Journal Description
Emergency Care and Medicine
Emergency Care and Medicine
is an international, peer-reviewed, open access journal on advancements and developments in emergency medical services, emergency medicine, acute internal medicine, and acute care surgery practice, theory, nursing, training, and education published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 18.9 days after submission; acceptance to publication is undertaken in 5.5 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names are published annually in the journal.
- Emergency Care and Medicine is a companion journal of Biomedicines.
Latest Articles
Approach to Precipitous Delivery in the Emergency Department: Best Practices for Managing Emergent Vaginal Deliveries and Associated Complications
Emerg. Care Med. 2025, 2(3), 42; https://doi.org/10.3390/ecm2030042 - 18 Aug 2025
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Precipitous deliveries in the emergency department are one of the highest-acuity events that emergency providers manage. These deliveries can range from uncomplicated to wrought with difficulty. They require emergency care providers to manage intrapartum complications, such as nuchal cords, shoulder dystocia, and breech
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Precipitous deliveries in the emergency department are one of the highest-acuity events that emergency providers manage. These deliveries can range from uncomplicated to wrought with difficulty. They require emergency care providers to manage intrapartum complications, such as nuchal cords, shoulder dystocia, and breech presentation, and maternal complications such as uterine atony, birth canal trauma, and postpartum hemorrhage. Delivery may additionally necessitate resuscitative hysterotomy or neonatal resuscitation. Our narrative review discusses preparatory practices, normal labor and delivery progression, and brief guidelines for managing complications of precipitous deliveries for emergency medicine providers.
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Open AccessArticle
Association Between Polyethylene Glycol Dose and Length of Hospital Stay in Body Packing Patients: A Retrospective Review
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Sara Fouad Mahmoud, Ashraf El Malik, Ziad Ibdah, Mohamed Saudi, Guillaume Alinier and Mohamed Omar Saad
Emerg. Care Med. 2025, 2(3), 41; https://doi.org/10.3390/ecm2030041 - 14 Aug 2025
Abstract
Objectives: Body packing is one of the methods used to smuggle illicit drugs and items. Identifying the drug and eradicating drug packs are essential tasks to complete in the shortest possible time to reduce the risk of toxicity. Polyethylene glycol is one of
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Objectives: Body packing is one of the methods used to smuggle illicit drugs and items. Identifying the drug and eradicating drug packs are essential tasks to complete in the shortest possible time to reduce the risk of toxicity. Polyethylene glycol is one of the safer laxatives to use if surgical exploration is not indicated. The objective of this study is to evaluate the association of the dose of polyethylene glycol (PEG) and the length of hospital stay and/or time for body packers to evacuate drug packs. Methods: This is a retrospective analysis completed at Hamad Medical Corporation in Qatar, studying adult patients who received polyethylene glycol to evacuate drug packs from January 2018 to September 2019. Results: The primary and secondary outcomes are association between PEG doses and length of hospital stay and time to drug pack clearance, respectively. There were a total of 39 patients included in this study. A minority of patients developed signs of systemic toxicity. The average hospital length of stay for all patients was 86.2 h. The results show that the PEG dose at 12 h is inversely proportional to the length of hospital stay where each extra 1 g will decrease length of hospital stay by 0.098 h. The results are even more statistically significant when analyzed compared to time to clearance with a regression coefficient of −0.136 (p = 0.022). Conclusions: This study shows that a higher polyethylene glycol dose, especially at 12 h, is safe and reduces the time needed to clear drug packs and reduces length of hospital stay.
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Open AccessReview
On the Move: A Review of Mobile and Military Surgery
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Colton D. Wayne, Taylor H. Jacobs, Kyle Alexander, Zachary Dumbauld, Siddharth Narayanan, Omar Rokayak and Forrest O. Moore
Emerg. Care Med. 2025, 2(3), 40; https://doi.org/10.3390/ecm2030040 - 14 Aug 2025
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The ability to provide ambulatory and mobile surgery services in rural and austere environments has seen tremendous growth in recent decades due to innovations in surgical techniques and equipment. These advances have been implemented in both civilian and military settings, increasing the capabilities
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The ability to provide ambulatory and mobile surgery services in rural and austere environments has seen tremendous growth in recent decades due to innovations in surgical techniques and equipment. These advances have been implemented in both civilian and military settings, increasing the capabilities of surgeons and surgical subspecialists across the globe. This review aims to briefly explore the history of ambulatory and mobile surgery and describe the recent efforts to make advancements in this field to improve global surgery opportunity and access, as well as to provide an overview of both military and civilian utilizations of mobile surgical teams and strategies.
