BMC Emergency Medicine最新文献

{"title":"First responders' experiences with major earthquakes in Türkiye: a qualitative study of innovation needs and challenges.","authors":"Zeynep Sofuoglu, Aysel Başer, Turhan Sofuoglu, Ömer Faruk Sönmez","doi":"10.1186/s12873-025-01217-9","DOIUrl":"https://doi.org/10.1186/s12873-025-01217-9","url":null,"abstract":"<p><strong>Background: </strong>The response phase is a phase of disaster management that begins when a disaster occurs. The experience of the First Responders who responded in the first days to the 2023 earthquake in Turkey, which killed more than fifty thousand people, is expected to inform and add value to the preparations for subsequent disasters.</p><p><strong>Methods: </strong>A qualitative approach was used; focus group interviews were conducted with 15 first responders (8 fire fighters and 7 medical personnel) that responded in the first moments of the devastating Kahramanmaraş and Hatay earthquakes. The interviews conducted in June 2023. A qualitative approach with the thematic analysis method was employed.</p><p><strong>Results: </strong>Based on the analyses the research six main themes and 13 subthemes were identified. The identified themes were resources, needs, collaboration, innovation, disaster management and challenges. The participants emphasized the need for better communication tools, protective equipment, and technologies such as drones and advanced sensors to enhance disaster response efforts. The findings also highlight the critical role of collaboration between different organizations and the necessity for integrated disaster management practices and applications. The findings obtained from the views of experienced first responders will inspire national and international disaster crisis managers, policy makers and technology providers to develop more effective disaster response methods. Through technological solutions and better training, the safety and effectiveness of first responders can be significantly improved in future disaster scenarios.</p><p><strong>Conclusions: </strong>This study fills an important gap in the literature by investigating the innovation needs and challenges faced by first responders during the 2023 earthquakes in Türkiye. In this study, the gap analysis was determined through interviews conducted with teams that responded to the 2023 major Turkey earthquake in the initial hours following the disaster. These findings are of significant value in guiding the improvement of the approaches and development of technological products in the field of disaster management.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"60"},"PeriodicalIF":2.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978270","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":"Appropriate cardiopulmonary resuscitation duration and predictors of return of spontaneous circulation in traumatic cardiac arrest.","authors":"Dongmin Seo, Inhae Heo, Kyoungwon Jung, Hohyung Jung","doi":"10.1186/s12873-025-01219-7","DOIUrl":"https://doi.org/10.1186/s12873-025-01219-7","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in trauma care, traumatic cardiac arrest (TCA) shows significantly poorer outcomes compared to non-traumatic cardiac arrest, with mortality rates exceeding 96%. However, no standardized protocol exists for appropriate cardiopulmonary resuscitation (CPR) duration in TCA. This study aimed to establish evidence-based CPR duration thresholds and identify factors associated with return of spontaneous circulation (ROSC) in TCA patients.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using a single-centre trauma registry of adult patients with TCA between January 2021 and December 2023. Univariate analysis was used to identify differences in the baseline and outcome variables between the ROSC and no-ROSC groups. We performed multivariable logistic regression analysis to identify factors independently associated with ROSC. We also investigated the appropriate cutoff time of pre-hospital and total CPR duration for ROSC (the CPR duration that has maximum sensitivity and specificity for ROSC).</p><p><strong>Results: </strong>In total, 422 patients with TCA were included, of whom 250 were eligible for analysis. The proportion of patients with ROSC was 22.4% (n = 56), and trauma bay/emergency department mortality and in-hospital mortality rates were 80.8% (n = 202) and 97.2% (n = 243), respectively. Factors associated with ROSC included alert mental status in the field, as indicated by verbal response (adjusted odds ratio [OR], 0.07; 95% confidence interval [CI], 0.01-1.12; p = 0.06), pain response (OR, 0.03; 95% CI, 0.01-0.43; p = 0.009), and unresponsiveness (OR, 0.04; 95% CI, 0.01-0.44; p = 0.009) and non-asystolic initial rhythms, such as pulseless electrical activity (OR, 4.26; 95% CI, 1.92-9.46; p < 0.001), shockable rhythm (OR, 14.26; 95% CI, 1.44-141.54; p = 0.023), pre-hospital CPR duration (OR, 0.90; 95% CI, 0.85-0.95), and total CPR duration (OR, 0.88; 95% CI, 0.84-0.92; p < 0.001). The upper limits of pre-hospital and total CPR durations for achieving a probability of ROSC < 1% were 23 and 30 min, respectively, whereas those for a cumulative portion of ROSC > 99% were 27 and 38 min, respectively. Among the survivors (n = 7), six had favourable functional outcomes at discharge.