Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias最新文献

{"title":"Adult patients in the emergency department with sepsis or suspected serious infection: Which patients should have blood cultures ordered?","authors":"Julio Javier Gamazo Del Río, Raúl López Izquierdo, Gema Delgado Cárdenas, Ángel Estella, Darío Eduardo García, Agustín Julián-Jiménez","doi":"10.55633/s3me/007.2025","DOIUrl":"https://doi.org/10.55633/s3me/007.2025","url":null,"abstract":"<p><strong>Objective: </strong>Too much controversy continues to surround the issue of ordering blood cultures in the emergency department (ED). The key question of which of our ED patients should have blood extracted remains unresolved. Nor is there clear consensus. Against this background it is still crucial to identify patients at risk of true bacteremia, as untreated bacteremia can lead to more serious life-threatening events such as septic shock. The main purpose of this narrative review was to look at the evidence on ED treatment of adults with suspected sepsis or serious infection in an attempt to define when cultures should be ordered, given that the results of microbiology can have an impact on prognosis, progression, and mortality. The authors report their consensus on recommendations for ordering cultures in cases of serious infection or sepsis attended in EDs.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"131-140"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"They couldn't look at me any better.","authors":"José Luis Santos Panero","doi":"10.55633/s3me/019.2025","DOIUrl":"https://doi.org/10.55633/s3me/019.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"152-153"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific output of emergency and urgency professionals in Spain during the 2015-2019 5-year period vs the previous 5 years (2010-2014).","authors":"Inés M Fernández-Guerrero, Concepció Moll Tudurí, Alba María Ruiz Allende, Òscar Miró","doi":"10.55633/s3me/011.2025","DOIUrl":"https://doi.org/10.55633/s3me/011.2025","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the scientific output of professionals working in emergency medicine in Spain during the 2015-2019 vs the previous 5 years (2010-2014).</p><p><strong>Methods: </strong>We included documents authored by professionals affiliated with emergency and urgency medicine in a Spanish center, indexed in the Science Citation Index (SCI)-Expanded, excluding conference communications. These documents were analyzed by publication year, authors (number, affiliation, and order of authorship), journal, document type, and research areas. Some output markers were analyzed by autonomous community and hospital based on the affiliation of the lead author from the emergency settins.</p><p><strong>Results: </strong>During the 2015-2019 5-year period, a total of 1,906 documents were published (64% original articles, 33% more vs 2010-2014), with a higher proportion of articles being published in Spanish (55%) vs English (45%). However, there was a significant increase in English articles vs the previous period (32%, p .001). Although most research activity came from hospital emergency departments (85%), the production from emergency medical services (EMS) professionals went up from 8.7% to 11.5%; p .001. First authorship went down from 67% to 50%; p .001, while university affiliation went up from 16% to 33%, p .001, as well as collaborative articles with other hospital and EDs, and other hospitals, including international collaborations (20% of international documents) (p .001 forall comparisons). Research areas with the most documents being published were cardiovascular (17.6%), infectious diseases (11.9%), pediatrics (10.7%), toxicology/pharmacology (8.0%), neurology (5.5%), and pulmonology (5.2%). Catalonia produced the most documents (510; 26.9%), followed by Madrid (419; 22.1%) and Andalusia (281; 14.8%). The regions with the largest relative increase in their share of Spanish output vs the previous 5-year period were Murcia (+71%), the Balearic Islands (+60%), Madrid (+40%), Castile-León (+37%), the Basque Country (+28%), and Asturias (+27%). Hospital Clínic led hospital production (199 out of 1,612 documents; 12%) while the Andalusian EMS led the out-of-hospital production (41 out of 219; 19%).