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Open AccessReview
Hemodynamic Support in Cardiogenic Shock in the Cardiac Catheterization Laboratory
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Cesar Jiménez-Méndez, Ana Lara-Palomo, Ana Pérez-Asensio, Luis Martín-Alfaro, Mauricio Urgiles, Rafael Vázquez-García and Livia Gheorghe
Emerg. Care Med. 2025, 2(3), 39; https://doi.org/10.3390/ecm2030039 - 13 Aug 2025
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Cardiogenic shock is a life-threatening, time-sensitive syndrome characterized by clinical and biochemical tissue hypoperfusion caused by circulatory failure secondary to inadequate cardiac output. Inadequate cardiac contractility secondary to acute myocardial infarction appears on the top of the list of the most prevalent etiologies
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Cardiogenic shock is a life-threatening, time-sensitive syndrome characterized by clinical and biochemical tissue hypoperfusion caused by circulatory failure secondary to inadequate cardiac output. Inadequate cardiac contractility secondary to acute myocardial infarction appears on the top of the list of the most prevalent etiologies of this syndrome. Despite some advances in its management, this primary cardiac disorder still has an extremely high mortality. In addition to treating the main etiology, immediate hemodynamic support is necessary to reduce the risk of developing multi-organ dysfunction and to preserve cell metabolism, as soon as we suspect it, even when needed in the catheterization laboratory. The cardiac catheterization laboratory has become a pivotal setting for implementing rapid hemodynamic support measures, such as pharmacological interventions and mechanical circulatory support, during critical procedures. Despite inotrope pharmacological treatment, mechanical circulatory support has recently garnered significant interest in this field. The aim of this review is to analyze hemodynamic support in cardiogenic shock in the most common contemporary scenario: the cardiac catheterization laboratory.
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Open AccessCorrection
Correction: Gianazza et al. Asymptomatic Intestinal Ischemia Secondary to Thrombosis of the Spleno-Mesenteric Portal Axis: Usefulness of Laparoscopic Approach for Diagnosis and Therapeutical Decisions—Case Report and Review of the Literature. Emerg. Care Med. 2024, 1, 39–45
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Simone Gianazza, Marika Morabito, Davide Inversini, Sabrina Garbarino, Marta Ripamonti, Giuseppe Ietto and Giulio Carcano
Emerg. Care Med. 2025, 2(3), 38; https://doi.org/10.3390/ecm2030038 - 12 Aug 2025
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In the original publication [...]
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Open AccessArticle
Evaluating the Safety of Tenecteplase Versus Alteplase for Acute Ischemic Stroke
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Salma Guerrero Miranda, Ifoma Ofoegbuna, Maicuc Tran, Ada Selina Jutba and Christine Vo
Emerg. Care Med. 2025, 2(3), 37; https://doi.org/10.3390/ecm2030037 - 8 Aug 2025
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Background/Objectives: This study aims to compare the safety of tenecteplase versus alteplase for acute ischemic stroke. Methods: This was a multicenter, retrospective cohort study including 11 Memorial Hermann Health System hospitals in Houston from 7 December 2022 to 7 June 2023. Adults presenting
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Background/Objectives: This study aims to compare the safety of tenecteplase versus alteplase for acute ischemic stroke. Methods: This was a multicenter, retrospective cohort study including 11 Memorial Hermann Health System hospitals in Houston from 7 December 2022 to 7 June 2023. Adults presenting with an acute ischemic stroke who received alteplase or tenecteplase were included in this study. The primary outcome was the incidence of hemorrhagic conversion after 24 h of thrombolytic administration. Secondary outcomes included door-to-needle time, incidence of a major or minor bleed, length of hospital stay, incidence of any adverse effect, modified Rankin score at discharge, patient discharge disposition, medication cost, and mortality. Results: A total of 173 patients were reviewed, with 87 patients in the tenecteplase group and 86 patients in the alteplase group. Gender, actual body weight, and use of aspirin or dual antiplatelet therapy within 24 h of thrombolytic administration were statistically disproportionate between both groups. Hemorrhagic conversion occurred in seven patients in the tenecteplase group and eight patients in the alteplase group (p = 0.79). Medication cost was statistically significant between both groups. All other secondary outcomes were similar between tenecteplase and alteplase. Conclusions: In this underpowered study, we did not observe a statistically significant difference in the rate of 24 h hemorrhagic conversion between the tenecteplase and alteplase groups. Further studies with a large sample size are warranted to assess safety outcomes.
