BMC Emergency Medicine最新文献

{"title":"\"We need to accept our limited resources\": a qualitative study exploring ambulance clinicians' experiences of working conditions when caring for patients with breathlessness.","authors":"Wivica Kauppi, Karl Hedman, Hanna Maurin Söderholm, Magnus Andersson Hagiwara","doi":"10.1186/s12873-026-01620-w","DOIUrl":"10.1186/s12873-026-01620-w","url":null,"abstract":"<p><strong>Background: </strong>Breathlessness is a common and potentially life-threatening symptom among patients and constitutes a frequent reason for ambulance dispatches. Within ambulance care, ambulance clinicians (ACs) are often required to make rapid clinical assessments and decisions under complex and unpredictable conditions. Despite this, there is limited knowledge of how ACs experience their working conditions in ambulance care when caring for patients with breathlessness. Little is known about how these working conditions influence their ability to balance clinical responsibility, patient needs, and environmental constraints in the ambulance care setting. This study aimed to explore how ACs experience their working conditions in connection with the care of patients with breathlessness.</p><p><strong>Methods: </strong>This qualitative exploratory sub-study included a sample of 16 ACs from southwestern Sweden, all with at least one year of clinical experience. Data were collected through semi-structured dyadic interviews following a simulation exercise and analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>The ACs experiences of their working conditions in connection with the care of patients with breathlessness is captured in three main higher-order themes: navigating constraints of the care environment, navigating professional judgment within institutional boundaries, and navigating responsibility in uncertain and distant care situations. ACs highlighted situations in which high-acuity care is delivered in environments that do not consistently ensure clinician safety. Clinical guidelines support decision-making in high-stress situations but may become restrictive when patients' conditions fall outside standard recommendations or when interventions are contraindicated. To address these constraints, ACs develop adaptive strategies. Non-conveyance decisions involving patients with breathlessness are described as particularly complex and burdensome, a challenge intensified by a shift toward selective transport and increased reliance on individual clinical judgment under uncertainty.</p><p><strong>Conclusion: </strong>The findings show that working conditions in ambulance services influence how care for patients with breathlessness is provided and experienced. Care is delivered in contexts marked by urgency, uncertainty, and constrained resources, requiring ACs to navigate patient needs, safety considerations, and organizational expectations. While acceptance of limitations functions as a professional strategy, it carries ethical implications for patients' safety, dignity, and care.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052286","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":"Understanding door-to-needle delays in acute ischemic stroke: a workflow-based analysis of emergency department care processes.","authors":"Wasin Rattanawichai, Nichapatr Phutthikhamin","doi":"10.1186/s12873-026-01606-8","DOIUrl":"10.1186/s12873-026-01606-8","url":null,"abstract":"<p><strong>Background: </strong>Door-to-needle (DTN) performance in acute ischemic stroke is commonly evaluated using aggregate treatment times or isolated predictors. These approaches may not fully capture how delays occur across sequential emergency department processes. Evidence describing the interaction between upstream activation and downstream workflow intervals in secondary-level settings remains limited.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults receiving intravenous thrombolysis at a secondary-level hospital. Multivariable logistic regression was used to identify upstream factors associated with delayed DTN (> 60 min). Interval-level decomposition and stratified quantile regression analyses were performed to examine where time differences occurred within the in-hospital pathway and to assess results according to prehospital stroke alert status.</p><p><strong>Results: </strong>Among 245 patients, 30.60% had DTN times exceeding 60 min, although the overall median DTN was 50 min (IQR 40-63). Absence of prehospital stroke alert, triage misclassification, and fluctuating neurological presentation were independently associated with delayed treatment. The largest median time differences were observed during coagulation processing, final test-to-needle intervals, and patient or family decision-making. In stratified analyses, final test-to-needle and decision intervals remained prolonged in delayed cases across both alert strata, whereas coagulation delay was significant only in the alert-positive group.