BMC Emergency Medicine最新文献

{"title":"Closed-loop and Artificial intelligence guided cardiopulmonary resuscitation using real-time physiological signals: a systematic review and meta-analysis.","authors":"Farnia Ghasemi, Mohammad Amin Gholami, Niloofar Ghasemi, Rakesh Garg","doi":"10.1186/s12873-026-01544-5","DOIUrl":"10.1186/s12873-026-01544-5","url":null,"abstract":"<p><strong>Background: </strong>Current cardiopulmonary resuscitation (CPR) includes breaks to check rhythm and pulse, while high-quality CPR requires continual chest compressions. Artificial intelligence (AI)-driven \"closed-loop\" or \"near-closed-loop\" systems may evaluate CPR-contaminated signals, guide shock and pulse decisions.</p><p><strong>Methods: </strong>According to PRISMA statement 2020, We searched databases from 2010 to 2025 for studies on animal or human cardiac arrest where AI-based or algorithmic tools gave real-time intended guidance during CPR or CPR-dominant analysis windows. Evidence was divided into animal perfusion-targeted closed-loop CPR, human shock-advisory algorithms, and human pulse/perfusing-rhythm detection. We classified shockable and non-shockable instances using a bivariate random-effects model and meta-analyses. Many studies reported performance on many electrocardiogram segments per episode; therefore, aggregated findings should be taken as segment-level diagnostic performance, not episode-level accuracy.</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria: three porcine closed-loop experiments, eight human shock-advisory studies, two pulse-detection studies, and one simulated individualized strategy. Eight shock-advisory studies demonstrated the pooled sensitivity = 0.93 and the specificity = 0.97. There were substantial variation and a high risk of bias in the patient selection and index test domains. Pulse-detection models worked well during clean pauses but not during compressions. Animal controllers enhanced coronary perfusion pressure, end-tidal carbon dioxide (EtCO₂), or ventricular fibrillation surrogates relative to fixed-depth CPR; however, these effects were transient.</p><p><strong>Conclusions: </strong>AI systems can execute guideline CPR in some datasets, and animal studies confirm perfusion-targeted control's physiological viability. Closed-loop AI-guided CPR is intriguing yet unvalidated, requiring episode-level clinical studies due to fragmented, varied, and methodologically problematic evidence.</p><p><strong>Registration: </strong>PROSPERO CRD420251239485.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455383","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 and clinical characteristics of drug-related poisoning presentations to the emergency department: a retrospective analysis.","authors":"İbrahim Sarbay, Yunus Emre Ayhan, Taha Abdurrahim Yilmaz, Hazal Karadag, Meltem Urlu, Begum Ezelsoy, Günes Eskidemir, Melike Mercan Baspinar, Mustafa Calik","doi":"10.1186/s12873-026-01542-7","DOIUrl":"10.1186/s12873-026-01542-7","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455482","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":"Trauma-informed procedural training in emergency medicine: a multi-site randomized control pilot study.","authors":"Taylor Brown, Henry Ashista, Gabriel Sudario, Michael Clery, Nicole M Dubosh, Aaron Harries, Nana Yaa Misa","doi":"10.1186/s12873-026-01535-6","DOIUrl":"10.1186/s12873-026-01535-6","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442392","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":"Awareness and management of sepsis among emergency medicine practitioners in China: a national cross-sectional study.","authors":"Yidan Hu, Yun Qu, Qijia Liu, Quan Li, Hai Kang, Chuanzhu Lv","doi":"10.1186/s12873-026-01534-7","DOIUrl":"10.1186/s12873-026-01534-7","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442371","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":"30-day hospital admission among older adults initially managed at home by a mobile emergency unit: a retrospective cohort study.","authors":"Masoud Moradi, Anita Maués Østergaard Pedersen, Katrine Jaquet Mavraganis, Mette Rahbek Kristensen, Johanne Overgaard Wessels, Sina Bayatshahbazi, Peter Biesenbach","doi":"10.1186/s12873-026-01536-5","DOIUrl":"10.1186/s12873-026-01536-5","url":null,"abstract":"<p><strong>Background: </strong>In recent years, Denmark has introduced mobile emergency unit (MEU) to provide patients with home-based evaluation and treatment by emergency medicine physicians. The aim is to avoid unnecessary hospital admissions and to reduce overcrowding in emergency departments. However, it is unknown which demographic, clinical, and paraclinical characteristics of patients at the index MEU assessment are related to subsequent hospital admission. Therefore, we aimed to describe these baseline characteristics and to examine their association with 30-day hospital admission.