BMC Emergency Medicine最新文献

{"title":"Characteristics and survival of hospitalized combat casualties during two major conflicts between Israel and Hamas: 2023 versus 2014.","authors":"Abebe Tiruneh, Ari M Lipsky, Gilad Twig, Adi Givon, Shachar Shapira, Sharon Goldman, Irina Radomislensky, Avi Benov, Eldad Katorza","doi":"10.1186/s12873-024-01149-w","DOIUrl":"10.1186/s12873-024-01149-w","url":null,"abstract":"<p><strong>Background: </strong>In the complex landscape of modern warfare, understanding combat-related injuries leading to hospitalization is crucial for optimizing injury treatment. This study aims to compare combat casualty characteristics and outcomes during the major conflicts between Israel and Hamas in 2023 and 2014 as a basis for understanding the effectiveness of trauma care practices for wounded soldiers.</p><p><strong>Methods: </strong>A cohort study of soldiers hospitalized due to combat injuries during two major wars between Israel and Hamas in 2023 and 2014, using data from the Israeli National Trauma Registry. This study did not include deaths before hospital arrival or casualties who were discharged from the Emergency Department.</p><p><strong>Results: </strong>Of the 1,198 study subjects, 67.8% belonged to the 2023 cohort and 32.2% to the 2014 cohort. The percentage of casualties with severe and critical injuries (Injury Severity Score [ISS] 16-75) was higher among the 2023 cohort (18.6% vs. 13.7%, p = 0.036), as was the percentage of casualties with multiple severe injuries (≥ 2 regions with Abbreviated Injury Score ≥ 3: 11.5% vs. 7.5%, p = 0.035) and firearm injuries (19.6% vs. 14.5%, p = 0.081). Injuries to the torso and extremities were more frequent among the 2023 cohort. Among the critically injured casualties (ISS 25-75), the mortality rates were 17.3% vs. 28.6%, respectively, for the 2023 and 2014 cohorts (p = 0.351); adjusted HR (95% CI): 0.56 (0.21-1.49). The 2023 cohort had higher rates for treatment in the trauma bay (61.5% vs. 47.9%, p < 0.001), ICU utilization (admission: 16.3% vs 11.7%, p = 0.036), surgical intervention (51.5% vs. 42.7%, p = 0.005), longer duration from arrival to surgery (median [interquartile range]: 4.6 (1.2-18.5) vs. 2.6 (1.1-10.1) hours, p = 0.037), and longer hospital stays (> 14 days: 15.5% vs. 8.8%, p < 0.001).</p><p><strong>Conclusions: </strong>Our data demonstrated that more casualties who survived to hospital arrival were severely and multiply injured in the 2023 Israel-Hamas war as compared to the 2014 war. Despite the increased severity, in-hospital survival did not worsen though there was an increase in hospital resource utilization.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"231"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852113","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":"Self-assessment and learning motivation in emergency point-of-care ultrasound: an online pilot investigation in German physicians.","authors":"Joachim Bansbach, Michael Bentele, Matthias Bollinger, Stefanie Bentele, Ronny Langenhan, Bianka Gerber, Milena Trifunovic-Koenig, Stefan Bushuven","doi":"10.1186/s12873-024-01154-z","DOIUrl":"10.1186/s12873-024-01154-z","url":null,"abstract":"<p><strong>Introduction: </strong>Learning motivation is essential to obtain and maintain ultrasound competencies in emergency medicine. One's competencies herein and the need for ongoing training are best evaluated by self-assessment. This may be flawed by overconfidence effects - the belief to be better than others or better than tests reveal. This study aims to clarify the underinvestigated interaction of learning motivation and self-assessment in emergency point-of-care-ultrasound (POCUS).</p><p><strong>Methods: </strong>In this cross-sectional multicenter project, physicians assessed their own and others' competence and learning motivation using the Situational Motivation Scale comprising intrinsic motivation, external and identified regulation, and amotivation. In addition, we presented eight ultrasound loops of different pathologies to emergency physicians of various specialties.</p><p><strong>Results: </strong>Overall, the motivation to learn was high, while self-assessment showed no significant overconfidence in POCUS. The rate of correct diagnoses based on the loops was relatively low. As a result, we did not detect overconfidence effects in participants who completed questions (n = 86) and tests (n = 56). Overplacing oneself above peers negatively correlated with intrinsic learning motivation and identified regulation and positively correlated to amotivation. Further analyses indicated that learning motivation was associated with the interactions of the physicians' risk perception, speciality, and self-assessment.</p><p><strong>Discussion: </strong>The absence of overconfidence effects, the complexity of learning motivation and their interaction show that prior findings in other contexts may not be easily transferable to POCUS and could be highly context-sensitive. In conclusion, this study highlights high levels of learning motivation but relatively low diagnostic accuracy in POCUS, which suggests the need for ongoing education and assessment. Ensuring that physicians continue to receive objective feedback and opportunities to refine their skills is critical for maintaining high standards of care. Despite the small sample size and other limitations of the study, the results primarily served to generate hypotheses for future research on emergency ultrasound education.