BMC Emergency Medicine最新文献

{"title":"Recognition of stroke symptoms indicative of anterior circulation large-vessel occlusion via telephone and video calls: a simulation study.","authors":"Matthias L Herrmann, Simone Meier, Florian F Schuchardt, Max Henningsen, Nicole Wimmesberger, Diana Rau, Erik Farin-Glattacker, Jochen Brich","doi":"10.1186/s12873-025-01344-3","DOIUrl":"https://doi.org/10.1186/s12873-025-01344-3","url":null,"abstract":"<p><strong>Background: </strong>Identifying suspected anterior circulation large-vessel occlusion (aLVO) strokes during emergency calls could enhance dispatch efficiency, particularly in rural areas. However, data on emergency medical dispatchers' (EMDs) ability to recognize aLVO symptoms remain limited. This simulation study aimed to evaluate the feasibility of identifying side-specific arm paresis, side-specific conjugate eye deviation (CED), and aphasia during emergency calls by instructing layperson callers to perform brief, standardized examination steps. Two communication methods were compared: (1) telephone calls and (2) video calls.</p><p><strong>Methods: </strong>Forty-eight laypersons interacted with simulated patients presenting various stroke syndromes. Simulated EMDs conducted standardized assessments during simulated emergency calls, guiding laypersons through patient examinations.</p><p><strong>Results: </strong>In 96 telephone-assisted and 95 video-assisted calls, EMDs identified aLVO stroke symptoms with high accuracy. In telephone calls, accuracy was 0.92 for side-specific arm paresis, 0.98 for side-specific CED, and 0.88-0.99 for aphasia. In video calls, accuracy was 0.97 for side-specific arm paresis, 0.97 for side-specific CED, and 0.94-1.00 for aphasia.</p><p><strong>Conclusions: </strong>These findings suggest that EMDs can identify stroke symptoms indicative for aLVO via both telephone and video calls using a standardized dispatch protocol to guide lay bystanders. This study provides a foundation for future real-world research on implementing aLVO detection protocols in emergency dispatch.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"180"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032782","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":"Difficult calls to emergency medical dispatch centres - a mixed method study.","authors":"Inger K Holmström, Hans Blomberg, Ulrika Winblad, Douglas Spangler","doi":"10.1186/s12873-025-01343-4","DOIUrl":"https://doi.org/10.1186/s12873-025-01343-4","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"179"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028900","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":"Perceptions of workload in emergency care in the Netherlands and how to influence this: a qualitative study.","authors":"Ties Eikendal, Naomi Prudon, Rudolf Bertijn Kool, Patrick Jeurissen, Menno Iskander Gaakeer, Bas de Groot, Simone A van Dulmen","doi":"10.1186/s12873-025-01334-5","DOIUrl":"10.1186/s12873-025-01334-5","url":null,"abstract":"<p><strong>Background: </strong>Adequate staffing and manageable workloads are crucial for high-quality emergency care. However, high perceived workloads in the emergency department (ED) threaten both. Increased demand and staff shortages intensify these issues and cause crowding. Understanding healthcare workers' perspectives on workload is essential for effective policymaking and maintaining a durable workforce. The objective of this study was to explore the current perceived workload of ED professionals, and their vision on how to influence it and to understand the healthcare worker's perspective on proposed healthcare reforms in the Netherlands.</p><p><strong>Methods: </strong>Qualitive study using semi-structured interviews with 33 healthcare professionals (ED physicians, physician assistants and nurses) working in a university medical center, and three general hospitals from March-July 2023. The interviews were audio-recorded and transcribed verbatim. The interview transcripts were coded. An inductive content analysis was performed, where codes were assigned to the transcripts and adjusted. Codes were then sorted into themes on causes of workload, consequences and proposed solutions for reducing the workload.</p><p><strong>Results: </strong>Emergency department professionals identified increasing patient inflow, barriers to patient throughput and output, and staff shortages as key workload causes. Consequences included increased time, mental and psychological demands, leading to stress and reduced job satisfaction. A well-coordinated team and having social interaction with colleagues is seen as a key part of the profession by ED-professionals. Next to that, training and development opportunities contribute to job satisfaction. Proposed solutions involved public education, improved care coordination, technological innovations, and enhanced collaboration within and among hospitals to improve efficiency and job satisfaction, and to reduce perceived workload pressure.</p><p><strong>Conclusions: </strong>Addressing perceived workload is crucial for maintaining quality and accessibility of care. Dutch ED professionals face a high workload leading to stress and lower job satisfaction. To ensure successful changes, adequate preconditions and engaging healthcare professionals in decision-making are crucial. In future research, a stronger focus on effective work habits and processes, including provider satisfaction and workplace well-being, is necessary.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"178"},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941601","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":"Moral distress and musculoskeletal disorders in Iranian prehospital EMS workers.","authors":"Hossein Sheikhi, Monir Nobahar, Elahe Saleh","doi":"10.1186/s12873-025-01342-5","DOIUrl":"10.1186/s12873-025-01342-5","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"177"},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941630","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":"Challenges faced by the Iranian health system in response process to terrorist explosive attacks: a descriptive phenomenology qualitative study of live experiences.","authors":"Asghar Tavan, Ahmad Mashkoori, Asiye Aminafshar, Afshin Khazaei, Sahar Salahi, Hojjat Farahmandnia","doi":"10.1186/s12873-025-01338-1","DOIUrl":"10.1186/s12873-025-01338-1","url":null,"abstract":"<p><strong>Introduction: </strong>Mass casualty incidents present significant challenges not only for healthcare providers and emergency service responders at the incident scene, but also for the hospitals that receive those affected. Terrorism related mass casualty incidents can lead to a diverse array of circumstances, necessitating those hospitals and their personnel be adequately prepared to manage more complex and demanding requirements. This study aimed to explore the health system challenges related to the response process to terrorist explosive bombing attacks from the perspective of Iranian health system managers and experts.