BMC Emergency Medicine最新文献

{"title":"Predictors of high-acuity outcomes among 10-17-year-olds utilizing pediatric emergency services in Taiwan: a sex-based comparison of male and female adolescents.","authors":"Mei-Wen Wang, Jiun-Hau Huang","doi":"10.1186/s12873-025-01237-5","DOIUrl":"https://doi.org/10.1186/s12873-025-01237-5","url":null,"abstract":"<p><strong>Background: </strong>Adolescents' emergency department (ED) presentations are multi-faceted. However, patient characteristics and chief complaints associated with severe outcomes, particularly sex differences, remain underexplored. This study aimed to identify predictors of high-acuity outcomes among adolescents utilizing pediatric emergency services in Taiwan and to examine sex differences.</p><p><strong>Methods: </strong>We analyzed data from 16,910 non-traumatic pediatric ED visits by adolescents aged 10-17 years at a major tertiary-care hospital in northern Taiwan (2009-2014). Trauma-related cases were not included, as they follow distinct clinical pathways. We tracked four severe outcomes longitudinally as high-acuity outcomes and used them in predictive modeling: (1) intensive care unit (ICU) admission or in-ED death; (2) inpatient ward admission; (3) return to the ED within 72 h for the same presenting complaint; and (4) ED length of stay exceeding 6 h. We used chi-square (χ²) and Fisher's exact tests to analyze bivariate associations. Multivariate logistic regression models, stratified by sex, were constructed with final model selection based on the lowest Akaike Information Criterion (AIC) value to optimize model fit and parsimony. Results are presented as adjusted odds ratios (AORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 2,508 adolescents (14.8%) experienced at least one high-acuity outcome. In the final model for all adolescents, the following patient characteristics were significantly associated with high-acuity outcomes: male sex (AOR = 0.90, 95% CI: 0.82-0.98); ages 16-17 (AOR = 1.23, 95% CI: 1.10-1.37); triage levels 1-2 (AORs = 1.98-2.27, 95% CIs: 1.45-3.00), indicating greater urgency for intervention; ≥2 abnormal vital signs (AORs = 1.59-1.91, 95% CIs: 1.08-2.87); and a Glasgow Coma Scale score of 13-14 (AOR = 0.49, 95% CI: 0.26-0.94), indicating mild impairment of consciousness. In this overall model, we also identified 10 chief complaints as significant predictors of high-acuity outcomes, including endocrine-related diseases (AOR = 2.10, 95% CI: 1.52-2.91), skin-related diseases (AOR = 1.95, 95% CI: 1.02-3.73), nervous system diseases (AOR = 1.34, 95% CI: 1.08-1.68), and poisoning (AOR = 1.38, 95% CI: 1.06-1.81). Among male adolescents, the significant chief complaints mirrored those in the overall model, except that eye diseases (AOR = 1.47, 95% CI: 1.01-2.17) emerged as an additional male-only predictor, and headaches were not, but musculoskeletal system diseases (AOR = 1.45, 95% CI: 1.01-2.08) were retained in the male-specific model. By contrast, only two chief complaints remained significant predictors among female adolescents: endocrine-related diseases (AOR = 1.97, 95% CI: 1.31-2.98) and headaches (AOR = 0.72, 95% CI: 0.54-0.96).</p><p><strong>Conclusions: </strong>This study demonstrated that male and female adolescents with high-acuity outcomes exhibited distinct clin","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"81"},"PeriodicalIF":2.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085847","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":"Effectiveness of Finnish SISU training in enhancing prehospital personnels' work performance: A randomised controlled pilot study.","authors":"Hanna Vihonen, Janne Karvonen, Harri Gustafsberg, Juha-Matti Huhta, Heidi Kangasniemi, Timo Jama, Sanna Hoppu","doi":"10.1186/s12873-025-01235-7","DOIUrl":"https://doi.org/10.1186/s12873-025-01235-7","url":null,"abstract":"<p><strong>Background: </strong>Resilience means coping with and recovering quickly from adversities. This is a highly beneficial quality for prehospital personnel, who encounter many unforeseen stressors while on duty. This study investigated whether a novel pre-emptive resilience coaching programme, 'Finnish SISU training' (hereafter SISU), based on the validated International Performance Resilience and Efficacy Program (iPREP), would improve the work performance by enhancing situational and decision-making skills of prehospital personnel. 'Sisu' is a Finnish word meaning the combination of toughness and resilience.</p><p><strong>Methods: </strong>This randomised controlled pilot study was conducted in Päijät-Häme, Finland. The sample comprised 16 paramedics, divided equally between the intervention and control groups. SISU was administered to the intervention group. Three full-scale simulation scenarios were then conducted. A blinded observer evaluated the participants' situational awareness and decision-making skills using a structured observer form, awarding them a maximum of 10 points. Participants completed a self-evaluation form before and after each simulation scenario and the responses were rated on a 5-point Likert scale. The results of these forms were compared between groups. We also compared the median values of heart rate variability (HRV), maximum heart rate, and respiratory rate between the groups.