BMC Emergency Medicine最新文献

{"title":"Epidemiology and clinical outcomes of injuries in motorcycle delivery riders in the United Arab Emirates: a four-year trauma registry analysis.","authors":"Omar Al-Nahhas, Khaled Alkheder, Munawar Farooq, Yousif Al Khafaji, Sara Ouda, Ahmad Alkheder, Yaman Al Harbat, Uffaira Hafeez, Moideen Abdul Nazeer, Gabriel Andrade, Hamid Chatha, Arif Alper Cevik, David Olukolade Alao","doi":"10.1186/s12873-025-01372-z","DOIUrl":"https://doi.org/10.1186/s12873-025-01372-z","url":null,"abstract":"<p><strong>Background: </strong>Motorcycle delivery riders represent a growing and vulnerable population of road users, particularly in urban centres experiencing rapid e-commerce expansion. Despite global reductions in road traffic injuries, this group remains at high risk due to occupational hazards and limited applications of traffic laws and protective measures. We examined the epidemiology, injury patterns, and clinical outcomes of motorcycle delivery riders admitted with trauma in Al Ain, United Arab Emirates (UAE), from 2020 to 2023.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of prospectively collected trauma registry data from two hospitals in Al Ain. The study included 290 motorcycle delivery riders who were hospitalized for more than 24 h. Data on demographics, injury mechanisms, anatomical injury sites, injury severity scores (ISS), surgical interventions, and outcomes were analyzed.</p><p><strong>Results: </strong>All patients were males with a median (IQR) age of 28 (25-33.8) years and were predominantly of South Asian origin. Road traffic collisions accounted for 89.3% of injuries. There were a total of 467 injuries, and over 40% involved two or more body regions. Lower limb injuries were most common (56.2%), followed by upper limb (30.3%), chest, and head injuries. The median ISS (IQR) was 3 (2-5), and 68.6% of the patients required surgical interventions. ICU admission was necessary for 7.9% of patients, and the overall mortality rate was 0.7%. While the number of admissions increased threefold over four years, the proportion of moderate to severe injuries declined.</p><p><strong>Conclusions: </strong>The rising incidence of injuries among motorcycle delivery riders in Al Ain underscores the urgent need for targeted safety regulations and occupational health interventions. Despite a high surgical burden, the decline in injury severity suggests potential benefits from evolving safety practices. These findings can inform policy and healthcare planning for similar high-risk occupational groups.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"211"},"PeriodicalIF":2.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343066","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":"Civilian mass exposure to hydrazine after an F-16 crash: a retrospective descriptive study.","authors":"Asli Bahar Ucar, Hasan Demir, Haldun Akoglu","doi":"10.1186/s12873-025-01373-y","DOIUrl":"https://doi.org/10.1186/s12873-025-01373-y","url":null,"abstract":"<p><strong>Background: </strong>Hydrazine is a volatile and highly toxic monopropellant used in the Emergency Power Unit (EPU) of F-16 aircraft. Although hydrazine is widely used in both military and industrial contexts, reports of its effects in non-occupational civilian populations are extremely limited. Acute civilian mass exposures are almost never systematically documented. On December 12, 2016, an F-16 crash in Diyarbakır, Türkiye, released hydrazine into an open-field setting, exposing unprotected civilians. This study aimed to characterize acute manifestations, evaluate associations with exposure duration and route, and identify operational implications.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive study of 30 previously healthy male civilians exposed at the crash site. Clinical data, laboratory findings, ECGs, and imaging were retrieved from standardized emergency department records. Exposure duration-triangulated from patient interviews and operational logs-was analyzed as a continuous surrogate for dose, in line with Haber's rule. Associations with symptom categories and exposure routes were assessed using nonparametric statistics, Fisher's exact tests, and exploratory receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Twenty patients (66.7%) developed symptoms, while ten remained asymptomatic. Symptom development correlated strongly with exposure duration (Spearman r = 0.61-0.68), with respiratory cases showing significantly longer exposures (median 45 vs. 14 min, p = 0.0017). Ophthalmologic findings (36.7%) were most frequent, while dermatologic (26.7%) and respiratory (13.3%) manifestations occurred exclusively in contact-exposed individuals (p < 0.001 and p = 0.012, respectively). Inhalation-only exposure primarily caused ocular irritation. No patient exposed ≤ 5 min developed symptoms, whereas all symptomatic individuals reported longer exposures; ROC analysis supported discriminatory potential (AUC > 0.80), though results remain exploratory. A 26-year-old first responder developed acute hypoxemic respiratory failure after 45-60 min, recovering with supportive care. No hepatic, renal, neurologic, or cardiovascular complications occurred, and all patients were discharged within 24 h.</p><p><strong>Conclusions: </strong>This study provides one of the most extensive civilian datasets on acute hydrazine exposure. Findings highlight a strong dose-time relationship and route-specific patterns, with exposures > 5 min associated with clinically significant toxicity. While thresholds remain hypothesis-generating, all patients recovered rapidly with supportive care. Operational lessons include the need for rapid evacuation, immediate decontamination, and strict use of personal protective equipment, offering practical insights for toxicology practice and disaster preparedness.