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Open AccessArticle
Efficacy of Portable Fugitive Aerosol Mitigation Systems for Nebulizer Therapy During High-Flow Nasal Cannula and Non-Invasive Ventilation
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Adithya Shyamala Pandian, Bhavesh Patel, Karam Abi Karam, Amelia Lowell, Kelly McKay, Sabrina Jimena Mora, Piyush Hota, Gabriel Pyznar, Sandra Batchelor, Charles Peworski, David Rivas, Devang Sanghavi, Ngan Anh Nguyen, Aliaa Eltantawy, Xueqi Li, Xiaojun Xian, Michael Serhan and Erica Forzani
Emerg. Care Med. 2025, 2(3), 36; https://doi.org/10.3390/ecm2030036 - 29 Jul 2025
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Objectives: This study evaluates the efficacy of existing and new aerosol mitigation methods during nebulization (Neb) in combination with high-flow nasal cannula (HFNC) oxygen supplementation and non-invasive ventilation (NIV). Methods: We recorded fugitive aerosol particle concentrations over time and assessed the peak (P)
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Objectives: This study evaluates the efficacy of existing and new aerosol mitigation methods during nebulization (Neb) in combination with high-flow nasal cannula (HFNC) oxygen supplementation and non-invasive ventilation (NIV). Methods: We recorded fugitive aerosol particle concentrations over time and assessed the peak (P) and area (A) efficacy of active and passive mitigation methods, comparing them to a no-mitigation condition. Peak efficacy was measured by the reduction in maximum aerosol concentration, while area efficacy was quantified by the reduction of the area under the aerosol concentration–time curve. Results: For HFNC with Neb, we found that active mitigation using a mask with a biofilter and a fan (referred to as the aerosol barrier mask) significantly outperformed passive mitigation with a face mask. The peak and area efficacy for aerosol reduction were 99.0% and 96.4% for active mitigation and 35.9% and 7.6% for passive mitigation, respectively. For NIV with Neb, the active mitigation method, using a box with a biofilter and fan, also outperformed passive mitigation using only the box. The peak and area efficacy for aerosol reduction were 92.1% and 85.5% for active mitigation and 53.7.0% and 25.4% for passive mitigation, respectively. Conclusion: We concluded that active mitigation set up systems advantageous for effective reduction of airborne aerosols during aerosol generated procedures.