</p><p><strong>Conclusions: </strong>This study provides evidence-based CPR duration thresholds in TCA, demonstrating that resuscitation efforts beyond 27 min in prehospital settings and 38 min in total were futile. Additionally, an alert mental status in the field and non-asystolic initial rhythm were identified as positive predictors of ROSC. These findings may help guide appropriate duration of resuscitation efforts in TCA.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"61"},"PeriodicalIF":2.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974332","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":"How much time do nurses in Norwegian emergency departments spend on different work tasks with and without a clinical pharmacist present-a time and motion study.","authors":"Renata Vesela Holis, Beate Hennie Garcia, Elin Christina Lehnbom, Marie Fagerli, Ashrak Majeed, Tine Johnsgård, Birgitte Zahl-Holmstad, Kristian Svendsen, Eirik Hugaas Ofstad, Torsten Risør, Scott R Walter, Marit Waaseth, Frode Skjold, Renate Elenjord","doi":"10.1186/s12873-025-01207-x","DOIUrl":"https://doi.org/10.1186/s12873-025-01207-x","url":null,"abstract":"<p><strong>Background: </strong>The emergency department (ED) is a demanding work environment where nurses undertake a variety of clinical and administrative tasks, including medication-related tasks. The integration of a clinical pharmacist into the ED team represents a complex intervention with potential implications for nurses' distribution of work time, particularly concerning medication-related tasks. This study examined the distribution of work time among ED nurses and assessed the impact of a clinical pharmacist's presence on this distribution, with an emphasis on medication-related work tasks.</p><p><strong>Methods: </strong>A direct observational time and motion study was conducted to evaluate the work time distribution of nurses in three Norwegian EDs, applying the Work Observation Method By Activity Timing (WOMBAT) methodology. Time distributions were measured for non-medication-related tasks, medication-related tasks, standby and movement, both in the absence and presence of a clinical pharmacist in the same ED.</p><p><strong>Results: </strong>A total of 298 h of nursing work time were observed, comprising 138 h without pharmacists present and 160 h with pharmacists present. In the absence of a pharmacist, nurses spent 62.7% of their time on non-medication-related tasks, 34.7% on standby and movement, and 3.3% on medication-related tasks. The introduction of a clinical pharmacist did not significantly change the overall distribution of nurses' work time, although some variations were noted across the EDs.</p><p><strong>Conclusion: </strong>ED nurses in three Norwegian EDs dedicated only 3.3% of their work time to medication-related tasks. The presence of clinical pharmacists did not substantially affect the distribution of nurses' work time.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"59"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961943","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 overall and high-risk return visits to the emergency department: a vital sign trajectory approach.","authors":"Hsiao-Chia Wang, Cheng-Chung Fang, Chien-Hua Huang, Jun-Wan Gao, Jiann-Hwa Chen, Chu-Lin Tsai","doi":"10.1186/s12873-025-01211-1","DOIUrl":"https://doi.org/10.1186/s12873-025-01211-1","url":null,"abstract":"<p><strong>Background: </strong>For patients and emergency department (ED) physicians, return visits to the ED represent a potentially detrimental issue. In this study, our goal was to examine factors associated with overall and high-risk ED revisits. Specifically, as vital signs during the ED stay may provide important clues for subsequent revisits, we also examined the association between vital sign trajectories and post-ED revisits.</p><p><strong>Methods: </strong>This retrospective cohort study utilized electronic clinical warehouse data from a tertiary medical center. We retrieved data from 454,330 ED visits over four years. The data included patient demographics, triage data, and repeated vital sign measurements. Group-based trajectory modeling was used to identify vital sign trajectories. A high-risk return ED visit was defined as a revisit within 72 h of the index visit with intensive care unit admission, receiving emergency surgery, or with in-hospital cardiac arrest. Multivariable logistic regression analysis was performed to evaluate the associations between vital sign trajectories and revisits.</p><p><strong>Results: </strong>A total of 39,138 potential index ED visits were analyzed. Of these, 3,201 resulted in revisits, accounting for an 8.2% overall revisit rate and a 0.2% high-risk revisit rate. A high but resolving body temperature trajectory was associated with overall revisits (adjusted odds ratio [aOR], 1.32; 95% confidence interval [95% CI], 1.13-1.53). By contrast, high-risk revisits were associated with a low/fluctuating oxygen saturation trajectory (aOR, 2.40; 95% CI, 1.15-4.99). Older age (aOR, 1.27 per 10-year increase; 95% CI, 1.11-1.46) and having a chronic major disease (aOR, 2.30; 95% CI, 1.38-3.84) were also associated with high-risk revisits.</p><p><strong>Conclusions: </strong>In addition to older age and having a chronic major disease, a low and fluctuating oxygen saturation trajectory during the index ED stay may signal subsequent high-risk revisits. Thus, discharge decisions should be carefully re-evaluated in these high-risk populations.