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"212"},"PeriodicalIF":2.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343125","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":"Impact of atypical presenting symptoms on door-to-balloon time and mortality outcomes in ST-segment elevation myocardial infarction.","authors":"Jeng-Fu Huang, Shi-Quan Zhang, Yu-Ting Hsiao, Ya-Ni Yeh, Jih-Chun Lin, Ming-Jen Tsai","doi":"10.1186/s12873-025-01368-9","DOIUrl":"https://doi.org/10.1186/s12873-025-01368-9","url":null,"abstract":"<p><strong>Background: </strong>The impact of atypical symptom presentation in ST-segment elevation myocardial infarction (STEMI) on treatment timeliness and long-term outcomes remains insufficiently characterized. This study aimed to examine the association between symptom presentation and delays in door-to-balloon (DTB) time components and short- and long-term mortality, and to identify triage characteristics independently associated with atypical STEMI presentation.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of STEMI patients undergoing primary percutaneous coronary intervention at a tertiary hospital in Taiwan between 2013 and 2022. Symptom presentation was classified as typical or atypical based on emergency department triage records. Primary outcomes included delays in DTB components and all-cause mortality at 30 days, 1 year, and 3 years. The secondary outcome was identification of triage characteristics associated with atypical presentation. Multivariable Cox and logistic regression models were used.</p><p><strong>Results: </strong>Of 807 patients, 13.5% presented with atypical symptoms. Atypical presentation was independently associated with higher 30-day (aHR: 2.20, 95% CI: 1.15-4.21), 1-year (aHR: 1.91, 95% CI: 1.09-3.37), and 3-year (aHR: 1.73, 95% CI: 1.04-2.87) mortality. It was also linked to delays in door-to-ECG (aOR: 11.52, 95% CI: 6.04-22.06), activation-to-Cath lab-arrival (aOR: 1.71, 95% CI: 1.04-2.80), and Cath lab-arrival-to-balloon time (aOR: 1.95, 95% CI: 1.24-3.06). Older age, female sex, diabetes, cerebrovascular disease, tachycardia, and hypotension were independently associated with atypical presentation.</p><p><strong>Conclusions: </strong>Atypical STEMI presentation is associated with treatment delays and increased short- and long-term mortality. Early identification of high-risk patients may improve timely care and clinical outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"207"},"PeriodicalIF":2.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343090","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":"Prognostic value of lactate-to-hemoglobin ratio in nontraumatic critically ill patients presenting to the emergency department: a retrospective cohort study.","authors":"İlter Ağaçkıran, Merve Ağaçkıran","doi":"10.1186/s12873-025-01371-0","DOIUrl":"https://doi.org/10.1186/s12873-025-01371-0","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"209"},"PeriodicalIF":2.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343127","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":"Multidimensional determinants of disaster response in prehospital emergency dispatch centers: content analysis of expert perspectives.","authors":"Mohammadreza Shafiei, Asghar Tavan, Seyed Mobin Moradi, Vahid Saadatmand, Mahmood Nekoei-Moghadam","doi":"10.1186/s12873-025-01354-1","DOIUrl":"https://doi.org/10.1186/s12873-025-01354-1","url":null,"abstract":"<p><strong>Background and objectives: </strong>Amid the escalating frequency and severity of disasters, the role of prehospital emergency dispatch centers in delivering a swift and effective response has become increasingly critical. Despite their pivotal role, there is a paucity of qualitative evidence, particularly from developing nations, concerning the multidimensional challenges these centers face during crises. This study aimed to identify the determinants affecting the performance of emergency dispatch centers during disaster response in Iran.</p><p><strong>Methods: </strong>This qualitative study was conducted between October 2024 and May 2025, employing an inductive approach with conventional qualitative content analysis. Data were gathered through semi-structured interviews with 20 participants, selected from diverse geographical regions and professional roles. Data analysis occurred concurrently with data collection, and analytical rigor was established through member checking and independent coding by multiple researchers.</p><p><strong>Results: </strong>A total of seven main categories and 19 subcategories influencing the performance of dispatch centers during disasters were identified. These categories include: (1) leadership and command (2), Resources and Logistics (3), Operations Management (4), Dispatch Assessment and Decision-Making (5), Call Management (6), Contextual and Environmental Factors, and (7) Enhancement of Functional Coordination. These factors, both independently and interactively, constitute the operational framework for an effective response in disaster situations.