BMC Emergency Medicine最新文献

{"title":"Validation of the PEACE score for predicting abnormal echocardiographic findings in pulmonary embolism patients.","authors":"Kazım Ersin Altınsoy","doi":"10.1186/s12873-025-01259-z","DOIUrl":"10.1186/s12873-025-01259-z","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism (PE) is a life-threatening condition requiring rapid risk stratification for optimal management. The Pulmonary Embolism Advanced Cardiac Evaluation (PEACE) Score is a novel tool integrating clinical, laboratory, and echocardiographic parameters to assess disease severity. This study aimed to evaluate the correlation between PEACE Score and echocardiographic abnormalities in PE patients, and to determine its effectiveness as a rapid risk assessment tool in emergency settings.</p><p><strong>Methods: </strong>Between June 2020 and June 2024, 120 patients were prospectively screened and enrolled in the study after being diagnosed with pulmonary embolism via CT angiography in the emergency department. Patients were categorized into three groups according to PEACE score as low risk (< 3 points, n = 42), intermediate risk (3-5 points, n = 52) and high risk (> 5 points, n = 26). Echocardiographic findings were not used for stratification but rather analyzed as outcome variables to assess the discriminative validity of the PEACE Score. Demographic data, laboratory findings and echocardiographic parameters were recorded. Patients were followed up for at least 1 year. Follow-up from 3 months to 6 months was evaluated and mortality rates at the end of 1 year were determined.</p><p><strong>Results: </strong>PEACE Score was strongly correlated with echocardiographic abnormalities (r = 0.685, p < 0.001) and inflammatory markers, including CRP (r = 0.524, p < 0.001). The PEACE Score had the highest diagnostic value for predicting echocardiographic abnormalities, with an AUC of 0.82 (95% CI: 0.74-0.90, p < 0.001). Specifically, in predicting right ventricular dysfunction, the PEACE Score achieved an AUC of 0.85 (95% CI: 0.77-0.93, p < 0.001). A cutoff of > 5 points showed a sensitivity of 84.6% and specificity of 79.2% for detecting severe echocardiographic abnormalities. One-year survival rates were 45% in the high-risk group, 65% in the intermediate-risk group, and 85% in the low-risk group. Kaplan-Meier analysis confirmed significant differences in survival among risk groups (p < 0.001).</p><p><strong>Conclusion: </strong>The PEACE Score demonstrated a strong association with echocardiographic abnormalities and patient survival in emergency department PE cases. These findings suggest that PEACE may serve as a valuable tool for rapid risk stratification, aiding emergency physicians in early clinical decision-making. Specifically, high PEACE Scores were associated with a greater need for thrombolytic therapy and ICU admission, suggesting its potential utility in guiding treatment escalation and resource allocation in critically ill PE patients.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"96"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246265","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":"Effectiveness of extended reality technologies in cardiopulmonary resuscitation training: a bayesian network meta-analysis.","authors":"Xiangmin Li, Xinbo Yin, Guoqing Huang, Xiaokai Wang","doi":"10.1186/s12873-025-01256-2","DOIUrl":"10.1186/s12873-025-01256-2","url":null,"abstract":"<p><strong>Background: </strong>High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods.</p><p><strong>Methods: </strong>A Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models.</p><p><strong>Results: </strong>11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected.</p><p><strong>Conclusions: </strong>XR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"94"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246262","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":"National survey on availability, use and clinical impact of point-of-care blood analysis systems in Swedish emergency departments.","authors":"Matthias Jörg, Tim Lundgren, Jens Wretborn, Daniel B Wilhelms","doi":"10.1186/s12873-025-01251-7","DOIUrl":"10.1186/s12873-025-01251-7","url":null,"abstract":"<p><strong>Background: </strong>Expedited diagnostic results are important in time sensitive operations like the Emergency Department (ED). Point-of-care testing (POCT) is used for a broad range of blood tests reducing wait times and providing faster decisions on patient management compared to central laboratory analysis. If POCT is to substitute central laboratory analysis as part of the decision making process in the ED, cognizance on the distribution and availability of the required instruments, staff training and workflow integration is essential. The aim of this study was to determine the accessibility of POCT, with particular emphasis on blood gas analysis, in all Swedish EDs and to describe its incorporation into workflow.