</p><p><strong>Conclusions: </strong>Delayed DTN was associated with both upstream activation factors and downstream workflow intervals. Combining determinant modeling with interval-level analysis provides a structured approach to identify operational intervals for evaluation in secondary-level stroke systems.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052236","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":"Artificial intelligence in emergency mechanical ventilation: a prospective observational comparison with emergency physician ventilator settings.","authors":"Gürkan Altuntaş, İsmail Ataş, Mümin Murat Yazıcı, Özlem Bilir, Bünyamin Onur Harmancı, Enes Hamdioğlu, Nurullah Parça","doi":"10.1186/s12873-026-01627-3","DOIUrl":"10.1186/s12873-026-01627-3","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has the potential to support clinicians in high-risk and complex decision-making processes, such as mechanical ventilation. This prospective observational study aimed to compare mechanical ventilator settings determined by emergency physician (EP) with recommendations generated by three large language models (ChatGPT-5, Gemini, and Copilot) in the emergency department (ED).</p><p><strong>Methods: </strong>This prospective, analytical, single-center study included 30 intubated patients managed in an ED over a three-month period. Clinical data, including diagnoses, vital signs, and initial arterial blood gas parameters, were presented to ChatGPT-5, Gemini, and Copilot. The AI models' recommendations for ventilation mode, tidal volume, respiratory rate, PEEP, and FiO₂ were compared with the initial settings adjusted by EP. Agreement for ventilator mode selection was assessed using Cohen's kappa statistics, while agreement for continuous ventilator parameters was evaluated using Bland-Altman analysis.</p><p><strong>Results: </strong>A total of 30 patients were included in the study. The median age was 73 years (IQR: 60-84), and 66.7% were male. When the ventilator setting preferences of the EP were analyzed, the most commonly used modes were VCV (46.7%) and SIMV (40.0%). Among the AI models, ChatGPT-5 primarily recommended VCV (76.7%) and, to a lesser extent, CPAP (10.0%); Gemini most frequently preferred VCV (56.7%) and PCV (43.3%); and Copilot predominantly recommended PCV (70.0%). Data on the compatibility of mechanical ventilator mode selection revealed that AI models showed 'poor' agreement with expert opinion (EP) based on diagnosis. ChatGPT showed 50.0% agreement (Cohen's kappa: 0.199; 95% Confidence Interval (CI): -0.087 to 0.486), Google Gemini 43.3% agreement (Cohen's kappa: 0.164; 95% CI: -0.098 to 0.426), and Microsoft Copilot 20.0% agreement (Cohen's kappa: -0.043; 95% CI: -0.230 to 0.143).</p><p><strong>Conclusion: </strong>Agreement between AI-generated ventilator settings and the EP was limited. Current AI models may offer supportive input; however, these findings should be interpreted as preliminary and exploratory, and further large-scale, multicenter studies are needed to validate these results.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052276","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":"Usefulness of chest compression landmarks for improving the quality of infant cardiopulmonary resuscitation: a simulation study.","authors":"Da Hyun Kim, Seung Jun Choi","doi":"10.1186/s12873-026-01625-5","DOIUrl":"10.1186/s12873-026-01625-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine whether using a visible landmark could improve the quality of infant cardiopulmonary resuscitation (CPR).</p><p><strong>Methods: </strong>In this matched, randomized, simulation-based study conducted at a tertiary academic hospital, PALS-certified nurses who provided informed consent performed three cycles of infant chest compressions on a Laerdal Little Baby manikin equipped with a QCPR sensor. Each participant completed compressions under one of three randomized conditions: correct landmark, incorrect landmark, and no landmark. The primary outcome was compression accuracy, and the secondary outcome was hand position consistency across cycles.</p><p><strong>Results: </strong>Twenty-seven PALS-certified nurses were enrolled and evenly randomized into the three groups. Mean compression accuracy was significantly higher in the correct-landmark group compared with the incorrect- and no-landmark groups (99.6% vs. 46.9% and 68.1%, respectively; p < 0.001). Compression depth and rate did not differ among groups, with all within the PALS-recommended range. Cycle-to-cycle spatial variability across cycles was also greatest in the correct-landmark group, demonstrating enhanced precision and reproducibility of infant chest compressions.