt;5.</div></div><div><h3>Conclusion</h3><div>The Sudbury Vertigo Risk Score identifies the risk of a serious diagnosis as a cause of a patient’s vertigo and if validated could assist physicians in guiding further investigation, consultation, and treatment decisions, improving resource utilization and reducing missed diagnoses.</div></div>","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Pages 122-131"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Door-In-Door-Out Times at Referring Hospitals and Outcomes of Hemorrhagic Stroke","authors":"Regina Royan MD, MPH ,&nbsp;Iyanuoluwa Ayodele MS ,&nbsp;Brian Stamm MD ,&nbsp;Brooke Alhanti PhD ,&nbsp;Kevin N. Sheth MD ,&nbsp;Peter Pruitt MD, MS ,&nbsp;Brian C. Mac Grory MB BCh ,&nbsp;William J. Meurer MD, MS ,&nbsp;Shyam Prabhakaran MD, MS","doi":"10.1016/j.annemergmed.2024.09.002","DOIUrl":"10.1016/j.annemergmed.2024.09.002","url":null,"abstract":"<div><h3>Study objective</h3><div>Interhospital transfer is often required in the care of patients with hemorrhagic stroke. Guidelines recommend a door-in-door-out (DIDO) time of ≤120 minutes at the transferring emergency department (ED); however, it is unknown whether DIDO times are related to clinical outcomes of hemorrhagic stroke.</div></div><div><h3>Methods</h3><div>Retrospective, observational cohort study using US registry data from Get With The Guidelines–Stroke participating hospitals. Patients include those aged ≥18 years with intracerebral hemorrhage (ICH) or subarachnoid hemorrhage (SAH) who were transferred from the ED to a Get With The Guidelines participating receiving hospital from January 1, 2019, to July 31, 2022. The primary outcome was ordinal discharge modified Rankin scale (mRS) score and secondary outcomes included dichotomous discharge mRS, ability to ambulate independently at discharge, and inhospital mortality at the receiving hospital.</div></div><div><h3>Results</h3><div>In all, 19,708 ICH and 7,757 patients with SAH were included. For patients with ICH, an increasing DIDO time was associated with greater odds of mRS 0 to 3 versus 4 to 6 at discharge in the unadjusted analyses (DIDO 91 to 180 minutes, odds ratio [OR] 1.15 [1.04 to 1.27]; DIDO 181 to 270 minutes, OR 1.51 [1.33, 1.71]; DIDO &gt;270 minutes, OR 1.83 [1.58, 2.11]; versus DIDO ≤90 minutes). In the adjusted analyses, no associations were observed. Similar results were seen for mRS at discharge in patients with SAH. In both patients with ICH and SAH, longer DIDO times were associated with greater odds of independent ambulation at discharge and lower odds of inhospital mortality in the unadjusted analyses. After adjustment, the effect sizes of these associations were reduced, with some of the results based on quartiles becoming statistically nonsignificant.</div></div><div><h3>Conclusion</h3><div>These findings suggest that EDs currently expedite the transfer of the sickest patients; however, prospective studies and more granular data are needed to understand the impact of early treatment and timing of transfer for patients with hemorrhagic stroke.</div></div>","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Pages 132-143"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In reply:","authors":"Emily M. Hayden MD, MHPE,&nbsp;Beth G. Grabowski MBA, MPH,&nbsp;Ekta B. Kishen MPH,&nbsp;Kori S. Zachrison MD, MSc,&nbsp;Benjamin A. White MD","doi":"10.1016/j.annemergmed.2024.09.010","DOIUrl":"10.1016/j.annemergmed.2024.09.010","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Page 197"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Osmolal Gap Has a Limited Role in the Evaluation of Possible Toxic Alcohol Poisoning","authors":"Joseph Kennedy MD,&nbsp;Samuel Paskin MD,&nbsp;Skyler Lentz MD","doi":"10.1016/j.annemergmed.2024.07.024","DOIUrl":"10.1016/j.annemergmed.2024.07.024","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Pages 180-182"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Erythematous Plaque on Sole of the Foot","authors":"Jia Liu MD,&nbsp;Cheng Tan MD","doi":"10.1016/j.annemergmed.2024.09.013","DOIUrl":"10.1016/j.annemergmed.2024.09.013","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 2","pages":"Pages 189-190"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}