</p><p><strong>Results: </strong>After 16 h of pre-emptive SISU, the intervention group improved their situational awareness and decision-making skills in the third simulation scenario (observer form results: intervention group median 10 [IQR 9-10] and control group median 6 [IQR 5-7], p ≤ 0.01). In contrast, observer ratings of the control group showed a diminishing trend in work performance across the three simulation scenarios. Self-evaluation revealed increased confidence in work performance in both study groups, in contrast to the blinded observer findings. Regarding HRV, the intervention group in contrast to the control group, recovered in minutes following the simulation scenarios, especially after the third simulation scenario (third defusing session: intervention group median HRV 27 [IQR 21-28], control group median HRV 21 [IQR 17-22], p < 0.01).</p><p><strong>Conclusion: </strong>SISU improved work performance, which was measured by situational awareness and decision-making skills under stressful conditions. Resilience, a skill gained from this novel training, may have positive effects on coping with stress.</p><p><strong>Trial registration: </strong>ISRCTN10221308. Registered at 19.3.2024. Retrospectively registered. https//www.isrctn.com/ISRCTN10221308.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"80"},"PeriodicalIF":2.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085734","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":"Perceived disaster preparedness, knowledge, and skills among Sudanese healthcare professionals during the armed conflict: cross-sectional study, 2024.","authors":"Fatima A Ayyad, Roaa Abdalsalam, Eltayeb Abdalla, Salih B Hamza, Baha Aldeen Alshareif, Alaa A Ayyad, Alaa Salih, Rana Hassan, Noura Mamdouh, Elmustafa Emad, Mihad Adil, Mohamed Abdelgader, Hussamaldin Mohammed, Maha Adam, Almiqdad Salahaldin, Faisal Shiekh, Afrah Tageldin, Walaa Mamoun, Anfal Alamir, Mohi Eldin Hassan","doi":"10.1186/s12873-025-01238-4","DOIUrl":"10.1186/s12873-025-01238-4","url":null,"abstract":"<p><strong>Background: </strong>Disaster preparedness is a critical component of healthcare, especially in regions prone to crisis. Sudan has faced significant challenges, including armed conflict, the displacement of millions, and outbreaks of diseases such as COVID-19, acute watery diarrhoea, and dengue fever. This study evaluated the perceived preparedness, knowledge, and skills of Sudanese healthcare professionals (HCPs) in disaster management.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted among 1,505 HCPs via an online self-administered questionnaire. The classical Arabic version of the Disaster Preparedness Evaluation Tool (DPET) was utilised. The data were analysed via SPSS v28, with univariate and multivariate analyses performed to identify predictors of disaster preparedness, knowledge, and skills.</p><p><strong>Results: </strong>Participants perceived themselves as moderately prepared (mean 4.15 ± 1.1), knowledgeable (mean 4.01 ± 1.1), and skilled (mean 3.72 ± 1.3) in disaster management. Nurses reported higher knowledge scores than physicians, whereas male participants and those with prior disaster exposure presented higher levels of perceived preparedness, knowledge, and skills (p < 0.001). Previous experience in disaster management was a significant predictor of disaster management competency (p < 0.001). Despite moderate perceptions overall, gaps were identified in specific areas, such as familiarity with local emergency systems and disaster triage.</p><p><strong>Conclusion: </strong>Sudanese HCPs face notable gaps in disaster preparedness, knowledge, and skills, exacerbated by limited training and practical experience. Addressing these deficiencies through targeted education, disaster drills, and integrating disaster medicine into curricula is imperative to build a resilient healthcare workforce capable of managing crises effectively.</p><p><strong>Clinical trial registration number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"79"},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075854","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":"Workplace violence in the ambulance service from the offender's perspective: a qualitative study using trial transcripts.","authors":"Magnus Viking, Karin Hugelius, Erik Höglund, Lisa Kurland","doi":"10.1186/s12873-025-01232-w","DOIUrl":"10.1186/s12873-025-01232-w","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence is a widely recognised problem within the ambulance service context. The causes of workplace violence have often been attributed to patient- or situation-related risk factors. However, there is a lack of research on workplace violence from the offender's perspective.</p><p><strong>Aim: </strong>To explore workplace violence directed toward ambulance services from the offender's perspective.</p><p><strong>Methods: </strong>An explorative qualitative study was conducted using inductive thematic analysis of trial transcripts from cases tried in court between 2013 and 2023. Plaintiffs in these cases were ambulance personnel or the ambulance service itself. Offenders were those convicted of committing or attempting any of the following acts: threats, theft, assault, molestation or murder.