</p><p><strong>Conclusions: </strong>The scientific oyutput of emergency professionals in Spain grew steadily during the 2015-2019 period, with significant positive changes in many qualitative aspects of this production vs the previous 5 years. Some significant changes were also detected regarding the relative weight of certain centers and autonomous communities in this production.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"117-130"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of syncope and emergency department management of patients included in the Spanish cohort of the Syncope in European Emergency Departments (SEED) study.","authors":"Josep Tost, Javier Jacob, Ana García-Martínez, Jose Carbajosa Dalmau, Lluís Llauger, Francisco Moya Torrecilla, Matthew J Reed, Òscar Miró","doi":"10.55633/s3me/091.2024","DOIUrl":"https://doi.org/10.55633/s3me/091.2024","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"156-158"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiviral prescription of mild to moderate COVID-19 and adherence to official recommendations in Spanish emergency departments.","authors":"Cristóbal M Rodríguez-Leal, Juan González Del Castillo, Pere Llorens, David Oteo Mata, Belén Morales Franco, Diana Moya Olmeda, Elizabeth Ortiz García, Octavio José Salmerón Béliz, Anna Pons Frigola, Rigoberto Jesús Del Rio Navarro, Hugo Martínez Faya, Francisco Román, Beatriz Valle Borrego, Alejandro Martín-Quirós, Henrique Villena García Del Real, Ivana Verónica Tavasci López, María Teresa Sánchez Moreno, Sara Gayoso Martín, Martín Sebastián Ruiz Grinspan, Teresa Pérez Pérez, Rosario Susi García","doi":"10.55633/s3me/016.2025","DOIUrl":"https://doi.org/10.55633/s3me/016.2025","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the prescription of antiviral therapy for mild to moderate COVID-19 in Spanish emergency departments, the incidence of missed opportunities to prescribe, and associated factors.</p><p><strong>Methods: </strong>Retrospective cross-sectional study in 16 hospital emergency departments. We collected data for adults with mild to moderate COVID-19 confirmed within 7 days of first symptoms. The patients studied were at risk for progression and were treated as outpatients during the first 8 months of 2022. We estimated the incidence of missed opportunities and evaluated associated factors with a Bayesian statistical approach assuming noninformative prior distributions.</p><p><strong>Results: </strong>The overall incidence of missed opportunities to prescribe was 33.5% (95% probability interval [PI], 31.7%- 35.3%). Incidences in the 16 hospitals ranged from 17.8% to 50.6%. Adjusted odds ratios (aORs) showed that factors associated with more missed opportunities were age (aOR, 1.021; 95% PI, 1.013-1.029); widening of recommended indications relative to the first period (aOR third period, 2.641 [95% PI, 1.844-3.783]; aOR fourth period, 7.440 [95% PI, 5.352-10.343]; and aOR fifth period, 17.743 [95% PI, 10.821-29.105]); immunosuppression (aOR, 2.698; 95% PI, 2.115-3.443); and fewer vaccine doses relative to no vaccination (aOR 3 doses, 0.287 [95% PI, 0.197-0-417] and aOR 4 doses, 0.115 [95% PI, 0.074-0.179]). Factors associated with increased antiviral prescription were obesity (aOR, 0.735, 95% PI, 0.567-0.952) and the existence of automated clinical pathway alerts (aOR, 0.287; 95% PI, 0.114-0.721).</p><p><strong>Conclusions: </strong>The incidence of missed opportunities to prescribe antiviral therapy is high. Incidences vary across hospitals and more often involve the most vulnerable patients.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiological changes during medical helicopter transport in the Canary Islands and their relationship with meteorological conditions.","authors":"Alejandro Artero García, Marisa Estarlich, Francisco Javier Fernández Carrasco, Luciano Rodríguez Díaz, Juana María Vázquez Lara, Juan Gómez Salgado, Carmen Casal-Angulo","doi":"10.55633/s3me/005.2025","DOIUrl":"https://doi.org/10.55633/s3me/005.2025","url":null,"abstract":"<p><strong>Objective: </strong>To identify hemodynamic changes in helitransported patients and how they are affected by meteorological factors and transport characteristics.