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"57"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962500","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":"Empowering future nurses: a comparative study of nursing students' disaster literacy and response self-efficacy in Türkiye and Iran.","authors":"Gülcan Taşkıran Eskici, Faezeh Soltani Goki, Jamileh Farokhzadian","doi":"10.1186/s12873-025-01212-0","DOIUrl":"https://doi.org/10.1186/s12873-025-01212-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As disasters become more frequent and severe, their impact on global health systems grows, highlighting the critical need for disaster preparedness in nursing education. As future healthcare providers, nursing students must be equipped with the knowledge and skills to anticipate, respond to, and mitigate the effects of disasters. This study evaluates and compares the disaster literacy and disaster response self-efficacy levels of nursing students in Türkiye and Iran, emphasizing the role of nursing education in strengthening global disaster resilience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Conducted from January to June 2024, this descriptive, correlational, and comparative study involved third and final-year undergraduate nursing students in Samsun and Istanbul provinces of Türkiye and in Kerman and Jiroft provinces of Iran. The study encompassed a population of 811 students, from which a sample of 508 participants was drawn using the convenience sampling method, comprising 288 students from Türkiye and 220 from Iran. Data collection was conducted through a face-to-face questionnaire, incorporating the Descriptive Information Form and validated, reliable scales: the Disaster Literacy Scale and the Disaster Response Self-Efficacy Scale. The data were analyzed using IBM SPSS Statistics 25.0, employing descriptive statistics, t-tests, Pearson correlation, and linear regression, with significance set at p &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Linear regression analysis utilizing dummy variables revealed that students in Türkiye exhibited higher disaster literacy than their counterparts in Iran (β = 6.720), with the country of study explaining 22.9% of the variance in disaster literacy scores. Similarly, Turkish students demonstrated greater disaster response self-efficacy (β = 3.945), with 1.9% of its variance attributable to the country of study. A statistically significant, medium, and positive correlation was identified between disaster literacy and disaster response self-efficacy for students in both countries (r = 0.470, p = 0.000 for Türkiye; r = 0.491, p = 0.000 for Iran). Furthermore, regression analysis indicated that nursing students' disaster literacy significantly predicted disaster response self-efficacy (β = 1.030, p &lt; 0.001 for Türkiye; β = 1.074, p &lt; 0.001 for Iran).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The findings show that disaster literacy and disaster response self-efficacy perceptions among nursing students in both countries are moderate, requiring improvement. Disaster literacy significantly and positively influenced disaster response self-efficacy. This study highlights the importance of disaster literacy in shaping students' confidence and competence in disaster response. Disaster preparedness courses should be integrated into nursing programs. Addressing identified gaps and implementing targeted educational strategies can enhance nursing students' disaster preparedness and improve response outcomes","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"55"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969448","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 emergency physician opinions with MSOFA and PREMEWS scores in determining the necessity of non-traumatic internal medicine patient transfers to the emergency department: a longitudinal study.","authors":"Abbasali Ebrahimian, Ali Fakhr-Movahedi, Mohammad Taghi Shahcheragh, Seyyed Hossein Shahcheragh","doi":"10.1186/s12873-025-01215-x","DOIUrl":"https://doi.org/10.1186/s12873-025-01215-x","url":null,"abstract":"<p><strong>Background: </strong>Accurate prehospital decision-making is critical in emergency care to ensure the appropriate use of resources and optimal patient outcomes. However, the alignment between emergency physicians' clinical judgments and scoring systems such as Prehospital Modified Early Warning Score (Pre-MEWS) and the modified Sequential Organ Failure Assessment (mSOFA) remains underexplored.</p><p><strong>Objective: </strong>This study investigates the consistency of prehospital Pre-MEWS and in-hospital mSOFA scores with emergency physicians' judgments in determining the necessity of non-traumatic Internal Medicine Patient transfers to emergency departments (EDs). Additionally, it evaluates the clinical outcomes of these transfers.</p><p><strong>Methods: </strong>In this longitudinal study conducted between 2019 and 2020 in Semnan, Iran, 675 non-traumatic Internal patients transferred to a single ED were analyzed. Pre-MEWS scores were recorded prehospital, while mSOFA scores and physicians' evaluations were documented post-transfer. Outcomes included discharge, hospital admission, ICU transfer, or death.</p><p><strong>Results: </strong>This study analyzed 675 non-traumatic Internal patients transferred to the emergency department, with a mean age of 55.93 ± 21.89 years. 