</p><p><strong>Results: </strong>Twenty-three trial transcripts were analysed, and four themes were found: (I) the offender was misunderstood, which included communication problems and other misunderstandings; (II) the offender was disrespected, which described perceived unprofessional behaviour and unpleasant or painful treatment by ambulance personnel; (III) the offender was vulnerable, which described the state of the offender (i.e., being under the influence of alcohol or drugs); and (IV) the offender had unmet expectations, which included perceived unreasonable waiting time and conflicting expectations of ambulance care.</p><p><strong>Conclusion: </strong>The analysis of trial transcripts revealed four themes from the offender perspective: feelings of being misunderstood, disrespected, vulnerable, and having unmet expectations. It is important to view these results critically, as they are based on trial transcripts in which the offender was found guilty of a crime and may have been attempting to defend his or her actions during the trial. Despite this caveat, healthcare professionals need also to recognise that their behaviour may influence the risk of workplace violence. This knowledge can be harnessed to develop training programs for ambulance personnel.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"77"},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958292","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":"Improving prediction accuracy of hospital arrival vital signs using a multi-output machine learning model: a retrospective study of JSAS-registry data.","authors":"Yasuyuki Kawai, Koji Yamamoto, Keisuke Tsuruta, Keita Miyazaki, Hideki Asai, Hidetada Fukushima","doi":"10.1186/s12873-025-01233-9","DOIUrl":"10.1186/s12873-025-01233-9","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients can deteriorate rapidly; therefore, prompt prehospital interventions and seamless transition to in-hospital care upon arrival are crucial for improving survival. In Japan, helicopter emergency medical services (HEMS) complement general emergency medical services (GEMS) by providing on-site care, reducing transport times, and aiding facility selection. Vital signs at hospital arrival determine initial management, but existing models are poor at predicting them, especially in patients receiving continuous interventions from both GEMS and HEMS. Therefore, we developed a machine-learning model to accurately predict the actual values of vital signs at hospital arrival using limited patient characteristic data and prehospital vital signs.</p><p><strong>Methods: </strong>Using data from the Japanese Society for Aeromedical Services registry, we retrospectively analyzed data from patients aged ≥18 years transported by HEMS between April 2020 and March 2022. Patients with cardiac arrest during transport, missing vital signs, and data inconsistencies were excluded. The predictive model used prehospital vital signs from GEMS and HEMS contact times, demographic characteristics, and intervention information. The primary outcome was the actual values of vital signs measured at hospital arrival. After data preprocessing, we constructed a deep neural network multi-output regression model using Bayesian optimization. Model performance was assessed by comparing the predicted values with the actual hospital arrival measurements using mean absolute error, R² score, residual standard deviation, and Spearman's correlation coefficient. Additionally, the NN model's performance was compared with alternative methods, namely HEMS contact values and change-based predictions derived solely from prehospital data.</p><p><strong>Results: </strong>The study included 10,478 patients (median age 70 years; 69% male). The model achieved mean absolute errors of 7.1 bpm for heart rate, 15.7 mmHg for systolic blood pressure, 10.8 mmHg for diastolic blood pressure, 2.9 breaths/min for respiratory rate, and 0.62 points for Glasgow Coma Scale score. The Spearman's correlation coefficients ranged from 0.54 to 0.86. The model outperformed other methods, especially for R² scores and residual standard deviations, demonstrating its superior ability to predict actual vital signs values.</p><p><strong>Conclusion: </strong>The multi-output regression model accurately predicted the actual values of vital signs measured at hospital arrival using limited prehospital information, demonstrating the effectiveness of advanced modeling techniques.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"78"},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969451","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":"Characterization of emergency department visits in pediatric patients within first year of liver transplantation: ten years experience in tertiary care center.","authors":"Reem Elmokattaf, Ahmad Aljumaa, Majd Alani, Jihad Aljumaa, Nayef Latta, Hossam Ali Basha, Ahmed Mohamed Elhassan, Ismail A Abdullah, Mohammad Aljumaa, Saleh M Al-Yahri, Farooq Pasha","doi":"10.1186/s12873-025-01231-x","DOIUrl":"https://doi.org/10.1186/s12873-025-01231-x","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation is a complex procedure associated with significant post-operative challenges. Monitoring the frequency and timing of Emergency Department (ED) visits post-transplant in a vulnerable population like pediatrics can provide critical insights into patient outcomes and the effectiveness of post-operative care.