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Open AccessArticle
Performance of the InfraScanner for the Detection of Intracranial Bleeding in a Population of Traumatic Brain Injury Patients in Colombia
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Santiago Cardona-Collazos, Sandra Olaya-Perea, Laura Fernández, Dylan Griswold, Alvaro Villota, Sarita Aristizabal, Elizabeth Ginalis, Diana Sanchez, Angelos Kolias, Peter Hutchinson and Andres M. Rubiano
Emerg. Care Med. 2025, 2(3), 35; https://doi.org/10.3390/ecm2030035 - 23 Jul 2025
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Background/Objectives: Traumatic brain injury (TBI) is a global public health concern, affecting over 60 million people annually. It is associated with high rates of mortality and disability, particularly among young and economically active individuals, and remains the leading cause of death in
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Background/Objectives: Traumatic brain injury (TBI) is a global public health concern, affecting over 60 million people annually. It is associated with high rates of mortality and disability, particularly among young and economically active individuals, and remains the leading cause of death in people under 40 years of age. Although computed tomography (CT) is the standard method for excluding intracranial bleeding (ICB), it is frequently unavailable in resource-limited settings where the burden of TBI is greatest. The InfraScanner 2000 is a near-infrared spectroscopy (NIRS) device designed to detect ICB and may serve as a triage tool in environments without access to CT imaging. This study aimed to evaluate the diagnostic performance of the InfraScanner 2000 for detecting ICB in the emergency department (ED) of a trauma center in a cohort of Colombian patients with TBI. Methods: This prospective study was conducted in Cali, Colombia, between December 2019 and February 2021. Adult patients presenting to the ED with blunt TBI were enrolled. InfraScanner assessments were performed according to a standardized protocol, and all participants underwent head CT within 6 h of injury. Results: A total of 140 patients were included. Of these, 66% were male and 34% were female. Most patients (63.57%) were between 18 and 39 years old, with a median age of 39 years (IQR: 18–86). The InfraScanner demonstrated a sensitivity of 60.0% (95% CI: 32.5–84.8), specificity of 78.4% (95% CI: 71.2–85.6), positive predictive value (PPV) of 25.0%, and negative predictive value (NPV) of 94.2% for detecting ICB. Conclusions: The InfraScanner 2000 showed good specificity and high NPV in identifying ICB among Colombian patients with TBI. These findings suggest it could serve as a useful triage tool to support decision-making in emergency settings with limited access to CT imaging.
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Open AccessCorrection
Correction: Wang, A. The Role of Acupuncture in the Management of Bell’s Palsy: A Review of the Evidence and Perspectives in Emergency Care. Emerg. Care Med. 2024, 1, 230–239
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Alan Wang
Emerg. Care Med. 2025, 2(3), 34; https://doi.org/10.3390/ecm2030034 - 16 Jul 2025
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There was an error in the original publication [...]
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Open AccessArticle
Surgical Decision-Making for the Treatment of Acute Diverticulitis: A Single-Center Retrospective Study
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Davide Inversini, Sara El Adla, Andrea Vigezzi, Simone Gianazza, Marika Morabito, Andrea Rizzi, Andrea Palillo, Giuseppe Ietto and Giulio Carcano
Emerg. Care Med. 2025, 2(3), 33; https://doi.org/10.3390/ecm2030033 - 14 Jul 2025
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Background: Several studies have suggested that laparoscopic peritoneal lavage for the treatment of diverticulitis might be associated with an increased event rate. The WSES (World Society of Emergency Surgery) guidelines recommend performing laparoscopic peritoneal lavage only in highly selected patients; however, selection criteria
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Background: Several studies have suggested that laparoscopic peritoneal lavage for the treatment of diverticulitis might be associated with an increased event rate. The WSES (World Society of Emergency Surgery) guidelines recommend performing laparoscopic peritoneal lavage only in highly selected patients; however, selection criteria remain poorly described. This study, based on a single-center retrospective cohort of patients presenting with acute diverticulitis and undergoing surgery, aimed to assess the complication and long-term outcomes of the lavage group and to report our experience with the treatment of acute diverticulitis. Methods: Operative management of acute sigmoid diverticulitis was involved, in particular, laparoscopic peritoneal lavage, primary resection, and the Hartmann procedure. Results: Six-month follow-ups showed the occurrence of Clavien–Dindo complications in ≥2 in 21.9% of patients in the sigmoidectomy group versus 61.1% of patients in the lavage group (p = 0.0028). Among the 11 patients with complications after laparoscopic lavage, 9 required a second surgery. After a comparison between the patients with complications and those without who were managed with laparoscopic lavage, descriptive differences were found regarding the BMI (95% CI, 21.7–24.3 vs. 95% CI, 24.7–31.3, p = 0.0419). In analysis, a BMI of ≥27 kg/m2 (OR, 16 p = 0.049) was associated with short- and long-term complications in the lavage group. There was no evidence for an association between complications and a BMI of ≥27 kg/m2 in the primary resection (OR, 1.61 p = 1) or the Hartmann procedure group (OR, 4.25 p = 0.1438). Perforated colonic diverticulitis treated with laparoscopic peritoneal lavage was associated with a high morbidity rate. Conclusions: The choice of surgical strategy for acute diverticular pathology is complex, influenced by various conditions. BMI could be a prognostic factor for long-term outcomes, including recurrent diverticulitis and the occurrence of abscesses.