31% of transfers were deemed unnecessary by emergency physicians. The mean length of stay was 5.63 ± 5.69 h, showing a significant correlation with higher Pre-MEWS and mSOFA scores (p < 0.0001). Based on Pre-MEWS, patients were stratified into three risk levels: Green (≤ 3, no ICU/mortality), Yellow (4-12, 3.8% ICU admissions, no deaths), and Red (≥ 13, all deceased patients). mSOFA scoring identified two risk levels: Yellow (1-5, 0% mortality, ICU risk rising to 20%) and Red (≥ 6, ICU admissions up to 100%, mortality risk reaching 676.8%). Specifically, all deceased patients had Pre-MEWS scores ≥ 13, and ICU admission was observed in 3.8% of patients with Pre-MEWS scores between 4 and 12. The mSOFA score demonstrated superior predictive accuracy for mortality and ICU admission compared to Pre-MEWS. However, Pre-MEWS provided practical utility for prehospital triage.</p><p><strong>Conclusion: </strong>Combining scoring systems with clinical judgment can improve decision-making in prehospital settings. Enhanced integration of tools and expertise is recommended to reduce unnecessary transfers and optimize emergency care.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"58"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969446","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":"Assessment of ambulance interventions; proposal of a performance measurement framework for healthcare improvement in EMS response to patient collapse.","authors":"Kamran Idris, Zainab Mubeen, Zeeshan Noor Shaikh, Aswad Latif, Shaheryar Hasan, Arshia Khan","doi":"10.1186/s12873-025-01206-y","DOIUrl":"https://doi.org/10.1186/s12873-025-01206-y","url":null,"abstract":"<p><strong>Background: </strong>Healthcare improvement at all levels involves systematic and continuous assessment of the system's operations, efficiency, and effectiveness to ensure quality care. Likewise, in Emergency Medical Services; performance measurement and root cause analysis may aid in identifying the system inadequacies and address potential shortcomings by developing Key Performance Indicators. In this paper, we propose a tailored framework to supplement the performance measurement and healthcare improvement, primarily to monitor the quality of EMS operations and personnel for ambulance transfers, which results in patient collapses in ambulances.</p><p><strong>Methods: </strong>We developed a Performance Measurement Framework (PMF) based on three essential domains- Structure/System, Process, and Outcome. Each domain was further assigned with different KPIs to assess the performance of EMS operations and personnel during patient transfers. The framework was pilot-tested for one year from January to December 2023, where its use was limited to the cases of patient collapse in ambulances, also referred to as out-of-hospital deaths. To assess progress, we compared the incidence of CIA between the pre-implementation and post-implementation phases, with service operational metrics including coverage, fleet size, workforce, and response times.</p><p><strong>Result: </strong>Using the PMF as a tool for quality improvement, we observed a 7% reduction in the incidence of patient collapse in ambulances and a 16% reduction in life-threatening cases resulting in CIA despite increases in service coverage (37%), ambulance workforce (32%), fleet (26%), and routine interventions (11%). A slight increases in response times indicate the greater service demands. Through pilot testing, we identified operational gaps including behavioral and communication issues, adherence to SOPs, and equipment management.</p><p><strong>Conclusion: </strong>Overall, this paper proposes a performance measurement tool in the field of prehospital care for organizations to thoroughly assess and advance their operations toward healthcare improvement. The study highlights areas requiring improvement such as training guidelines, adherence to operating protocols, and resource optimization. In addition; the integration of technology and advanced training programs for the ambulance workforce may strengthen the overall EMS performance; thereby promising positive patient outcomes, and efficient service delivery and utilization.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"56"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956724","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":"Development of a severity score based on the International Classification of Disease-10 for general patients visiting emergency centers.","authors":"Ji Eun Kim, Jinwoo Jeong, Yuri Choi, Sung Woo Lee","doi":"10.1186/s12873-025-01214-y","DOIUrl":"10.1186/s12873-025-01214-y","url":null,"abstract":"<p><strong>Background: </strong>When comparing mortality, the severity of illness or injury should be considered; therefore, scoring systems that represent severity have been developed and used. Given that diagnosis codes in the International Classification of Disease (ICD) and vital signs are part of routine data used in medical care, a severity scoring system based on these routine data would allow for the comparison of severity-adjusted treatment outcomes without substantial additional efforts.</p><p><strong>Methods: </strong>This study was based on the National Emergency Department Information System database of the Republic of Korea. Patients aged 15 years or older were included. Data from between 2016 and 2018 were used to develop the scoring system, and data from 2019 were used for testing. We calculated the products of the number of disease-specific survival probabilities (DSPs) to reflect the severity of the patients with multiple diagnoses. A logistic regression model was developed using DSPs, age, and physiological parameters to develop a more accurate mortality prediction model.