</p><p><strong>Methods: </strong>This was an exploratory survey study conducted in 2024 using a digital questionnaire focusing on POCT availability, perceived reliability, sampling, analysis and workflow integration. Descriptive data is reported as percentage, mean with standard deviation. Qualitative data in open-ended questions was analyzed in a descriptive manner and systematically summarized.</p><p><strong>Results: </strong>All Swedish EDs (n = 71) responded to our survey. All EDs utilized some kind of POCT with the most prevalent being blood gas, Hb, glucose and CRP. 75% of all EDs had at least one blood gas instrument on site. 44% had guidelines to define indication and usage, 67% replaced certain central laboratory analyses in favor of POCT. ED staff assessed the reliability of results of POCT blood gas analysis as 8 on a 1-10 likert scale (SD 1). All EDs provided staff training on sampling and analysis, but only 30% of EDs had repeated training sessions to avoid misoperation and preanalytical errors. In 32% of reporting EDs, POCT blood gas analysis was performed on more than 30% of patients, mainly triggered by standard operating procedures.</p><p><strong>Conclusion: </strong>All Swedish EDs utilized basic POCT to accelerate patient flow. The majority of Swedish EDs have access to POCT blood gas analysis, the replacement of central laboratory analyses was common. Perceived reliability of POCT blood gas analysis results was considered high, despite the fact that staff training varied substantially. The overall utilization of other POCT remains low - that despite good evidence for cost-effectiveness, reliability and shortened length of stay.</p><p><strong>Trial registration: </strong>Clinical trial number: Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"93"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246263","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":"Enhancing emergency department triage for older patients: a prospective study on the integration of the identification of seniors at risk.","authors":"Lanxin Ouyang, Shuzhen Yu, Ziwei Hu, Yin Lin, Di Liu","doi":"10.1186/s12873-025-01253-5","DOIUrl":"10.1186/s12873-025-01253-5","url":null,"abstract":"<p><strong>Background: </strong>Older adults are a growing demographic in emergency departments (EDs) worldwide, yet traditional triage systems often fail to account for their unique risks, leading to under-triage and adverse outcomes. The Identification of Seniors at Risk (ISAR) tool offers a pragmatic approach to enhance risk stratification, but its integration into ED triage systems remains underexplored.</p><p><strong>Methods: </strong>This prospective single-center observational cohort study assessed older patients (≥ 65 years) using both the standard ED triage system and the ISAR scale. After a 30-day follow-up, triage levels were retrospectively adjusted upward by one level for patients with ISAR scores ≥ 2. The predictive accuracy of the revised triage system was compared to the original system using logistic regression and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Among 973 patients completing follow-up, 38.1% had an ISAR score ≥ 2. Older patients (≥ 75 years) were more likely to be classified as high risk and had significantly higher rates of adverse outcomes, including ICU admission and 30-day mortality. The revised triage system slightly improved discriminative ability in patients aged ≥ 65 years (AUC 0.697 to 0.714), with stable performance maintained in those aged ≥ 75 years (AUC 0.703). Sensitivity declined slightly, while specificity improved.</p><p><strong>Conclusion: </strong>Integrating ISAR into ED triage modestly enhanced the identification of older patients at risk for short-term adverse outcomes, particularly among those aged ≥ 65 years. These findings support the value of incorporating geriatric screening into routine triage to enable more tailored risk stratification. Further studies are needed to evaluate implementation feasibility across different healthcare settings and to inform integration into routine practice.