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Open AccessCase Report
Magnetic Mishap: Multidisciplinary Care for Magnet Ingestion in a 2-Year-Old
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Niharika Goparaju, Danielle P. Yarbrough and Gretchen Fuller
Emerg. Care Med. 2025, 2(3), 32; https://doi.org/10.3390/ecm2030032 - 8 Jul 2025
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Background/Objectives: A 2-year-old male presented to the emergency department (ED) with vomiting and abdominal discomfort following ingestion of multiple magnets from a sibling’s bracelet. This case highlights the risks associated with magnet ingestion and the need for coordinated multidisciplinary care and public health
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Background/Objectives: A 2-year-old male presented to the emergency department (ED) with vomiting and abdominal discomfort following ingestion of multiple magnets from a sibling’s bracelet. This case highlights the risks associated with magnet ingestion and the need for coordinated multidisciplinary care and public health intervention. Methods: Radiographs revealed magnets in the oropharynx, stomach, and small bowel. Emergency physicians coordinated care with otolaryngology, gastroenterology, and general surgery. Results: Laryngoscopy successfully removed two magnets from the uvula, and endoscopy retrieved 30 magnets from the stomach. General surgery performed a diagnostic laparoscopy, identifying residual magnets in the colon. Gastroenterology attempted a colonoscopy but was unable to retrieve magnets due to formed stool, leading to bowel preparation and serial imaging. The patient eventually passed 12 magnets per rectum without surgical intervention. Conclusions: This case emphasizes the importance of multidisciplinary collaboration in managing magnet ingestion, a preventable cause of serious gastrointestinal injury. Recent studies highlight the increasing incidence and severity of such cases due to accessibility and inadequate regulation. These findings underscore the need for public awareness and adherence to management protocols to mitigate morbidity and mortality in pediatric patients.
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Open AccessArticle
No Learner Left Behind: How Medical Students’ Background Characteristics and Psychomotor/Visual–Spatial Abilities Correspond to Aptitude in Learning How to Perform Clinical Ultrasounds
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Samuel Ayala, Eric R. Abrams, Lawrence A. Melniker, Laura D. Melville and Gerardo C. Chiricolo
Emerg. Care Med. 2025, 2(3), 31; https://doi.org/10.3390/ecm2030031 - 25 Jun 2025
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Background/Objectives: The goal of educators is to leave no learner behind. Ultrasounds require dexterity and 3D image interpretation. They are technologically complex, and current medical residency programs lack a reliable means of assessing this ability among their trainees. This prompts consideration as to
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Background/Objectives: The goal of educators is to leave no learner behind. Ultrasounds require dexterity and 3D image interpretation. They are technologically complex, and current medical residency programs lack a reliable means of assessing this ability among their trainees. This prompts consideration as to whether background characteristics or certain pre-existing skills can serve as indicators of learning aptitude for ultrasounds. The objective of this study was to determine whether these characteristics and skills are indicative of learning aptitude for ultrasounds. Methods: This prospective study was conducted with third-year medical students rotating in emergency medicine at the New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA. First, students were given a pre-test survey to assess their background characteristics. Subsequently, a psychomotor task (Purdue Pegboard) and visual–spatial task (Revised Purdue Spatial Visualization Tests) were administered to the students. Lastly, an ultrasound task was given to identify the subxiphoid cardiac view. A rubric assessed ability, and proficiency was determined as a 75% or higher score in the ultrasound task. Results: In total, 97 students were tested. An analysis of variance (ANOVA) was used to ascertain if any background characteristics from the pre-test survey was associated with the ultrasound task score. The student’s use of cadavers to learn anatomy had the most correlation (p-value of 0.02). Assessing the psychomotor and visual–spatial tasks, linear regressions were used against the ultrasound task scores. Correspondingly, the p-values were 0.007 and 0.008. Conclusions: Ultrasound ability is based on hand–eye coordination and spatial relationships. Increased aptitude in these abilities may forecast future success in this skill. Those who may need more assistance can have their training tailored to them and further support offered.