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"235"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852319","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":"Association between glottis screen location and intubation difficulty: a retrospective video laryngoscopy study.","authors":"Kai-Yuan Cheng, Pang Hsu Liu, Yung-Cheng Su, Yen-Yu Chen, Ya-Ni Yeh, Jih-Chun Lin, Ming-Jen Tsai","doi":"10.1186/s12873-024-01148-x","DOIUrl":"10.1186/s12873-024-01148-x","url":null,"abstract":"<p><strong>Background: </strong>In emergency settings, difficult intubations often occur unexpectedly despite pre-intubation assessments. Traditional glottic view scoring systems for direct laryngoscope may not apply to video laryngoscopy. With video laryngoscopy, the vertical location of the glottis on the monitor can be clearly defined. If the glottis location is associated with intubation difficulty, it could serve as a simple indicator for anticipating intubation challenges. This study aimed to investigate the relationship between the glottis screen location during video laryngoscopy-guided intubation and the success and timing of the first-attempt intubation.</p><p><strong>Methods: </strong>We retrospectively analyzed laryngoscopy recordings from adult intubations in the emergency department of a tertiary teaching hospital in Chiayi, Taiwan, using the C-MAC video laryngoscope between March 2020 and April 2023. The vertical screen location of the vocal cords, determined by the arytenoid cartilage position after laryngeal blade engagement, was categorized into upper and lower locations for analysis. The primary outcome was first-attempt intubation success within 90 s, analyzed using Kaplan-Meier survival curves and multivariable Cox proportional hazard analysis.</p><p><strong>Results: </strong>Among 209 laryngoscopy records, 113 had the arytenoid in the lower field of view and 96 in the upper field. Kaplan-Meier analysis showed a significantly lower cumulative success rate for intubations with a higher arytenoid location (log-rank test, P < 0.001). Multivariable Cox models, adjusted for factors like modified Cormack-Lehane grade, blade tip engagement, and other intubation findings, confirmed the arytenoid's location as an independent predictor of successful intubation within 90 s, with an adjusted hazard ratio of 0.55 (95% confidence interval, 0.38-0.79) for the upper location group compared to the lower (P < 0.001).</p><p><strong>Conclusions: </strong>A higher screen location of the vocal cords after blade engagement is associated with reduced first-attempt intubation success. Assessing glottis location during video laryngoscopy intubation provides a quick method to anticipate intubation challenges.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"236"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852163","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 the effects of group and individual reflection methods on self-regulated learning strategies and learning motivation among emergency medical technicians: a quasi-experimental study.","authors":"Naser Darvishi Tabas, Zahra Amouzeshi, Seyyed Abolfazl Vagharseyyedin","doi":"10.1186/s12873-024-01147-y","DOIUrl":"10.1186/s12873-024-01147-y","url":null,"abstract":"<p><strong>Background: </strong>Reflection is an essential educational practice often characterized as a self-regulated learning activity. Self-regulated learning has been shown to positively influence learning motivation and metacognition. This study aimed to compare the effect of group and individual reflection methods on self-regulation learning strategies and motivational components among emergency medical technicians.</p><p><strong>Methods: </strong>This quasi-experimental study was conducted on 54 emergency medical technicians in South Khorasan province in 2023. Thirty pre-hospital emergency centers affiliated to Birjand University of Medical Sciences were randomly assigned to three blocks (A, B, and C). Participants were then selected through convenience sampling based on predetermined inclusion and exclusion criteria. Eighteen participants working in pre-hospital emergency centers were selected from each block. The three blocks (A, B, and C) were randomly assigned into three arms: individual reflection, group reflection, and control. The individual reflection group members were asked to record their feelings and experiences using the Gibbs model in provided notebooks during four weeks (at the end of each week). The group reflection members, after forming groups and selecting leaders, engaged in the group reflection sessions in a designated room, following the Gibbs model for four weeks. The self-regulated learning strategies and learning motivation components of all participants were measured using standardized questionnaires before and after the intervention. Data were analyzed using paired t-test, one-way analysis of variance, Tukey's post hoc test, and Fisher's exact test.