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"91"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214801","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":"Influence of different relationships of bystanders to out-of-hospital cardiac arrest patients on the effectiveness of dispatcher-assisted CPR.","authors":"Liang-Tien Chien, Chien-Hsiung Huang, Hsin-Tzu Yeh, Chip-Jin Ng, Ming-Fang Wang, Chen-Bin Chen, Shang-Li Tsai, Li-Heng Tsai, Kang-Wei Chang, Cheng-Yu Chien, Ching-Ter Chang","doi":"10.1186/s12873-025-01244-6","DOIUrl":"10.1186/s12873-025-01244-6","url":null,"abstract":"<p><strong>Background: </strong>Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) significantly improves CPR performance by bystanders, increasing the survival of patients. However, emotional stress among family members witnessing out-of-hospital cardiac arrest (OHCA) may hinder their ability to effectively perform CPR, leading to delayed and poorer quality CPR. The influence of the relationships of callers to patients (i.e., family members, friends, and strangers) on DA-CPR outcomes remains insufficiently explored.</p><p><strong>Materials and methods: </strong>This retrospective observational study analyzed the data of nontraumatic OHCA cases in Taoyuan City, Taiwan, from August 2021 to January 2023. Data from the registries of emergency medical services and emergency call recordings were examined. Relationships of callers to patients, emotional barriers, time metrics (time to CPR instruction initiation and first compression), and barriers to DA-CPR success were evaluated. Associations between callers' relationships to patients and DA-CPR performance were analyzed through multivariable logistic regression.</p><p><strong>Results: </strong>Among 1,036 nontraumatic OHCA cases, 59.3% of callers were family members, 13.6% were friends, and 27.1% were strangers. Cardiac arrest recognition rates were lower for family members (68.2%) than for strangers (84.0%) (p < 0.001). Time to CPR instruction (117 vs. 91 s, p = 0.034) and the first chest compression (200 vs. 179 s, p = 0.018) were significantly delayed for family members. For family members, emotional stress and protocol nonadherence were the main barriers to CPR performance.</p><p><strong>Conclusion: </strong>The relationship of the caller to the patient significantly influences DA-CPR outcomes. Family members experience increased emotional stress, resulting in delays and decreased recognition rates. Targeted family-centered education and enhanced dispatcher support are essential to address these challenges and improve the survival outcomes of patients with OHCA.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"90"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214820","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":"Experiences with and perspectives on firearm injury prevention among emergency medical services clinicians.","authors":"Amanda J Aubel, Avery Baldwin, Amy Barnhorst, Angela M Bayer","doi":"10.1186/s12873-025-01241-9","DOIUrl":"10.1186/s12873-025-01241-9","url":null,"abstract":"<p><strong>Background: </strong>Firearm-related injury is a significant public health problem in the United States. Emergency medical services (EMS) personnel are uniquely positioned to recognize and counsel individuals at risk, but little is known about their firearm screening and counseling practices, experience with firearms, and training needs. To address these knowledge gaps and inform training efforts, this study examined the current and potential role of EMS clinicians in firearm injury prevention.</p><p><strong>Methods: </strong>A 22-item survey was e-mailed to EMS agencies, predominantly in California and Nevada. EMS clinicians who had worked 5 + shifts in the previous three months were eligible to participate. Question topics included: participant characteristics, recent encounters with at-risk patients, career exposure to firearm risk situations, experience with firearms, and training on firearm injury prevention. Descriptive statistics were calculated, and write-in responses were analyzed thematically.</p><p><strong>Results: </strong>Among 234 participants, 75% reported that at least some of their calls in the past three months involved someone at risk of firearm-related injury. Among those who responded to at-risk patients, 47% reported that they never asked these patients about firearm access and 88% said that they did not provide them with education/counseling on firearm injury prevention. 76% were at least somewhat worried about being injured by a firearm while on duty, and 19% reported having had a firearm drawn on or used against them during a call. Participants reported being on duty without law enforcement when firearms were accessible to suicidal patients (70%), to children (47%), and in domestic violence situations (49%). Approximately 70% reported current or previous firearm ownership, and 82% felt comfortable handling firearms. More than one-third had not received medical education on firearm injury prevention, and 85% expressed interest in future training.