</p><p><strong>Objective: </strong>This study aims to evaluate the indications, frequency, reasons and length of stay for ED visits among liver transplant recipients within the first year following discharge post-transplantation.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on 361 liver transplant recipients, analyzing the frequency, timing, indications, reasons and length of stay for their ED visits post-discharge over 10 years.</p><p><strong>Results: </strong>361 patients were analyzed in this study with a total of 1300 emergency department visits. (52%) of the patients were males and (48%) were females. Most transplants were from living donors (93%, N = 338). Patients with at least one comorbidity accounted for 35% of total patients with hypertension 6% (20), congenital heart disease 5% (n = 18), and seizure disorder 4% (n = 15) representing the most common comorbidities. Most common indications for liver transplant were biliary atresia (21%) and progressive familiar intrahepatic cholestasis (20%). The most common reasons for ED visits were gastrointestinal symptoms (32%), pulmonary symptoms (22%), and infectious symptoms (16%). Patients' average length of stay in the hospital was 4 ± 10.7 days. Visits within the first 6 months accounted for 58% of total visits in the first year with first and second visits accounting for 47% of total emergency department visits.</p><p><strong>Conclusion: </strong>The study highlights the high frequency of emergency department visits in pediatric subgroup as well the first 6 months as a critical period for follow-up. The study also demonstrated the continuous representation to the emergency department which calls for a closer follow-up and interventions to prevent those revisits.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"76"},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953184","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":"Knowledge about crime scenes and evidence management among emergency medical team professionals.","authors":"Mayada A Daibes, Mohammad R Alsadi, Majed M Alruwaili, Mohammad Y Alzaatreh, Majd T Mrayyan, Hamzeh Y Abunab, Mohammad J ALhemedi","doi":"10.1186/s12873-025-01230-y","DOIUrl":"https://doi.org/10.1186/s12873-025-01230-y","url":null,"abstract":"<p><strong>Background: </strong>To ensure that no criminal evidence has been moved or destroyed from the crime scene, emergency medical team (EMT) professionals should receive appropriate training, particularly in recognizing, collecting, preserving, and documenting evidence in both prehospital and intrahospital environments.</p><p><strong>Aim: </strong>To assess the knowledge and practices of EMT professionals in recognizing, collecting, preserving, and documenting criminal evidence.</p><p><strong>Method: </strong>A cross-sectional design utilizing an online survey was used to collect data from EMT professionals, including nurses, paramedics and physicians. Healthcare settings, including governmental, private, civil defense, and military hospitals in Jordan, participated in the study.</p><p><strong>Results: </strong>A total of 441 EMT professionals participated in the study. EMT professionals in Jordan had \"moderate\" levels of knowledge about recognizing and collecting forensic evidence. Moreover, their knowledge of preserving it was relatively low. The levels of knowledge were higher among physicians and paramedics compared to nurses, as well as in military and private hospitals compared to governmental ones. On the other hand, EMT professionals did perform well in documenting forensic evidence.</p><p><strong>Conclusion: </strong>Integrating the topics of forensic medicine into the undergraduate educational preparation of EMT professionals is essential. This extends to the continuous educational efforts taking place in healthcare settings, as well as highlighting them in the job descriptions of healthcare professionals, particularly in the emergency department. A graduate degree and specialization in forensic medicine are also required for EMTs in Jordan.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"75"},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963943","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":"Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis.","authors":"Yen-Wen Chen, Jian-Heng Lee, Cheng-Ying Chiang, Ya-Ni Yeh, Jih-Chun Lin, Ming-Jen Tsai","doi":"10.1186/s12873-025-01229-5","DOIUrl":"https://doi.org/10.1186/s12873-025-01229-5","url":null,"abstract":"<p><strong>Background: </strong>Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications.</p><p><strong>Methods: </strong>A retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital's electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays.</p><p><strong>Results: </strong>Among the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00-1.01), female sex (aOR: 1.49, 95% CI: 1.31-1.69), limited mobility (aOR: 1.38, 95% CI: 1.17-1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03-1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09-1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05-1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04-1.93), blood tests (aOR: 1.73, 95% CI: 1.30-2.30), radiography (aOR: 2.22, 95% CI: 1.87-2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37-1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16-0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18-0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55-0.93).</p><p><strong>Conclusions: </strong>Several patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"74"},"PeriodicalIF":2.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976240","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":"The impact of the Kermanshah earthquake experiences of Iranian nurses as rescuers: a qualitative study.","authors":"Amirhossein Naghibzadeh, Keivan Moradi, Hamid Saidi, Jalal Karimi, Khalil Moradi","doi":"10.1186/s12873-025-01227-7","DOIUrl":"https://doi.org/10.1186/s12873-025-01227-7","url":null,"abstract":"<p><strong>Background: </strong>Over the past few years, Iran has experienced several earthquakes. The literature has highlighted the significant role played by Iranian nurses in the Kermanshah earthquake. However, few studies have been conducted to investigate nurses' responses to disasters. This study aimed to explore the impacts of rescue experiences on nurses who cared for the injured following the Kermanshah earthquake.</p><p><strong>Method: </strong>This is a qualitative study utilizing a conventional content analysis approach, following the Granheim and Landman framework. Sixteen nurses with experience in caring for earthquake survivors in Kermanshah were selected using a purposeful sampling method. Data were collected through in-depth semi-structured interviews, with ethical considerations applied at all stages of the research. MAXQDA software (version 10) was employed to assist in managing the data.</p><p><strong>Results: </strong>The study included 16 nurses: nine females (56.25%) and seven males (43.75%). The mean age of the participants was 34.13 ± 5.78 years, and the mean work experience was 10.75 ± 5.3 years. Following the coding of the interviews, 274 initial codes were extracted. These codes were merged to form 17 subcategories, five categories, and two main themes. The main themes were (i) Positive impacts (professional maturity, and the emergence of a new horizon in the meaning of life) and (ii) Negative impacts (psychological trauma, a decline in professional performance, and spiritual despair).</p><p><strong>Conclusion: </strong>In the context of this type of care, nurses experience dual impacts: on one hand, it uplifts their personal lives and professional performance, while on the other hand, it poses significant threats to them.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"72"},"PeriodicalIF":2.3,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973223","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":"\"You treat your stress by doing what you're supposed to do\": a qualitative inquiry into emotion regulation of paramedics and paramedic students in critical incidents.","authors":"Branislav Uhrecký, Veronika Kučerová, Denisa Paksi","doi":"10.1186/s12873-025-01228-6","DOIUrl":"https://doi.org/10.1186/s12873-025-01228-6","url":null,"abstract":"<p><strong>Background: </strong>Emergency medical services (EMS) are among the professions with a high degree of responsibility and the frequency of critical situations. Existing research is largely quantitative and provides little insight into the specifics of critical incidents and the emotion regulation strategies used to manage them. Furthermore, little is known about the process by which an experienced paramedic is equipped with emotion regulation resources in the profession.</p><p><strong>Method: </strong>In this study, we interviewed 12 experienced paramedics (at least 4 years of practice) and 10 urgent medical care students about the most intense acute stressors they encounter and the emotion regulation that these stressors trigger.</p><p><strong>Results: </strong>Psychological distancing, attention management, cognitive framing and interpersonal self-regulation were used by both groups as means of emotion regulation. Identification with the professional role is a key aspect of maintaining a sense of psychological distance. A balance between distance and connectedness is sought. It is not so easy for paramedic trainees to achieve a sense of psychological distance from patients and relatives, and their attention may shift from the situation to themselves, leading to greater anxiety.</p><p><strong>Conclusion: </strong>Emotions and emotion regulation are taboo subjects in paramedic community, but greater awareness of them might be beneficial in psychological adaptation to work.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"73"},"PeriodicalIF":2.3,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958321","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}