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

{"title":"Prehospital airway management with a second generation laryngeal mask in a patient with severe tracheal stenosis.","authors":"Daniel Perez-Ajami","doi":"10.55633/s3me/063.2024","DOIUrl":"10.55633/s3me/063.2024","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"399-400"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373902","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":"SEMES' long road to specialty status for emergency medicine in Spain.","authors":"Juan Jorge González Armengol, Francisco Aramburu Vilariño, Tomás Toranzo Cepeda, Manuel José Vázquez Lima","doi":"10.55633/s3me/079.2024","DOIUrl":"10.55633/s3me/079.2024","url":null,"abstract":"<p><strong>Text: </strong>July 2 of this year saw the publication of Spanish Royal Decree 610/2024, which establishes emergency medicine as an official specialization. This event represents the culmination of a long-running effort to improve the care of patients in the emergency and urgent care system and throughout the national health service. This article offers a brief account of some of the legal, administrative, and political steps the Spanish Society of Emergency Medicine(SEMES) took to achieve this goal over the course of nearly 40 years. The effort has involved many SEMES members, who strictly speaking had the sole obligation of knowing how to care appropriately for patients based on clinical expertise along with organizational, scientific, and other professional skills. Competences in these areas have been shown to fall short in Spain. The article provides examples of some of the bright lights and dim shadows in our rule of law. Nonetheless, the long road traveled has also shown us how skills and knowledge are developed in adverse circumstances and crises, provided there is vocation for public service.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"367-374"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373903","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":"Spain now recognizes specialization in emergency medicine.","authors":"Manuel José Vázquez Lima","doi":"10.55633/s3me/071.2024","DOIUrl":"10.55633/s3me/071.2024","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"321-323"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373905","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":"Spain approves specialization in emergency medicine: one more country declares its interest in high quality medicine following European standards.","authors":"Jim Connolly","doi":"10.55633/s3me/074.2024","DOIUrl":"10.55633/s3me/074.2024","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"324-325"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373904","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":"Specialisation in emergency nursing: an essential driver for quality and safety in emergency care.","authors":"Regina Allande-Cussó, Juan Gómez-Salgado","doi":"10.55633/s3me/075.2024","DOIUrl":"10.55633/s3me/075.2024","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"389-390"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373906","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":"Concordance between risk scales for venous thromboembolism in patients treated in emergency departments.","authors":"Mónica Olid Velilla, Sònia Jiménez Hernández, Fahd Beddar, Vanesa Sendín Martín, Línder Cárdenas Bravo, Ángel Álvarez Márquez, Daniel Sánchez Díaz-Canel, Susana Diego Roza, Ángel Sánchez Garrido-Lestache, David Jiménez Castro, Ramón Lecumberri, Pedro Ruiz Artacho","doi":"10.55633/s3me/084.2024","DOIUrl":"10.55633/s3me/084.2024","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate agreement between risk-assessment models for venous thromboembolism (VTE) in patients hospitalized for medical conditions and to analyze variables associated with the decision to prescribe pharmacological thromboprophylaxis in hospital emergency departments (EDs). Conclusions.</p><p><strong>Methods: </strong>Prospective observational multicenter cohort study. We included adults attended in 15 hospital EDs who were hospitalized for medical conditions, calculating VTE risk according to the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) score, the Padua Prediction Score (PPS), and the National Institute for Health and Care Excellence (NICE) score. In addition to assessing interscore concordance, we analyzed variables associated with the prescription of thromboprophylaxis in the ED.</p><p><strong>Results: </strong>A total of 1203 patients were included. The PADUA, IMPROVE, and NICE scales assigned high risk scores for 68.7%, 47.4%, and 69.5% of the patients, respectively. The κ statistic for agreement between the PADUA and NICE scores was 0.80 (95% CI, 0.76-0.84); 102 patients (8.5%) had discordant scores. The κ statistics for agreement between the IMPROVE score and the PADUA and NICE classifications were 0.47 (95% CI, 0.43-0.52) and 0.37 (95% CI, 0.33-0.42), respectively; 322 (26.8%) and 384 patients (31.9%), respectively, had discordant scores. Variables associated with starting thromboprophylaxis in the ED were a diagnosis of acute myocardial infarction or stroke (adjusted odds ratio [aOR], 4.26), immobility in the last 2 months (aOR, 2.19), chronic obstructive pulmonary disease (aOR, 1.97), ischemic heart disease (aOR, 1.51), reduced mobility of 3 days or longer (aOR, 1.14), body mass index (aOR, 1.04), age (aOR, 1.02), recent trauma or surgery (aOR, 0.40), and risk for bleeding (aOR, 0.56).</p><p><strong>Conclusions: </strong>There is disagreement among the recommended models for predicting risk for VTE in patients hospitalized for medical conditions. The basis for emergency physicians' clinical judgment regarding thromboprophylaxis extends beyond risk scales to include multiple risk factors for VTE and bleeding.