</p><p><strong>Conclusions: </strong>As the sole health care providers for many patients and given their unique prehospital perspective, with additional training, EMS clinicians can expand their role in firearm injury prevention. Training should: respect the right to own firearms; prioritize a risk-based approach to firearms screening; highlight interventions for reducing firearm injury risk; address the increased risk of firearm injury among EMS clinicians; and align with local policies, including those involving law enforcement.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"88"},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207524","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 and critical care services in Somalia: a cross-sectional nationwide hospital assessment using the WHO Hospital Emergency Unit assessment tool.","authors":"Haron Ndwiga Njiru, Pryanka Relan, Sk Md Mamunur Rahman Malik, Azad Abdullah, Mukhtar Shube, Ali Haji Adam Abubakar, Ibrahim Nur, Abdinasir Yusuf Osman, Paul Sonethal, Shada Rouhani, Bernard Olayo, Naoko Ohno, Ireneaus Sebit Sindani, Ali Abdirahman Osman, Md Shajib Hossain, Ndithia James, Monther Alabesat, Mohamed Derow","doi":"10.1186/s12873-025-01234-8","DOIUrl":"10.1186/s12873-025-01234-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Data on emergency and critical care services in Somalia and other countries with fragile and conflict-affected (FCA) situations are limited, although the burden of emergency health conditions remain high. Improving emergency care services could significantly help improve health outcomes and realize the goals of achieving the Universal Health Coverage in these fragile countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional survey to assess the service availability and readiness for emergency and critical care (ECC) services in the country covering 131 hospitals in Somalia. The survey included both the public and private sector hospitals as well as those at the district, regional and national level hospitals representing the whole organizational structure of emergency health care system in the country. We administered the WHO Hospital Emergency Unit assessment tool which was slightly modified and adapted for this assessment. The survey included questions on the availability of staff, supplies/equipment, services, and systems. The respondents were hospital administrators and clinicians in outpatient departments, emergency departments and inpatient units. An overall median capacity score indicating the service availability and readiness for ECC was calculated for the country as well as for each hospital. Data were collected from December 2020 to March 2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;A total of 524 staff members across 131 hospitals participated in the survey. The median and interquartile range (IQR) ECC readiness score for all health facilities in the country was 0.31 (0.22-0.46) and only 26 (19.8%) facilities assessed had a median readiness score of more than 0.5 (p value = 0.001). Using the cut-off point of 0.5, over 80% of the hospitals assessed were not considered ready to provide ECC services in the country. The third-level hospitals of the private sector including those facilities situated in predominantly urban areas were found to have better readiness to provide ECC services. User fees, lack of equipment and the absence of staff availability around the clock were identified as the most common barriers to emergency and critical care readiness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This is the first study of its kind to be conducted in Somalia using a standardized tool and methodology and provides a comprehensive understanding of emergency and critical care services available in Somalia by facility type and levels of care. The study highlighted that significant capacity gaps exist at all levels in the provision of emergency care services especially in the public sector and at the first-level of care. Investment in emergency care services is urgently needed in the country bringing the primary care into the care continuum for ECC services along with implementing a set of cost-efficient interventions at the first-level of care given the country's high burden of emergency health conditions.