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Open AccessCorrection
Correction: Strauss et al. Insights from a Decade of Optimizing Emergency Medical Services Across Three Major Regions in Switzerland. Emerg. Care Med. 2024, 1, 368–381
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Christoph Strauss, Michael Schmid, Daniel Kliem and Martin Müller
Emerg. Care Med. 2025, 2(3), 30; https://doi.org/10.3390/ecm2030030 - 23 Jun 2025
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There was an error in the original publication [...]
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Open AccessReview
Tranexamic Acid on Admission to Hospital in Hip Fracture Patients: A Scoping Review of Early Use for Reducing Blood Loss and Transfusion Risk
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Nick D. Clement, Rosie Clement and Abigail Clement
Emerg. Care Med. 2025, 2(3), 29; https://doi.org/10.3390/ecm2030029 - 20 Jun 2025
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Background: Hip fractures are a major cause of morbidity and mortality, particularly in the elderly, and the incidence is expected to rise significantly in the coming years. One of the key challenges in managing hip fracture patients is perioperative blood loss, which often
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Background: Hip fractures are a major cause of morbidity and mortality, particularly in the elderly, and the incidence is expected to rise significantly in the coming years. One of the key challenges in managing hip fracture patients is perioperative blood loss, which often necessitates allogeneic blood transfusion. Tranexamic acid (TXA), a synthetic antifibrinolytic agent, has been shown to reduce blood loss in various surgical settings, including elective orthopaedics. However, unlike elective surgery where bleeding begins intraoperatively, bleeding in hip fracture patients starts at the time of injury. This scoping review aimed to evaluate the existing literature on the use of early TXA administration, specifically at the point of admission, in patients with hip fractures. Methods: A comprehensive search of EMBASE and PubMed was conducted up to March 2025, and eight studies were identified that met the inclusion criteria, including three randomised controlled trials (RCTs). Six of these studies compared patients receiving TXA on admission to controls who received no TXA, involving a total of 840 patients. Most studies focused on extracapsular fractures in elderly, predominantly female patients. Results: Findings were mixed: four of the six studies found no statistically significant differences in haemoglobin levels or transfusion rates, while two RCTs demonstrated significantly reduced transfusion needs in the TXA group. Trends across studies suggested reduced blood loss and transfusion risk with TXA administered on admission. Importantly, no increase in complications, including venous thromboembolism, were observed. Conclusion: Early TXA administration in hip fracture patients appeared to be safe and may reduce transfusion requirements. Further high-quality research is warranted to determine the optimal timing and dosing strategy for TXA in this setting and to confirm the efficacy in reducing perioperative blood loss and transfusion risk.
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Open AccessSystematic Review
Nurses’ Responsibilities Towards Victims of Violence in the Preservation of Forensic Traces and Evidence: A Scoping Review
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Isabel Rabiais, Adília Rosas, Luís Sousa, Susana Gonçalves, Paulo Monteiro, Sérgio Deodato and Sandy Severino
Emerg. Care Med. 2025, 2(2), 28; https://doi.org/10.3390/ecm2020028 - 10 Jun 2025
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Background/Objectives: The objective of this review is to map nurses’ responsibilities in addressing individuals who are victims of violence, specifically in the preservation of forensic evidence in both intra- and extra-hospital contexts. The research question is as follows: What are a nurse’s responsibilities
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Background/Objectives: The objective of this review is to map nurses’ responsibilities in addressing individuals who are victims of violence, specifically in the preservation of forensic evidence in both intra- and extra-hospital contexts. The research question is as follows: What are a nurse’s responsibilities regarding the care of victims of violence for the preservation of forensic evidence in in-hospital and out-of-hospital emergencies? Methods: The mnemonic PCC (P-Population, C-Concept, and C-Context) method was followed according to the recommendations of the Joanna Brigs Institute (2024). The population is defined as “individuals who are victims of violence”, the concept (phenomenon of interest) as “nursing interventions determining responsibilities in forensic evidence preservation”, and the context as “intra- and extra-hospital emergencies”. A search was conducted in the following databases: CINAHL Complete via EBSCO Host, Medline Complete via EBSCO Host, PubMed, Web of Science, and RCAAP via B-ON. From the total articles retrieved, 18 were selected for analysis. Results: The 18 articles emphasized the critical role of nurses in preserving forensic evidence in both intra- and extra-hospital contexts. These findings were grouped into six domains to clarify the topic: (1) knowledge and training of nurses on forensic evidence preservation and the implementation of standardized protocols; (2) collection of biological and non-biological samples to preserve evidence on the victim’s body; (3) collection of biological and non-biological samples to preserve evidence on the victim’s objects and belongings; (4) documentation of forensic traces and evidence; (5) maintenance of the chain of custody; and (6) ongoing interprofessional collaboration between nurses, law enforcement, and judicial authorities. Conclusions: Intra- and extra-hospital emergencies, teams must be proficient in recognizing victims of violence and in conducting appropriate evidence preservation to ensure their legal admissibility.