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"342-350"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373893","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":"Congratulations to all Spain's emergency physicians and to the Spanish Society of Emergency Medicine (SEMES): Let the fun begin!","authors":"Judith E Tintinalli","doi":"10.55633/s3me/073.2024","DOIUrl":"10.55633/s3me/073.2024","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"326-328"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373894","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":"Impact of an emergency department nurse training intervention on the adequacy of thromboprophylaxis for venous thromboembolism: the PROTESU III study.","authors":"César Rincón Díaz, Sònia Jiménez Hernández, Fahd Beddar Chaib, Laura Lozano Polo, Leticia Guirado Torrecillas, María Cortés Ayaso, Ana Isabel Condon Abanto, Jorge Pedraza García, Gema Muñoz Gamito, David Jiménez, Ramón Lecumberri, Pedro Ruiz Artacho, En Representación Del Grupo de Trabajo de Enfermedad Tromboembólica Venosa de la Sociedad Española de Medicina de Urgencias Y Emergencias Etv-Semes","doi":"10.55633/s3me/080.2024","DOIUrl":"10.55633/s3me/080.2024","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of training for emergency department (ED) nurses on adequate thromboprophylaxis for patients admitted to hospital from the ED for medical conditions.</p><p><strong>Methods: </strong>Multicenter quasiexperimental pre-post study of an ED nurse training intervention in 8 hospitals. Patients were recruited from January 2022 through May 2023 in 3 phases: before nurse training, in the first month after training, and in the sixth month after training. Included were patients attended in the ED for medical conditions. Adequate thromboprophylaxis was defined as 1) use of prophylactic drugs in patients at high risk for venousthromboembolism according to the Padua Prediction Score (PPS), and 2) nonuse in patients at low risk. We compared the percentage of adequate prophylaxis in the first phase to the percentages in the second and third phases.</p><p><strong>Results: </strong>A total of 928 patients were included (326 in phase 1, 295 in phase 2, and 307 in phase 3). PPS scores indicated that 238 (73%) of the patients were at high risk in phase 1 vs 189 (64.1%, P = .016) in phase 2 and 207 (67.4%, P = .125) in phase 3. A total of 187 patients (57.4%, 95% CI, 51.8%-62.8%) were adequatelythromboprophylaxed in phase 1 vs 178 (60.%, 95% CI, 54.5%-66%) in phase 2 (absolute difference in proportions, 3.0% (95% CI, -4.8% to 10.6%; P = .462)]. In phase 3, 166 patients (54.1%, 95% CI, 48.3%-59.7%) received adequate prophylaxis (difference, -3.3% (95% CI, -11.0% to 4.4%; P = .405).</p><p><strong>Conclusions: </strong>A training intervention for ED nurses, implemented as an isolated strategy, had no impact on the adequacy of thromboprophylaxis in patients admitted from the ED for medical conditions.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"359-366"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373899","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":"Comparing answers of artificial intelligence systems and clinical toxicologists to questions about poisoning: Can their answers be distinguished?","authors":"Santiago Nogué-Xarau, José Ríos-Guillermo, Montserrat Amigó-Tadín","doi":"10.55633/s3me/082.2024","DOIUrl":"10.55633/s3me/082.2024","url":null,"abstract":"<p><strong>Objective: </strong>To present questions about poisoning to 4 artificial intelligence (AI) systems and 4 clinical toxicologists and determine whether readers can identify the source of the answers. To evaluate and compare text quality and level of knowledge found in the AI and toxicologists' responses.</p><p><strong>Methods: </strong>Ten questions about toxicology were presented to the following AI systems: Copilot, Bard, Luzia, and ChatGPT. Four clinical toxicologists were asked to answer the same questions. Twenty-four recruited experts in toxicology were sent a pair of answers (1 from an AI system and one from a toxicologist) for each of the 10 questions. For each answer, the experts had to identify the source, evaluate text quality, and assess level of knowledge reflected. Quantitative variables were described as mean (SD) and qualitative ones as absolute frequency and proportion. A value of P .05 was considered significant in all comparisons.</p><p><strong>Results: </strong>Of the 240 evaluated AI answers, the expert evaluators thought that 21 (8.8%) and 38 (15.8%), respectively, were certainly or probably written by a toxicologist. The experts were unable to guess the source of 13 (5.4%) AI answers. Luzia and ChatGPT were better able to mislead the experts than Bard (P = .036 and P = .041, respectively). Text quality was judged excellent in 38.8% of the AI answers. ChatGPT text quality was rated highest (61.3% excellent) vs Bard (34.4%), Luzia (31.7%), and Copilot (26.3%) (P .001, all comparisons). The average score for the level of knowledge perceived in the AI answers was 7.23 (1.57) out of 10. The highest average score was achieved by ChatGPT at 8.03 (1.26) vs Luzia (7.02 [1,63]), Bard (6.91 [1.64]), and Copilot (6.91 [1.46]) (P .001, all comparisons).</p><p><strong>Conclusions: </strong>Luzia and ChatGPT answers to the toxicology questions were often thought to resemble those of clinical toxicologists. ChatGPT answers were judged to be very well-written and reflect a very high level of knowledge.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"351-358"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373881","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":"Expected impact on Spanish emergency care systems when residency training in emergency medicine begins.","authors":"Carmen Camacho Leis","doi":"10.55633/s3me/076.2024","DOIUrl":"10.55633/s3me/076.2024","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"36 5","pages":"337-339"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373896","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}