&lt;/p&gt;&lt;p&gt;","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"89"},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207523","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":"Barriers to the success of cardiopulmonary resuscitation teams in emergency departments: A perspective from nurses.","authors":"Alireza Sadeghi, Hosein Jahani, Mojtaba Senmar, Farzaneh Mehdipour, Amir Reza Mirzaei, Ali Poorshivaee, Faranak Sadat Hosseini","doi":"10.1186/s12873-025-01245-5","DOIUrl":"10.1186/s12873-025-01245-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiopulmonary arrest is one of the most important emergency situations in hospitals. Although cardiopulmonary resuscitation has long been the first step in these conditions, the low success rate of this process is still a major concern in treatment systems. Therefore, identifying the barriers and causes of failure of the cardiopulmonary resuscitation team has become an important factor in improving the results. The present study was conducted to identify the barriers to the success of cardiopulmonary resuscitation teams in emergency departments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A descriptive-analytical study was conducted in the emergency department of teaching hospitals in Qazvin, Iran 2023-2024. Using available sampling, 198 emergency department nurses were included in the study. Nurses were included in the study if they had at least 6 months of work experience in the emergency department, had at least a bachelor's degree, and experienced at least one cardiopulmonary resuscitation operation. The exclusion criteria were incomplete completion of the questionnaires and withdrawal from the study for any reason. The data was collected using the demographic characteristics checklist and the questionnaire on barriers to the success of the cardiopulmonary resuscitation team. Data analysis was performed using SPSS-24 software and descriptive and inferential statistics. The significance level of all tests was considered less than p &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the participants was 30.96 ± 5.15. Out of 198 nurses participating in the study, 125 were female (63.1%) and the rest were male. According to the results, the main barriers to the success of the cardiopulmonary resuscitation team in the emergency department are related to the individual and professional characteristics of the resuscitation team members with a score of 2.50 ± 0.38 and the least reason is related to the program and educational facilities dimension with a score of 2.32 ± 0.50. In the patient characteristics dimension, the initial rhythm (2.70 ± 0.58) and in the individual and professional characteristics of the resuscitation team members, the lack of skilled and experienced people (2.62 ± 1.51) were the main barriers to the success of the cardiopulmonary resuscitation team. From the nurses' point of view, in the dimension of resuscitation team management, the absence of an effective leader in the team (2.41 ± 0.64), in the dimension of equipment and devices needed for resuscitation, the absence and unpreparedness of resuscitation equipment and devices in the department (2.53 ± 0.55), and in the dimension of program and educational facilities related to resuscitation, the lack of adequate and appropriate educational facilities and equipment (2.40 ± 0.64) were the main barriers to the success of the cardiopulmonary resuscitation team. The results of the t-test showed that there is no significant relationship between age, gender","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"85"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179663","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":"Explaining the experience of telephone cardiopulmonary resuscitation in Kermanshah emergency medical dispatch: A qualitative, phenomenological study.","authors":"Fatemeh Zaheri, Alireza Abdi, Mahmoud Rahmati","doi":"10.1186/s12873-025-01240-w","DOIUrl":"10.1186/s12873-025-01240-w","url":null,"abstract":"<p><strong>Background: </strong>Telephone Cardiopulmonary Resuscitation (T-CPR), administered by Emergency Medical Dispatchers (EMDs) to bystanders at the scene of an out-of-hospital cardiac arrest (OHCA), faces significant challenges. These challenges arise when collaboration for CPR is difficult due to the bystander's condition or when the patient's condition is not visible. Limited research exists on T-CPR, which is why our study aims to explore the experiences of Kermanshah EMDs in providing T-CPR.</p><p><strong>Method: </strong>This descriptive phenomenological (because there is lack of information and study about this subject in Iran and importance of a deep understanding to examine different aspect of the subject) study was conducted with 12 EMDs from a total of 20 in Kermanshah EMDs. Data were collected through in-depth, semi-structured interviews with participants selected via purposive sampling. The study was qualitative and the questionnaire was not validated. Interviews consisted of both open-ended and probing questions. This research was carried out in 2020-2021. Data were analyzed thematically using Collizi's seven-step.