</p><p><strong>Methods: </strong>The present qualitative study employs a descriptive phenomenology approach conducted in Iran. Data were gathered through in-depth individual interviews with 16 health managers and experts, using purposive sampling. The Data analysis was conducted utilizing Colaizzi's 7-step method. To ensure the trustworthiness of the findings, the study adhered to the recommendations set forth by Lincoln and Guba.</p><p><strong>Results: </strong>After multiple rounds of analyzing and summarizing the data and taking into consideration similarities and differences, 230 initial codes, 18 sub-categories, 5 categories and 2 main themes were created based on the results of data analysis. Theme 1: Intra-organizational challenges including categories of (prehospital and hospital challenges). Theme 2: Inter-organizational challenges including categories of (chain of command, insufficient security and ineffective communication and information).</p><p><strong>Conclusion: </strong>This study explored healthcare workers and managers experiences with internal and external organizational challenges in responding to terrorist explosive bombing attacks. Findings reveal that such incidents pose unique demands distinct from other emergencies, requiring tailored preparedness strategies, especially in prehospital, hospital, and logistical sectors, despite existing general disaster plans. An effective response needs multisectoral collaboration with security forces and aid organizations. The presentation of real-world insights can inform targeted preparedness programs for high-risk, chaotic terrorist scenarios.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"175"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941389","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":"Performance of ChatGPT, Gemini and DeepSeek for non-critical triage support using real-world conversations in emergency department.","authors":"Sukyo Lee, Sumin Jung, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sejoong Ahn","doi":"10.1186/s12873-025-01337-2","DOIUrl":"10.1186/s12873-025-01337-2","url":null,"abstract":"<p><strong>Background: </strong>Timely and accurate triage is crucial for the emergency department (ED) care. Recently, there has been growing interest in applying large language models (LLMs) to support triage decision-making. However, most existing studies have evaluated these models using simulated scenarios rather than real-world clinical cases. Therefore, we evaluated the performance of multiple commercial LLMs for non-critical triage support in ED using real-world clinical conversations.</p><p><strong>Methods: </strong>We retrospectively analyzed real-world triage conversations prospectively collected from three tertiary hospitals in South Korea. Multiple commercial LLMs-including OpenAI GPT-4o, GPT-4.1, O3, Google Gemini 2.0 flash, Gemini 2.5 flash, Gemini 2.5 pro, DeepSeek V3, and DeepSeek R1-were evaluated for the accuracy in triaging patient urgency based solely on unsummarized dialogue. The Korean Triage and Acuity Scale (KTAS) assigned by triage nurses was used as the gold standard for evaluating the LLM classifications. Model performance was assessed under both a zero-shot prompting condition and a few-shot prompting condition that included representative examples.</p><p><strong>Results: </strong>A total of 1,057 triage cases were included in the analysis. Among the models, Gemini 2.5 flash achieved the highest accuracy (73.8%), specificity (88.9%), and PPV (94.0%). Gemini 2.5 pro demonstrated the highest sensitivity (90.9%) and F1-score (82.4%), though with lower specificity (23.3%). GPT-4.1 also showed balanced high accuracy (70.6%) and sensitivity (81.3%) with practical response times (1.79s). Performance varied widely between models and even between different versions from the same vendor. With few-shot prompting, most models showed further improvements in accuracy and F1-score.</p><p><strong>Conclusions: </strong>LLMs can accurately triage ED patient urgency using real-world clinical conversations. Several models demonstrated both high sensitivity and acceptable response times, supporting the feasibility of LLM in non-critical triage support tools in diverse clinical environments. These findings apply to non-critical patients (KTAS 3-5), and further research should address integration with objective clinical data and real-time workflow.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"176"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941658","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":"Identifying challenges and future directions of flood hazards mitigation strategies in health facilities: a systematic literature review.","authors":"Farhad Arefi, Asghar Tavan, Seyed Mobin Moradi, Salman Daneshi, Hojjat Farahmandnia","doi":"10.1186/s12873-025-01339-0","DOIUrl":"10.1186/s12873-025-01339-0","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"174"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941628","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":"Disparities between two possible thresholds for frequent contacts to a Norwegian emergency medical communication centre: ≥5 contacts in one month vs. ≥12 contacts in three months.","authors":"Astrid K V Harring, Magnus Hjortdahl, Kristin Häikiö, Trine M Jørgensen","doi":"10.1186/s12873-025-01333-6","DOIUrl":"https://doi.org/10.1186/s12873-025-01333-6","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"173"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941409","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, confidence, guideline adherence and improvement needs regarding suicide prevention in acute care: a cross-sectional study in hospitals in the Netherlands.","authors":"Kinke Marloes Lommerse, Yvonne Lucia Luigjes-Huizer, David Nico Baden, Marjolein Anniek Veerbeek, Renske Gilissen, Saskia Yvonne Mérelle","doi":"10.1186/s12873-025-01331-8","DOIUrl":"https://doi.org/10.1186/s12873-025-01331-8","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"171"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941596","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":"It's time to talk to emergency medical dispatchers: survey study on performance feedback and patient outcome follow-up to EMDs.","authors":"Erik J Wanberg, Greg Scott, Kristina M Dostal, Aidan F Mullan, Sarayna S McGuire","doi":"10.1186/s12873-025-01332-7","DOIUrl":"https://doi.org/10.1186/s12873-025-01332-7","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"172"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941674","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}