</p><p><strong>Results: </strong>The mean score of self-regulation learning strategies and learning motivation significantly increased in the group reflection arm after the intervention (p < 0.05). While the mean scores of motivational component and its individual components increased significantly in the individual reflection group after the intervention (p < 0.05), no significant difference was observed in the mean scores of self-regulation learning strategies and their components before and after the intervention (p > 0.05).</p><p><strong>Conclusion: </strong>The results of this research highlight the superiority of group reflection method over individual reflection in promoting self-regulated learning. While both methods were effective in enhancing learning motivation, group reflection proved to be more beneficial. Therefore, it is recommended that Emergency Medical Services managers provide training programs that incorporate group reflection to enable technicians to benefit from its advantages in terms of self-regulated learning strategies and learning motivation.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"233"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852179","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":"Using machine learning and natural language processing in triage for prediction of clinical disposition in the emergency department.","authors":"Yu-Hsin Chang, Ying-Chen Lin, Fen-Wei Huang, Dar-Min Chen, Yu-Ting Chung, Wei-Kung Chen, Charles C N Wang","doi":"10.1186/s12873-024-01152-1","DOIUrl":"10.1186/s12873-024-01152-1","url":null,"abstract":"<p><strong>Background: </strong>Accurate triage is required for efficient allocation of resources and to decrease patients' length of stay. Triage decisions are often subjective and vary by provider, leading to patients being over-triaged or under-triaged. This study developed machine learning models that incorporated natural language processing (NLP) to predict patient disposition. The models were assessed by comparing their performance with the judgements of emergency physicians (EPs).</p><p><strong>Method: </strong>This retrospective study obtained data from patients visiting EDs between January 2018 and December 2019. Internal validation data came from China Medical University Hospital (CMUH), while external validation data were obtained from Asia University Hospital (AUH). Nontrauma patients aged ≥ 20 years were included. The models were trained using structured data and unstructured data (free-text notes) processed by NLP. The primary outcome was death in the ED or admission to the intensive care unit, and the secondary outcome was either admission to a general ward or transferal to another hospital. Six machine learning models (CatBoost, Light Gradient Boosting Machine, Logistic Regression, Random Forest, Extremely Randomized Trees, and Gradient Boosting) and one Logistic Regression derived from triage level were developed and evaluated using EPs' predictions as reference.</p><p><strong>Result: </strong>A total of 17,2101 and 41,883 patients were enrolled from CMUH and AUH, respectively. EPs achieved F1 core of 0.361 and 0.498 for the primary and secondary outcomes, respectively. All machine learning models achieved higher F1 scores compared to EPs and Logistic Regression derived from triage level. Random Forest was selected for further evaluation and fine-tuning, because of its robust calibration and predictive performance. In internal validation, it achieved Brier scores of 0.072 and 0.089 for the primary and secondary outcomes, respectively, and 0.076 and 0.095 in external validation. Further analysis revealed that incorporating unstructured data significantly enhanced the model's performance. Threshold adjustments were applied to improve clinical applicability, aiming to balance the trade-off between sensitivity and positive predictive value.</p><p><strong>Conclusion: </strong>This study developed and validated machine learning models that integrate structured and unstructured triage data to predict patient dispositions, distinguishing between general ward and critical conditions like ICU admissions and ED deaths. Integrating both structured and unstructured data significantly improved model performance.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"237"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852331","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":"Epidemiological pattern of injuries among road traffic crash victims: the first experience of a large tertiary care hospital in the West Bank of Palestine.","authors":"Alaa H Rostom, Duha Suboh, Tasneem Dweikat, Inam Hindi, Zain Farounyeh, Ramzi Shawahna","doi":"10.1186/s12873-024-01153-0","DOIUrl":"10.1186/s12873-024-01153-0","url":null,"abstract":"<p><strong>Background: </strong>Road traffic injuries are a global public health challenge. This study was conducted to describe the epidemiological patterns of road traffic injuries in a large tertiary care hospital in the West Bank of Palestine. In addition, associations between the different variables of the victims and the patterns of road traffic injuries were also assessed.