</p><p><strong>Conclusion: </strong>In this simulation-based study, placing a visible landmark at the correct anatomical site significantly improved the accuracy and consistency of infant chest compressions. Further studies in clinical settings are warranted to validate these findings.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041193","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":"\"We are not allowed to give any pain relief\" - Swedish mountain-rescue operations from the perspective of mountain-rescue personnel: an interview study.","authors":"Amanda Gezelius, Anton Westman, Johan Hylander","doi":"10.1186/s12873-026-01624-6","DOIUrl":"10.1186/s12873-026-01624-6","url":null,"abstract":"<p><strong>Background: </strong>Rescue efforts in mountainous terrain remain a challenge for responding organizations such as police, emergency medical services and the mountain rescuers. This study aimed to shed light on Swedish mountain-rescue operations from the perspective of mountain rescuers.</p><p><strong>Methods: </strong>Individual interviews were conducted with 21 Swedish mountain rescuers from four different counties bordering the 1,700-km long and 300-km wide Swedish/Norwegian mountain range \"The Scandes.\" The collected data were analyzed using qualitative content analysis.</p><p><strong>Results: </strong>The overall theme was \"A unique environment demands a tailored response.\" Five categories were identified: (1) major incident preparedness, (2) intra-organizational preconditions, (3) initial incident response, (4) welfare concerns on-route and on-site, and (5) a difficult injury assessment.</p><p><strong>Conclusion: </strong>Intra-organizational bureaucracy may impede Swedish mountain-rescue response. Legislative issues regarding timely access to helicopters for the transportation of personnel and injured, as well as the restrictions on the administration of pain-relief drugs by licensed medical professionals, need to be addressed to decrease time to definitive treatment and improve patient comfort in future rescue efforts.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148026785","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":"Emergency physicians' perspectives on structural factors associated with mental health and burnout.","authors":"Anish K Agarwal, Rachel E Gonzales, Devon Schroeder, Lauren Southwick, Raina M Merchant","doi":"10.1186/s12873-026-01610-y","DOIUrl":"10.1186/s12873-026-01610-y","url":null,"abstract":"<p><strong>Importance: </strong>The well-being of emergency medicine (EM) physicians significantly impacts health care systems, and patients. Understanding the interplay of factors contributing to EM physicians' mental health issues and burnout is essential for developing targeted support mechanisms.</p><p><strong>Objective: </strong>To investigate the individual, environmental, and structural factors influencing the mental health and burnout experienced by EM physicians, thereby informing potential strategies for intervention and support.</p><p><strong>Design: </strong>A qualitative study using recorded and de-identified semi-structured interviews.</p><p><strong>Setting and participants: </strong>Twenty EM residents and faculty physicians at a large urban academic health system.</p><p><strong>Measures: </strong>Interviews followed a semi-structured interview guide focusing on clinical work experiences and factors influencing well-being and mental health. Thematic analysis was applied. The study outlined underlying themes from the participants' responses, utilizing a general inductive approach.</p><p><strong>Results: </strong>Four primary themes emerged with subthemes: (1) Individual Coping - detailing strategies for managing stress during and outside shifts, including long-term adjustments; (2) Interpersonal Factors - examining the interactions with patients, peers, and family; (3) Environmental Factors - highlighting the challenges posed by patient boarding and workload; and (4) Systemic Issues - addressing stigma in mental health, confidentiality, and the strain from public health crises.</p><p><strong>Conclusions: </strong>The study underscores the complex challenges impacting EM physicians' mental health and career longevity. It highlights the need for comprehensive interventions that move beyond resilience training and build upon interpersonal support and systemic health system reforms. Fostering a culture of workplace safety and implementing targeted resources to manage capacity strain are essential approaches for supporting the well-being of EM physicians.