</p><p><strong>Methods: </strong>A longitudinal study was conducted using the Canary Islands Emergency Service medical records database, from January 1, 2022, to December 31, 2022. Data from patients without mechanical ventilation or administration of vasoactive drugs were used. Systolic and diastolic blood pressure (BP), oxygen saturation, and heart rate (HR) variables were collected before, during, and at the end of the transfer, were collected. Meteorological variables during the flight, as well as sociodemographic variables, were taken into account. For bivariate analyses, Student's t-tests and ANOVA were used to assess the relationship between the variables described above. Mixed linear regression models were used to assess factors associated with hemodynamic changes.</p><p><strong>Results: </strong>The 383 patients experienced changes in HR, oxygen saturation, and BP. These changes are due to altitude, exposure to wind and temperature variations. The study also shows that the duration of the flight and the speed of the helicopter affect hemodynamic stability.</p><p><strong>Conclusions: </strong>Significant changes in HR, oxygen saturation and systolic BP during flights, which are restored after landing. The climatic conditions in the islands and altitude characteristic of this area influence the patient's physiology.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"111-116"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevance of constipation in the decompensation of chronic diseases: a case study of heart failure.","authors":"Constanza Ciriza de Los Ríos","doi":"10.55633/s3me/017.2025","DOIUrl":"https://doi.org/10.55633/s3me/017.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"85-86"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in mass casualty incidents: current status and future perspectives.","authors":"Carlos Romero Olóriz","doi":"10.55633/s3me/018.2025","DOIUrl":"https://doi.org/10.55633/s3me/018.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"159-160"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic constipation in patients with acute heart failure is related to prognosis.","authors":"Alberto Domínguez-Rodríguez, Néstor Báez-Ferrer, Pablo Avanzas, Francesco Formica, Rocío Díaz, Pedro Abreu-González, Elisa Trujillo-Martín, Guillermo Burillo-Putze, Daniel Hernández-Vaquero","doi":"10.55633/s3me/006.2025","DOIUrl":"https://doi.org/10.55633/s3me/006.2025","url":null,"abstract":"<p><strong>Objective: </strong>To study whether chronic constipation (CC) in patients hospitalized for acute heart failure (AHF) is associated with short-term prognosis.</p><p><strong>Methods: </strong>Baseline and clinical data were prospectively collected for a cohort of patients consecutively admitted for AHF. CC was diagnosed if a patient reported having at least 2 of the following symptoms lasting at least 3 months within the past year: a) straining when emptying bowels, b) hard or lumpy stool, c) a feeling that bowels have not been fully emptied, d) a feeling of anorectal blockage, and e) fewer than 3 spontaneous bowel movements per week. We estimated crude and adjusted associations between CC and a composite outcome of 30-day mortality or readmission for AHF.</p><p><strong>Results: </strong>A total of 492 patients hospitalized for AHF were studied; 116 (23.6%) were diagnosed with CC on admission. The mean (SD) age was 64 (11) years for patients without CC and 65 (10) years for patients with CC. Patients with CC had higher prevalences of chronic kidney insufficiency, valvular heart disease, atrial fibrillation, and need for mechanical ventilation on admission. The Kaplan-Meier analyses before and after propensity score matching showed that risk for 30-day mortality or readmission for AHF was significantly greater in patients with CC (before, log-rank P .001); after, log-rank P = .046).</p><p><strong>Conclusions: </strong>Poorer clinical outcomes were associated with CC in this cohort of patients with AHF.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"103-110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceilings of treatment established by emergency physicians based on the sex of patients who deteriorate during their stay in Spanish emergency departments: a secondary analysis of a European survey.","authors":"Òscar Miró, Daniel Repullo, Blanca Coll-Vinent, Marie Anette Arce, Yonathan Freund, Amélie Vromant","doi":"10.55633/s3me/116.2024","DOIUrl":"https://doi.org/10.55633/s3me/116.2024","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 2","pages":"154-156"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}