</p><p><strong>Methods: </strong>This study was conducted in a retrospective cohort observational design between January 2021 and July 2023 at a large tertiary care hospital in Nablus, Palestine. The data were collected from the electronic medical record system of the large tertiary care hospital using a data collection form.</p><p><strong>Results: </strong>A total of 1,544 victims of traffic road injuries were included in this study. Lower limb (43.0%), neck (41.2), and upper limb (39.8%) injuries were the most common types of road traffic injuries sustained by the victims admitted to the large tertiary care hospital. The victims who were 30 years or older were more likely to sustain back injuries (aOR = 1.71, 95% CI: 1.20-2.45) pelvic injuries (aOR = 1.84, 95% CI: 1.08-3.12), chest injuries (aOR = 1.59, 95% CI: 1.06-2.38), and neck injuries (aOR = 2.54, 95% CI: 1.68-3.82) compared to the victims who were younger than 30 years. The victims who did not use seatbelts were more likely to sustain abdominal injuries (aOR = 1.88, 95% CI: 1.34-2.63) and head injuries (aOR = 1.49, 95% CI: 1.06-2.10) compared to the victims who used seatbelts. The victims who did not have the airbag deployed were more likely (aOR = 1.85, 95% CI: 1.31-2.63) to sustain neck injuries compared to the victims who had the airbag deployed.</p><p><strong>Conclusion: </strong>The epidemiological patterns of road traffic injuries in a large tertiary care hospital in Nablus, Palestine were described and the associations between the different variables of the victims and the patterns of road traffic injuries were assessed. The findings indicated a need to design measures to prevent/minimize these injuries. Future studies are still needed to determine the best measures to avoid/minimize the incidence of serious road traffic injuries.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"229"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852268","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":"Human trafficking screening in Saskatoon Emergency Departments: What can be learned from high-risk patient presentations?","authors":"Shayan Shirazi, Tracy D Wilson, Maryellen Gibson, Lynsey Martin, James Stempien","doi":"10.1186/s12873-024-01130-7","DOIUrl":"10.1186/s12873-024-01130-7","url":null,"abstract":"<p><strong>Objective: </strong>Studies have shown that Emergency Department physicians have little to no training in recognizing and supporting victims of human trafficking despite being uniquely situated to identify and intervene on behalf of these patients. We assessed if screening for human trafficking was being completed by emergency physicians in three Saskatoon emergency departments.</p><p><strong>Methods: </strong>We performed a retrospective chart review of patients presenting to three Saskatoon emergency departments deemed to potentially be at risk of human trafficking, based on discharge diagnosis. Of the 223 included charts, data extracted included sex, age, ethnicity, chief complaint, diagnosis, disposition, HT Screening (Y/N), specific quotes relating to HT, time of visit, intimate partner violence (Y/N), and travel history. Both quantitative and qualitative thematic analyses were conducted on this data.</p><p><strong>Results: </strong>None of the charts (0%) included in this study had any documentation around screening for human trafficking. Furthermore, 21.1% of the high-risk patient charts included in this study -- which included many patients with a discharge diagnosis of sexually transmitted disease or pelvic inflammatory disease -- did not contain a documented sexual history. Thematic analysis revealed that the patients included in this study frequently had challenges with sexual health, substance use, and houselessness.</p><p><strong>Conclusion: </strong>This study found that Emergency physicians in Saskatoon were not routinely screening for human trafficking. Implementation of further training is needed to help these physicians recognize and subsequently support potential victims of human trafficking.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"228"},"PeriodicalIF":2.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784068","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":"Exploring Saudi paramedics' experiences in managing adult trauma cases: a qualitative study.","authors":"Ateeq Almuwallad, Naif Harthi, Hussin Albargi, Bahja Siddig, Rayan Jafnan Alharbi","doi":"10.1186/s12873-024-01145-0","DOIUrl":"10.1186/s12873-024-01145-0","url":null,"abstract":"<p><strong>Background: </strong>Saudi paramedics face numerous challenges while providing care for adult trauma patients affecting their care but little is known about these specific challenges.</p><p><strong>Methods: </strong>A qualitative study was conducted using a purposive sample of Saudi paramedics from the Saudi Red Crescent Authority (SRCA) across various cities. Data were collected through online semi-structured interviews and analyzed using the framework method.