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013323","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":"Diagnostic performance of the lactate dehydrogenase-to-albumin ratio for early acute kidney injury in crush syndrome: a retrospective cohort study.","authors":"Ayşenur Gür, Ramiz Yazıcı, Hüseyin Mutlu, Medine Akkan Öz, Yunus Yatmaz, Bensu Bulut, Murat Genç, Şükrü Yorulmaz, Hakan Güner, Mustafa Sırrı Kotanoğlu","doi":"10.1186/s12873-026-01617-5","DOIUrl":"10.1186/s12873-026-01617-5","url":null,"abstract":"<p><strong>Background: </strong>Crush syndrome is a life-threatening consequence of prolonged muscle compression, and acute kidney injury (AKI) is a major determinant of morbidity and mortality. Rapid AKI risk stratification at emergency department (ED) presentation remains challenging. We evaluated whether the lactate dehydrogenase-to-albumin ratio (LDAR) measured at ED admission could discriminate creatinine-defined AKI among patients with crush syndrome.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study in the ED of a Level I trauma center from 1 January 2019 to 31 December 2025. Adults (≥ 18 years) meeting a predefined operational definition of crush syndrome, including traumatic compression injury, biochemical rhabdomyolysis, and compatible clinical or systemic features, were included. AKI was defined using serum creatinine-based Kidney Disease: Improving Global Outcomes criteria with a predefined approach for baseline creatinine determination. LDAR was calculated as admission lactate dehydrogenase divided by admission albumin. Discrimination was assessed using receiver operating characteristic (ROC) analysis with area under the curve (AUC) and 95% confidence intervals. Independent associations with AKI and RRT were examined using multivariable logistic regression.</p><p><strong>Results: </strong>Among 512 patients, 180 (35.2%) were classified as having creatinine-defined AKI; 374 (73.0%) were male. Hemodialysis was required in 78/180 (43.3%) patients with AKI, and in-hospital mortality was higher in patients with AKI (15.0% vs. 0.6%). Creatine kinase (CK) showed the highest discrimination for AKI (AUC 0.977, 95% CI 0.964-0.989), followed by LDAR (AUC 0.966, 95% CI 0.953-0.980). A Youden-derived LDAR cut-off of ≥ 23.59 yielded 86.7% sensitivity and 96.7% specificity. In addition, an LDAR cut-off of ≥ 22.68 predicted RRT requirement in patients with CS with 97.4% sensitivity and 77.6% specificity.</p><p><strong>Conclusions: </strong>LDAR measured at ED presentation showed high discrimination for AKI and RRT in crush syndrome. Although not a stand-alone treatment trigger, it may support early renal risk stratification when interpreted together with CK, renal function, electrolyte status, and clinical severity.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004422","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":"Regional disparities in emergency medical services in Poland: a preliminary study.","authors":"Przemysław Żuratyński, Daniel Ślęzak, Michał Borowczyk, Tomasz Czynszak, Marta Janowska-Zientara","doi":"10.1186/s12873-026-01586-9","DOIUrl":"10.1186/s12873-026-01586-9","url":null,"abstract":"<p><strong>Introduction: </strong>Equitable access to emergency medical services (EMS) is a core principle of health system performance. However, in territorially heterogeneous countries, resource allocation often fails to reflect interacting demographic and spatial determinants. In Poland, systematic nationwide evidence integrating demographic, spatial, and operational determinants of EMS utilisation remains limited. This study examines whether EMS allocation aligns with actual demand patterns and identifies structural imbalances across regions.</p><p><strong>Methods: </strong>A nationwide cross-sectional analysis was conducted using official EMS dispatch data covering all 16 voivodeships over a 31-day period (16 February-18 March 2025). Indicators were calculated per 100,000 inhabitants and per km² using national demographic statistics. Associations between population size, density, territorial extent, EMS team allocation and workload were assessed using correlation and regression analyses.</p><p><strong>Results: </strong>Daily call volume averaged 13,106 nationwide, with 71.5% resulting in ambulance dispatch. Population size strongly predicted absolute demand (r = 0.96, p < 0.001), explaining most regional variance (R² = 0.964). However, population-standardized and area-adjusted indicators revealed substantial structural discrepancies. Population density was positively associated with spatial call intensity (r = 0.88, p < 0.001) but negatively associated with per-capita rates (r = - 0.62, p = 0.008). Workload per EMS team varied significantly across regions (p < 0.001), indicating that resource allocation does not fully correspond to operational burden.</p><p><strong>Conclusions: </strong>EMS demand in Poland is not solely a function of population size. Territorial accessibility and density shape operational pressure in distinct ways, exposing structural allocation imbalances. Sustainable EMS planning requires integrated, multidimensional allocation models that simultaneously account for demographic scale, spatial dispersion and workload intensity.