</p><p><strong>Conclusion: </strong>An effective dispatch response during disasters emerges from the dynamic interplay among a multi-level command structure, resilient resources, rapid decision-making, and organizational coordination. While the findings are rooted in the Iranian context, many of the identified concepts are transferable to Emergency Medical Services (EMS) systems in other countries. Enhancing dispatcher training, fortifying communication infrastructures, and reinforcing coordination protocols are crucial interventions for improving the preparedness and resilience of health systems in the face of disasters.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"208"},"PeriodicalIF":2.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343051","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":"Epidemiological and clinical characteristics of seawater drowning cases in Sinop, a Turkish coastal city: a 13-year retrospective study.","authors":"Teoman Erşen, Kıvanç Öncü, Özhan Özcan, Şeyma Şimşirgil Kara, Mustafa Sağlam, Elif Orhun, Dilşan Özcanoğlu Sağlam, Huriye Demet Cabar","doi":"10.1186/s12873-025-01365-y","DOIUrl":"https://doi.org/10.1186/s12873-025-01365-y","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"210"},"PeriodicalIF":2.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343088","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":"Major challenges and barriers for successful management of health exercises in emergencies and disasters: findings from a qualitative conventional content analysis study.","authors":"Hojjat Farahmandnia, Majid Sartipi, Ali Nasiri, Ali Khosravizad, Asiye Aminafshar","doi":"10.1186/s12873-025-01360-3","DOIUrl":"10.1186/s12873-025-01360-3","url":null,"abstract":"<p><strong>Introduction: </strong>Enhancing health system preparedness requires the design, implementation, and evaluation of disaster exercises. Conducting these exercises improves preparedness planning and promotes staff awareness and capabilities in responding to emergencies and disasters. Given the existing challenges in designing and executing disaster exercises within the health sector, this study aims to identify the main challenges and barriers to the successful management of health sector disaster exercises.</p><p><strong>Method: </strong>This study was a conventional qualitative content analysis. Data were collected through purposive sampling through in-depth, semi-structured individual interviews with 23 managers from various health sectors. Graneheim and Lundman's conventional content analysis was employed to analyze the data, and Lincoln and Guba's recommendations were utilized to ensure the trustworthiness of the data.</p><p><strong>Result: </strong>A total of 170 challenges (initial codes), organized into one them, five main categories and 15 subcategories, emerged after several rounds of data analysis and summarization, considering both similarities and differences. These main categories included \"Organizational management\", \"structural and administrative system\", \"Ineffective policymaking\", \"Cultural sensitivity and social participation\", and \"organizing exercise steps\".</p><p><strong>Conclusion: </strong>Understanding the obstacles and challenges in implementing discussion-based and operations-based exercises in emergencies and disasters derived from the experiences of exercise implementers in the health system can help health planners and managers proactively address these obstacles and by considering these challenges and striving to reduce them before designing an exercise they can maintain and improve preparedness of their community's healthcare system through the implementation of successful and effective exercises.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"205"},"PeriodicalIF":2.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital transfusion: an 8-year descriptive retrospective monocenter study.","authors":"Fabien Coisy, Martin Corbefin, Florian Ajavon, Dimitri Ceausu, Mélodie Lagarrigue, Thibaut Markarian, Laurent Muller, Xavier Bobbia, Romain Genre Grandpierre","doi":"10.1186/s12873-025-01366-x","DOIUrl":"10.1186/s12873-025-01366-x","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhagic shock (HS) is a critical prehospital condition. This study aimed to evaluate the predictive value of the Red Flag criteria on scene versus clinical judgment (gestalt) at initial call for massive transfusion (MT). Secondary aims included determining the proportion of prehospital interventions with packed red blood cells (pRBCs) units and to describe the characteristics of patients for whom dispatch physicians decided to send mobile prehospital team with pRBCs.</p><p><strong>Methods: </strong>A retrospective study in a French tertiary care hospital (2015-2023) analyzed prehospital interventions involving RBCs. MT was defined as the transfusion of ≥ 4 pRBCs or fresh frozen plasma units within 24 h. The data included demographics, clinical parameters, and outcomes. The predictive performance of the gestalt and Red flag criteria was compared via the area under the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>Among 38,128 interventions, 105 (0.3%) involved 2 pRBCs units transport and 11 (5%) pRBCs units were discarded. Seventy-four (72%) patients were men, median age was 50 (28-67) years old and trauma was the reason for intervention for 67 (65%) patients. A total of 69 (67%) patients received prehospital transfusion: 39 (57%) were trauma patients. The dispatch physician's gestalt score had an AUROC of 0.81, and the Red Flags criteria had an AUCROC of 0.80 in predicting MT within 24 h for trauma patients (p = 0.69).</p><p><strong>Conclusion: </strong>Gestalt and Red Flag criteria showed similar ability to predict massive transfusion, but gestalt requires experience and lacks reproducibility. Our results advocate for the implementation of standardized decision tools to guide prehospital transfusion practices.