</p><p><strong>Results: </strong>A total of 20 paramedics were recruited and interviewed. They identified challenges in trauma response, including coordinating care, ensuring the accuracy and accessibility of patient information, and maintaining confidence and readiness. Participants emphasized the need for independent knowledge acquisition through courses, simulations, and peer discussions. They also highlighted the need for more paramedics, strategies to reduce burnout, and the importance of accurately assessing patient conditions. Additionally, they also stressed the importance of raising public awareness to enhance trauma care.</p><p><strong>Conclusion: </strong>This study explored Saudi paramedics' experiences in managing adult trauma patients. standardized handovers, more staff, and greater public awareness are the main key needs to improve daily practice.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"227"},"PeriodicalIF":2.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765671","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":"Health problems among disaster responders to the 2023 Turkey-Syria earthquake: a cross-sectional study.","authors":"Karin Hugelius, Jason Murphy, Karin Blomberg","doi":"10.1186/s12873-024-01143-2","DOIUrl":"https://doi.org/10.1186/s12873-024-01143-2","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to describe perceived health problems among disaster responders after the earthquake in eastern Turkey/Syria in February 2023.</p><p><strong>Methods: </strong>A non-probability cross-sectional study was conducted using an online survey.</p><p><strong>Results: </strong>A total of 525 local (18%) and international disaster responders (81%) participated in the study. Of these responders, 46% reported physical or mental health problems during or after their deployment, 15% required medical care during the mission, and 7% required medical evacuation. The most common health problems during the field mission were feeling scared or unsafe, sleeping problems, and headache. After the mission, fatigue, sleeping problems, and feeling depressed were the most frequently reported health problems. The local responders perceived significantly more health problems than did the international responders. Approximately 11% of the participants could not return to their ordinary work after deployment because of infections or mental health issues.</p><p><strong>Conclusions: </strong>Physical and mental health problems are commonly perceived by disaster responders and may reduce the effectiveness of disaster response. Raising awareness of health risks among disaster response workers and employers is essential to ensure proper duty of care and should include reparations and medical support during and after disaster response operations.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"226"},"PeriodicalIF":2.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765672","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":"Elderly patients re-transferred from long-term care hospitals to emergency departments within 48 h.","authors":"Tae Young Lee, Sung-Keun Ko, Seong Jung Kim, Jin-Hee Lee","doi":"10.1186/s12873-024-01140-5","DOIUrl":"10.1186/s12873-024-01140-5","url":null,"abstract":"<p><strong>Background & objectives: </strong>The increasing proportion of elderly populations has led to a rise in chronic diseases and frequent transfers between long-term care hospitals (LTCHs) and emergency departments (EDs). This study investigates the patterns of risk factors of initial-transfers and subsequent re-transfers among patients aged 65 or older. Specifically, we focus on those re-transferred from LTCHs to EDs within 48 h of discharge, often without adequate treatment.</p><p><strong>Method: </strong>This nationwide cross-sectional study used data from South Korea's National Emergency Department Information System (NEDIS) from January 1, 2017, to December 31, 2019. Patients aged 65 or older who were initially transferred from LTCHs to EDs and re-transferred within 48 h, were identified. Logistic regression was employed to analyze risk factors associated with re-transfers.</p><p><strong>Results: </strong>140,282 elderly patients were identified as having been transferred from LTCHs to EDs. Of these, 38,180 patients received emergency care in the EDs and were discharged back to LTCHs. Among them, 679 patients were returned to LTCHs after receiving acute treatment but revisited the EDs within 48 h. Hospital ward admission rates were higher for re-transferred patients (71.3%) compared to initial transfers (42.1%, p < 0.0001). Risk factors for re-transfer included male, nighttime admissions, and longer ED stays (> 6 h). Tertiary hospitals showed higher re-transfer rates to other facilities (13.1%) than general hospitals (2.9%).</p><p><strong>Conclusion: </strong>This study reveals that many health outcomes worsen upon re-transfer compared to the initial-transfer. These findings underscore the need for a coordinated healthcare system that ensures elderly patients from long-term care facilities are initially sent to appropriate hospitals during the initial transfer, which could mitigate repeated ED visits and ensure timely care.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"225"},"PeriodicalIF":2.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749552","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}