</p><p><strong>Methods: </strong>In this retrospective, single-centre cohort study at Esbjerg Hospital (Region of Southern Denmark), we screened 1656 MEU contacts (from 1 January to 31 December 2024) and included adults aged ≥ 65 years, who were not directly admitted/conveyed to hospital at the index visit (i.e. initially managed at home). These patients were potential candidates for hospital admission, and the emergency physician made an on-scene decision regarding admission. Data were analysed using multivariable logistic regression.</p><p><strong>Results: </strong>We included 357 MEU contacts, with a median (interquartile range) age of 83.5 (77.6-89.2) years. 140 (39.2%) of these contacts were admitted to hospital within 30 days. A higher proportion of the admitted patients had a pre-existing do-not-attempt-resuscitation (DNAR) order compared with the non-admitted patients (85.0% vs 66.4%; p < 0.001) and lived at home (57.8% vs. 47.4%; p = 0.055). Chronic pulmonary disease was more common among the admitted patients (31.4% vs 19.3%; p = 0.009), whereas dementia was less frequent (18.6% vs 28.1%; p = 0.042). Both a pre-existing DNAR order (odds ratio [OR] 3.83, 95% confidence interval [CI] 2.05-7.16) and home (vs nursing home) residence (OR 1.76, 95% CI 1.03-2.98) were significantly associated with hospital admission in the adjusted model.</p><p><strong>Conclusions: </strong>Among older adults assessed at home by MEU physicians, a pre-existing DNAR order and home (vs nursing home) residence were independently associated with 30-day hospital admission. These findings may inform triage and follow-up planning. However, prospective studies are required to establish causal links.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430700","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":"Inadequate pain management with opioids fentanyl and morphine by paramedics and emergency physicians in rural Germany: an observational study.","authors":"Olga Scharonow, Maria Raker, Christian Weilbach, Matthias Maak, Maximilian Scharonow","doi":"10.1186/s12873-026-01520-z","DOIUrl":"10.1186/s12873-026-01520-z","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430731","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":"Investigating changes in care patterns and lessons learned during COVID-19 pandemic - an exploratory, convergent mixed method study at two university emergency departments in Germany.","authors":"Jennifer Hitzek, Bettina Völzer, Martina Schmiedhofer, Dörte Huscher, Anja Alberter, Miriam Mayer, Martin Möckel, Anna Slagman","doi":"10.1186/s12873-026-01528-5","DOIUrl":"10.1186/s12873-026-01528-5","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389165","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":"AI-powered surveillance of bronchiolitis in the Nirsevimab era: comparative performance of machine learning, deep learning, and large language models on free-text ED records.","authors":"Marianna Costa, Mohd Rashid Khan, Luca Vedovelli, Dario Gregori, Danila Azzolina, Silvia Bressan","doi":"10.1186/s12873-025-01468-6","DOIUrl":"10.1186/s12873-025-01468-6","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430717","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":"Machine learning-based model for triage-stage prediction of emergency department disposition.","authors":"Kentaro Yoshimura, Takeshi Moriguchi","doi":"10.1186/s12873-026-01523-w","DOIUrl":"10.1186/s12873-026-01523-w","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430705","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":"Improving preparedness for mass casualty incidents in hospitals: insights from a large-scale simulation exercise with geotracking and validated questionnaires.","authors":"Maik von der Forst, Hanne Schaefer, Stefan Mohr, Hannes G Kenngott, Elyes Farjallah, Matthias Huck, Anke S Baetzner, Marie Ottilie Frenkel, Markus Ries, Martin Loos, Christoph W Michalski, Christine Leowardi, Markus Weigand, Erik Popp, Gabriel A Salg","doi":"10.1186/s12873-026-01527-6","DOIUrl":"10.1186/s12873-026-01527-6","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389221","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}