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Open AccessEditorial
Emergency Care and Medicine: Update on the Journal’s Definition, Aim, Scope, Requirements, and Recommendations for 2025
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Raimundas Lunevicius
Emerg. Care Med. 2025, 2(2), 27; https://doi.org/10.3390/ecm2020027 - 21 May 2025
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After organisational and preparatory work in 2023, Emergency Care and Medicine (ECM) was launched in 2024, culminating in the journal’s formal recognition by the Directory of Open Access Journals (DOAJ) on 17 January 2025, https://doaj [...]
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Open AccessReview
Comprehensive Management of Severe Burn Injuries: A Multidisciplinary Approach from Resuscitation to Rehabilitation
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Maryum Merchant, Scott B. Hu, Chris Miller, Tamana Ahmadi, Edwin Garcia and Malcolm I. Smith
Emerg. Care Med. 2025, 2(2), 26; https://doi.org/10.3390/ecm2020026 - 14 May 2025
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Severe burns are among the most traumatic injuries, characterized by tissue damage, systemic inflammation, significant fluid shifts, and a high risk of complications such as infections, organ failure, anemia, malnutrition, and psychological trauma. This article reviews recent literature from the PubMed and Google
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Severe burns are among the most traumatic injuries, characterized by tissue damage, systemic inflammation, significant fluid shifts, and a high risk of complications such as infections, organ failure, anemia, malnutrition, and psychological trauma. This article reviews recent literature from the PubMed and Google Scholar databases to outline critical components of burn care, from initial resuscitation and stabilization through rehabilitation. Key topics include early airway management to prevent respiratory compromise, meticulous fluid resuscitation to maintain tissue perfusion while avoiding complications like fluid overload, and optimal pain management. It also discusses nutritional support tailored to the burn patient’s hypermetabolic state and surgical techniques like early debridement and skin grafting. Beyond physical recovery, the review emphasizes the importance of addressing the psychological impact of burn injuries, including depression, anxiety, and post-traumatic stress, which can significantly affect long-term outcomes. By integrating the expertise of a multidisciplinary team with a personalized approach and practical recommendations, this review aims to provide clinicians with a comprehensive framework for managing severe burns, from the initial emergency response to the challenges of inpatient care and, finally, rehabilitation.
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Open AccessArticle
Education and Awareness of Sports Concussion Detection and Management in Quadball: A Cross-Sectional Study
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Som Singh, Kiera Borthwick, Rebecca Martin, Demetrius Collins and Christopher Shaw
Emerg. Care Med. 2025, 2(2), 25; https://doi.org/10.3390/ecm2020025 - 8 May 2025
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Background: Concussion education for athletes can improve long-term outcomes in injury prevention. As a contact sport, Quadball has seen tremendous growth in its player population over the past decade. However, there is a paucity of understanding of sports injury epidemiology in these sports
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Background: Concussion education for athletes can improve long-term outcomes in injury prevention. As a contact sport, Quadball has seen tremendous growth in its player population over the past decade. However, there is a paucity of understanding of sports injury epidemiology in these sports compared to other contact sports in the world. The aim of this study is to describe the attitude, knowledge, and awareness of concussions among Quadball players in the United States. Methods: This study implemented a cross-sectional methodology. Specifically, a modified version of the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) was introduced to Quadball participants to address the primary aim of this study. Results: A total of 237 Quadball players participated in this study. In this cohort, 57.8% of participants reported having some form of prior concussion training or education. A cumulative 77.0% accuracy of concussion knowledge index questions was found among participants. Conclusions: The findings of this study indicate that the knowledge of sports concussions in Quadball may be greater than or comparable to that of other contact sports in the United States.