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004439","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":"Radiological detection rate and clinical impact of thoracoabdominal computed tomography in suspected infection in the emergency department: a retrospective cohort study.","authors":"Abdullah Enes Ataş, Mustafa Emir, Fatih Cemal Tekin, Abdurrahman Koç","doi":"10.1186/s12873-026-01622-8","DOIUrl":"10.1186/s12873-026-01622-8","url":null,"abstract":"<p><strong>Background: </strong>Identifying the anatomical source of infection in emergency department (ED) patients with suspected sepsis is challenging. This study evaluates the radiological detection rate of thoracoabdominal computed tomography (TACT) and its association with downstream clinical management.</p><p><strong>Methods: </strong>In this retrospective cohort study, 267 adult ED patients who underwent TACT for suspected severe infection were evaluated. The primary outcome was the radiological detection of an infectious focus, confirmed by a composite reference standard (CT findings, microbiology, clinical follow-up, and treatment response). Demographic data, quick Sequential Organ Failure Assessment (qSOFA) scores, and biomarkers were analyzed alongside clinical outcomes, including hospital admission and the need for interventional procedures.</p><p><strong>Results: </strong>The radiological detection rate of TACT for a definitive infectious focus was 41.2% (n = 110), while non-infectious acute pathologies mimicking sepsis were identified in 18.0% (n = 48). Thoracic infections were the most common (54.5%). Multivariate logistic regression identified a qSOFA score ≥ 2 (OR = 3.14; p = 0.009) and elevated C-reactive protein (OR = 1.009; p = 0.034) as independent predictors of a positive CT scan. Patients with a radiologically confirmed infectious focus underwent source-control interventions more frequently than those with normal CT findings (14.8% vs. 2.9%; OR = 5.72, p = 0.014). The detection of any pathological finding on CT was strongly associated with hospital admission.</p><p><strong>Conclusion: </strong>TACT is a valuable diagnostic tool in suspected infections. High qSOFA scores and CRP levels correlate with a higher probability of detecting an infectious focus on CT. Beyond primary diagnosis, positive TACT findings are strongly associated with hospital admission and facilitate targeted source-control interventions.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986450","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":"Reporting of Utstein-recommended variables in prehospital traumatic cardiac arrest: a scoping review.","authors":"Saeed Khayat Kakhki, Majid Daneshfar, Alireza Namaei Qasemnia, Mehrdad Yousefnezhad, Matina Rajaee","doi":"10.1186/s12873-026-01609-5","DOIUrl":"10.1186/s12873-026-01609-5","url":null,"abstract":"<p><strong>Background: </strong>Traumatic cardiac arrest (TCA) is a time-critical emergency with substantial heterogeneity across prehospital systems. Standardized reporting using Utstein-recommended variables is essential to enable valid comparison and synthesis across studies. To map how prehospital TCA studies published between 2020 and 2025 report Utstein-recommended variables, assess adherence to core and supplementary elements, and identify gaps and variation in reporting practice.</p><p><strong>Methods: </strong>We conducted a scoping review following Joanna Briggs Institute guidance and reported according to PRISMA-ScR. PubMed, Embase, Scopus, and Web of Science were searched for English-language primary studies. Utstein-recommended variables were charted using a prespecified codebook and mapped to Utstein core and supplementary elements. Reporting completeness was summarized descriptively, and study-level reporting patterns were visualized using a heatmap and an UpSet plot.</p><p><strong>Results: </strong>Fifty studies were included. Core elements were more consistently reported than supplementary elements (≥50% reported in 72.0% vs 12.0% of studies). Demographics and arrest etiology were almost universally reported (98-100%), whereas time-interval and dispatch-related variables were rarely reported, including time to first shock (0%), dispatch time variables (4.0%), and time to first CPR (2.0%).</p><p><strong>Conclusions: </strong>Reporting of Utstein-recommended variables in contemporary prehospital TCA studies is incomplete and uneven, with persistent underreporting of dispatch- and time-interval elements and limited co-reporting of key core variables required for comparability. Improved adherence to a minimum Utstein-aligned dataset, augmented by trauma-specific descriptors, may strengthen standardization and interpretability of the TCA evidence base.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969778","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}