</p><p><strong>Result: </strong>Analysis of the 12 interviews conducted with dispatchers who had an average age of 28.33 years and 2.33 years of work experience resulted in the identification of 456 codes. These codes were categorized into three main themes: (1) \"Perceived Nursing Care in T-CPR,\" which includes sub-themes such as Ethical and Emotional Management in Care, Empathetic Care, Crisis Management and Stress Control; (2) \"Professional Abilities of EMDs,\" which includes sub-themes like Perceived Professional Skills and Satisfaction from Successful Performance; and (3) \"Cultural Necessities Related to Telephone Resuscitation,\" with sub-themes such as Challenges of Training, Communication Barriers and the Need for Public Education and Cultural Change.</p><p><strong>Conclusion: </strong>Participants reported that T-CPR is often unsuccessful due to factors such as non-collaboration from bystanders or improper execution, stemming from low education levels, cultural barriers and a general lack of public awareness about emergency procedures. Successful T-CPR requires dispatchers to skillfully communicate with anxious bystanders and correct misconceptions that CPR may worsen the patient's condition. Additionally, fluency in various accents, improving public education, and implementing effective stress management strategies are essential for improving outcomes. Addressing these issues through better education and cultural change is vital for enhancing T-CPR effectiveness.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"87"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186444","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":"Comparison of Glasgow coma scale, motor component, eye component, and simplified motor scale for predicting trauma outcomes: a 13-year multicenter retrospective cohort study.","authors":"Shu-Jui Lee, Yu-Long Chen, Tsung-Hsien Wu, Chi-Yuan Liu, Chien-Hsing Wang, Chia-Hung Tsai, Jui-Yuan Chung, Giou-Teng Yiang, Meng-Yu Wu","doi":"10.1186/s12873-025-01246-4","DOIUrl":"10.1186/s12873-025-01246-4","url":null,"abstract":"<p><strong>Background: </strong>To address the complexity and time-consuming nature of the full Glasgow Coma Scale (GCS), various simplified tools for assessing brain function have been proposed, such as the eye (GCSE) and motor component of the GCS (GCSM), and the Simplified Motor scale (sMS). However, few studies have evaluated the predictive ability of these scoring systems.</p><p><strong>Methods: </strong>A 13-year cohort study was conducted using the trauma database of Tzu Chi Hospital to compare the accuracy of the full GCS with those of the GCSE, GCSM, and sMS for predicting short- and long-term mortality (3-day mortality, 7-day mortality, and in-hospital mortality), intensive care unit (ICU) stay of ≥ 14 days, and hospital stay of ≥ 30 days in patients with trauma.</p><p><strong>Results: </strong>This study included 41,297 patients with trauma. The full GCS achieved slightly higher area-under-the-receiver-operating-characteristic-curve (AUROC) values for predicting 3-day mortality (full GCS vs. GCSM vs. sMS: 0.899 vs. 0.894 vs. 0.890), 7-day mortality (0.871 vs. 0.864 vs. 0.861), in-hospital mortality (0.833 vs. 0.817 vs. 0.815), ICU length of stay (LOS)of ≥ 14 days (0.645 vs. 0.628 vs. 0.628), and hospital LOS of ≥ 30 days (0.607 vs. 0.587 vs. 0.587). The GCSE exhibited inferior discriminative ability for all clinical outcomes. The AUROC values for the ability of the sMS to predict 3-day mortality, 7-day mortality, and in-hospital mortality were comparable to those of the GCSM but lower than those of the full GCS for patients aged ≥ 65 years, aged < 65 years, with or without cardiovascular diseases, and with or without traumatic brain injury. For predicting ICU LOS of ≥ 14 days and hospital LOS of ≥ 30 days, the discriminative accuracy of the full GCS was marginally higher than those of the GCSE, GCSM, and sMS across the aforementioned subgroups. However, GCSE, GCSM, and sMS had similar discriminative accuracy.</p><p><strong>Conclusions: </strong>Although the full GCS assessment exhibited higher accuracy in predicting 3-day mortality, 7-day mortality, in-hospital mortality, ICU LOS of ≥ 14 days, and hospital LOS of ≥ 30 days compared with the GCSE, GCSM, and sMS, the marginally higher accuracy of the full GCS may be negligible given its time-consuming nature. Furthermore, use of the GCSM provides no substantial advantage over use of the simpler sMS, which has comparable predictive accuracy.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"86"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180539","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}