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Open AccessReview
The Invisible Threat That Leaves You Breathless—A Literature Review on Pneumothorax in the Emergency Department
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Silvia Fattori, Gabriele Bellio, Matteo Maria Cimino and Hayato Kurihara
Emerg. Care Med. 2025, 2(2), 24; https://doi.org/10.3390/ecm2020024 - 2 May 2025
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Pneumothoraces are a common and potentially severe condition in the emergency setting. Various pathophysiological mechanisms (spontaneous and traumatic) could be involved, consequently defining the diagnostic–therapeutic pathway. Understanding these underlying etiologies is essential for advancing diagnostic strategies and guiding therapeutic measures. Recent insights into
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Pneumothoraces are a common and potentially severe condition in the emergency setting. Various pathophysiological mechanisms (spontaneous and traumatic) could be involved, consequently defining the diagnostic–therapeutic pathway. Understanding these underlying etiologies is essential for advancing diagnostic strategies and guiding therapeutic measures. Recent insights into diagnostic and therapeutic strategies focus on the role of ultrasound and the effectiveness of small-bore chest tubes in managing all types of pneumothoraces with a reduced risk of complications. Moreover, observation is emerging as a possible conservative approach in hemodynamically stable patients regardless of the etiology of the pneumothorax. This review aims to provide a valuable resource to improve diagnostic and therapeutic management, comparing traditional methods and promising, less invasive therapeutic interventions.
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Open AccessSystematic Review
Interventions to Reduce Musculoskeletal Pain in Ophthalmologists: A Systematic Review
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Justin Grad, Keean Nanji, Reese Kapusta, Tony Jin, Merve Kulbay, Stuti M. Tanya and Femida Kherani
Emerg. Care Med. 2025, 2(2), 23; https://doi.org/10.3390/ecm2020023 - 29 Apr 2025
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Background: Musculoskeletal (MSK) discomfort is a significant occupational hazard for eye care professionals, including ophthalmologists, who report high rates of MSK discomfort. This systematic review investigated the impact of various interventions, such as regular exercise, posture-correcting aids, and surgical heads-up displays, on reducing
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Background: Musculoskeletal (MSK) discomfort is a significant occupational hazard for eye care professionals, including ophthalmologists, who report high rates of MSK discomfort. This systematic review investigated the impact of various interventions, such as regular exercise, posture-correcting aids, and surgical heads-up displays, on reducing MSK pain in the operating room. Methods: This review was reported following PRISMA guidelines and was prospectively registered in the PROSPERO database (CRD42024559189). A systematic literature search was conducted of Embase, MEDLINE, and Web of Science from inception to 2024. Included studies were categorized as exercise modifications, equipment modifications, or training aids. All MSK pain-related outcomes from any time point were extracted. Risk of bias was assessed using the Murad tool, the Cochrane risk-of-bias tool for randomized trials (RoB 2), and the Risk Of Bias In Non-Randomized Studies-of Interventions (ROBINS-I) tool. Results: The systematic search strategy identified 2276 studies, of which 53 qualified for full-text screening with 13 resultant studies including 712 eyecare specialists. Physical activity was found unanimously to reduce MSK pain, with favourable evidence for the utilization of posture-correcting aids. There was mixed—but mostly favourable—evidence for the use of surgical heads-up displays. Conclusions: Exercise modifications, such as yoga and regular exercise; equipment modification with heads-up displays during surgery; and training aids for posture correction were shown to be beneficial for MSK-related pain among ophthalmologists. Future studies should strive to improve the certainty of evidence on ergonomics-related interventions for ophthalmologists, which will better support practice and guideline development.
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