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"206"},"PeriodicalIF":2.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of regional medical network systems on emergency transport time for older patients in Japan: a retrospective observational study.","authors":"Ayako Matsuda, Akemi Nishio, Asuka Suzuki, Keika Hoshi, Tomonori Nakano, Yuya Yamamoto","doi":"10.1186/s12873-025-01364-z","DOIUrl":"10.1186/s12873-025-01364-z","url":null,"abstract":"<p><strong>Background: </strong>The Saitama Tone Health and Medical Care Region Medical Collaboration Promotion Council has established a regional medical network system (Patient-Centered Digital Health Records, Tonetto) that shares medical information among healthcare facilities and provides medical services to Tonetto users. This system has facilitated the sharing of medical information between core hospitals, general hospitals, and clinics, thereby contributing to improved medical care. Furthermore, Tonetto has facilitated the availability of patient information for emergency transport. This study aimed to evaluate the impact of Tonetto on emergency transportation times for older patients.</p><p><strong>Methods: </strong>The study population consisted of 1,820 older patients (aged 65 and over) among 2,542 emergency patients transported to East Saitama General Hospital between January and December 2023. Based on their registration status in the Tonetto system, the patients were divided into two groups: a Tonetto-registered group (n = 319) and a Tonetto-nonregistered group (n = 1,501). Statistical analysis was performed using a general linear model that included main effects and interaction terms for the three categories of transport distance (< 5, 5-10, and ≥ 10 km) and two categories of Tonetto registration status. The difference in transport time was estimated based on Tonetto registration status for each transport distance category. To control for confounding variables, the model included severity, age, sex, and transport distance as covariates.</p><p><strong>Results: </strong>The difference in transport time (minutes) between the Tonetto-nonregistered group and the Tonetto-registered group (95% confidence interval) was - 0.3 (- 3.0, 2.4), - 3.5 (- 8.9, 1.9), - 24.3 (- 38.3, - 10.2), respectively. A reduction of 24 min in transport time was observed in the Tonetto-registered group for distances of 10 km or more (p = 0.001).</p><p><strong>Conclusions: </strong>Tonetto registration was associated with a substantial reduction in emergency transport time for older patients over long distances. These findings demonstrate the potential of regional medical information networks to improve the efficiency of emergency care and support the development of a nationwide emergency medical information system in Japan.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"204"},"PeriodicalIF":2.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a clinical decision tool to support paramedics when assessing and managing children with minor head injury.","authors":"Alyesha Proctor, Mark D Lyttle, Sarah Voss, Jonathan Benger","doi":"10.1186/s12873-025-01362-1","DOIUrl":"10.1186/s12873-025-01362-1","url":null,"abstract":"<p><strong>Background: </strong>Head-injured children are commonly transported to the Emergency Department (ED) by ambulance. However, most of those conveyed are deemed non-serious and are discharged at triage. Hospital clinicians use clinical decision tools to support their assessment of head-injured children; however, this is generally to determine whether a computed tomography (CT) scan is indicated. Currently, there is no pre-hospital clinical decision tool designed to support paramedics when assessing and managing head-injured children at scene. The aim of this study was to determine consensus amongst experts and stakeholders to inform the development of a new tool to support paramedics in safely assessing and managing children with minor head injury.</p><p><strong>Methods: </strong>A consultation process using a modified online Delphi technique comprising two rounds and a consensus meeting was completed between September 2023 and January 2024. A 5-point Likert scale was used to assess consensus, set a-priori at 67%. Free text survey responses arising from the Delphi were studied and concepts were developed. Data were analysed anonymously, and feedback was given after each round.</p><p><strong>Results: </strong>An expert stakeholder group comprising 36 participants took part in Round One, and 34 participants in Round Two of the online Delphi. The participants included parents/grandparents/caregivers, paramedics, primary care clinicians, ED doctors, ED nurses and Paediatricians. Consensus was reached in 36 statements following Rounds One and Two. The remaining eight statements were discussed at a consensus meeting, which was attended by 12 stakeholders. Seven of the eight statements reached agreement.</p><p><strong>Conclusion: </strong>This Delphi study has established consensus amongst a group of experts and stakeholders on the content and format of a pre-hospital paediatric head injury clinical decision tool, designed for use by paramedics: PATCH (Pre-hospital Assessment Tool for Children with Head injury). Future research should include an evaluation of the acceptability and usability of PATCH by paramedics.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"203"},"PeriodicalIF":2.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}