</p><p><strong>Results: </strong>The newly developed model showed predictive ability, as indicated by an area under the receiver-operating characteristic curve of 0.975 (95% CI: 0.974-0.977). When a threshold value of -5.869 was used for determining mortality, the overall accuracy was 0.958 (0.958-0.958).</p><p><strong>Conclusion: </strong>We developed a scoring system based on ICD codes, age, and vital signs to predict the in-hospital mortality of emergency patients, and it achieved good performance. The scoring system would be useful for standardizing the severity of emergency patients and comparing treatment results.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"53"},"PeriodicalIF":2.3,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787548","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":"Does heart rate variability predict and improve performance in pediatric CPR?-a simulation study.","authors":"Yosef Kula, Oren Wacht, Izhar Ben Shlomo, Asaf Gitler, Yori Gidron","doi":"10.1186/s12873-025-01209-9","DOIUrl":"10.1186/s12873-025-01209-9","url":null,"abstract":"<p><strong>Introduction: </strong>Out-of-hospital pediatric resuscitation is a severe medical condition with a low survival rate. Providing pediatric resuscitation is a significant stressor for medical teams that may impair performance. The vagal nerve is a crucial moderator of stress responses, and its activation (indexed by heart rate variability, HRV) has been shown to predict and improve performance in various settings. However, there is limited data about vagal activation and performance in medical settings.</p><p><strong>Methods: </strong>In a randomized simulation Study, paramedic students and medics were assigned to 3 min of slow-paced breathing or watching an educational 3-minute video. The participant received a scenario describing an unconscious baby without a pulse and with no breathing. The participants then performed CPR (cardiopulmonary resuscitation) on a manikin. During the scenario, every 2 min, the participant was asked a question that tested the recall of information from the scenario, and CPR performance was continuously monitored. HRV and subjective stress were taken 3 times.</p><p><strong>Results: </strong>Higher baseline HRV predicted better CPR performance. No difference in CPR performance between the groups was found, and explanations for these results will be discussed.</p><p><strong>Conclusion: </strong>HRV may be used to predict CPR performance. Short-term slow-paced breathing does not improve CPR performance. Future studies should investigate the effect of long-term stress reduction interventions on CPR performance.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"52"},"PeriodicalIF":2.3,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787553","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 work system of prehospital medication administration: a qualitative mixed methods study with ambulance professionals.","authors":"Kristian Ringsby Odberg, Karina Aase, Eystein Grusd, Anne Vifladt","doi":"10.1186/s12873-025-01213-z","DOIUrl":"10.1186/s12873-025-01213-z","url":null,"abstract":"<p><strong>Background: </strong>The characteristics of medication administration within the prehospital setting are underexplored. Ambulance professionals operate under varied levels of responsibility, dependent on their training and collaboration with local emergency facilities and other medical personnel. Given the critical condition of many patients using these services and the challenging environments they operate in, the risk of adverse drug events is significant. The aim was to advance the knowledge of the medication administration process in the setting of ambulance services.</p><p><strong>Methods: </strong>A qualitative mixed-methods design was applied to examine the medication administration process among ambulance professionals in a Norwegian hospital trust. Data collection included individual semi-structured interviews with 11 ambulance professionals at three ambulance stations, complemented by 114 h of observations. Interviews and observations were guided by the System Engineering Initiative for Patient Safety (SEIPS) work system model, and data were analyzed using a combined deductive-inductive content analysis.</p><p><strong>Results: </strong>The medication administration process in the ambulance work system is condensed into three stages: preparation, administration, and patient transfer, primarily due to constraints related to time and available information. The medication administration work system is influenced by a set of eight interrelated categories. These include technological aspects such as workarounds necessitated by inadequate equipment, organizational dynamics such as the fluid delegation of tasks, physical environmental conditions that impact on decision-making, and personal factors such as collaboration in managing critical patient scenarios.</p><p><strong>Conclusion: </strong>Medication administration tasks in the ambulance service take place along a continuum involving physical, technological, and organizational factors that interact and continuously influence ambulance professionals in their everyday practices. The study highlights the need for enhanced medication administration processes in ambulance services through improved collaboration, training, technological usability, and organizational adaptability.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"54"},"PeriodicalIF":2.3,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787561","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}