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Pre-Hospital and In-Hospital Emergency Care Research
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Pre-Hospital and In-Hospital Emergency Care Research

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1892

Special Issue Editors

Prof. Dr. Marcus Eng Hock Ong

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Guest Editor
1. Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School, Singapore 169857, Singapore
2. Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
Interests: emergency medicine; prehospital emergency care; emergency cardiac care; health services research; artificial intelligence
Dr. Fahad Javaid Siddiqui

E-Mail Website
Guest Editor
Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School, Singapore 169857, Singapore
Interests: public health; clinical epidemiology; prehospital; emergency care
Dr. Yohei Okada

E-Mail Website
Guest Editor
1. Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School, Singapore 169857, Singapore
2. Department of Preventive Services, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
Interests: emergency medicine; resuscitation; trauma; critical care; cardiac arrest; airway management; CPR

Special Issue Information

Dear Colleagues,

Pre-hospital and Emergency Care has a direct impact on outcomes for time-critical conditions, and research in this area is urgently needed. From a global perspective, improvements in pre-hospital and emergency care has the potential impact more than 30 million time-sensitive conditions annually. In particular, Emergency Care requires a systems approach incoporating a population health perspective, which involves the delivery of essential clinical services in a timely manner. In this Special Issue, we welcome authors to submit papers on research relating to pre-hospital and in-hospital emergency care from various perspectives, including population health, clinical services research, prevention, diagnosis, treatment, rehabilitation, and many others.

Prof. Dr. Marcus Eng Hock Ong
Dr. Fahad Javaid Siddiqui
Dr. Yohei Okada
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pre-hospital
  • in-hospital
  • emergency care
  • emergency medical services
  • acute care

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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14 pages, 1374 KB  
Article
Hypoglycemic Events Focusing on Situational Factors, Bystander Identification, and Prehospital Management
by Asami Okada, Shiruku Watanabe, Yasuaki Koyama, Ryosuke Nomura and Tadahiro Goto
J. Clin. Med. 2026, 15(7), 2746; https://doi.org/10.3390/jcm15072746 - 5 Apr 2026
Viewed by 463
Abstract
Background: Severe hypoglycemia is a major reason for emergency medical service (EMS) activation among patients with diabetes. However, real-world epidemiology, including onset location, timing, caller identity, and prehospital management, remains insufficiently described. This study aimed to characterize these cases and assess prehospital interventions [...] Read more.
Background: Severe hypoglycemia is a major reason for emergency medical service (EMS) activation among patients with diabetes. However, real-world epidemiology, including onset location, timing, caller identity, and prehospital management, remains insufficiently described. This study aimed to characterize these cases and assess prehospital interventions and patient outcomes. Methods: We conducted a retrospective, descriptive study using EMS transport records and emergency department (ED) data from two core hospitals and their regional EMS systems in Japan between January 2018 and December 2023. Included patients were those transported by EMS for hypoglycemia with a corresponding ED diagnosis. Extracted data included patient characteristics, episode location and time, EMS caller identity, prehospital interventions, and clinical outcomes. Results: Among 237 episodes, the median age was 74 years and 59.9% were male. Most events occurred at home (78.1%) and during evening or nighttime hours (51.9%). Family members were the most frequent EMS callers (67.5%), yet 12.5% of patients received bystander medical intervention. EMS teams performed most prehospital interventions (68.8%), primarily intravenous glucose administration (65.2%). At EMS arrival, 16.0% were fully conscious and 21.1% were comatose. Hospitalization occurred in 44.3%. The hospitalization rate was 34.2% among patients who received prehospital intervention and 53.2% among those who did not. Conclusions: Most hypoglycemia episodes were discovered by family members, but bystander intervention was uncommon. Differences in hospitalization rates were observed according to the presence and timing of prehospital intervention. Full article
(This article belongs to the Special Issue Pre-Hospital and In-Hospital Emergency Care Research)
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12 pages, 1342 KB  
Article
Impact of Violations of the Shortest Distance-Based Transport Protocol for Intra-Arrest on Clinical Outcomes in a Metropolitan City: A Large-Scale Registry Study
by Ju Hwan Choi, Arom Choi, Hanna Yoon, Chaeryoung Park, Soyoung Jeon, Eunju Lee and Ji Hoon Kim
J. Clin. Med. 2026, 15(3), 1282; https://doi.org/10.3390/jcm15031282 - 5 Feb 2026
Viewed by 367
Abstract
Background/Objective: The optimal strategy for hospital transport of patients with out-of-hospital cardiac arrest is unclear. A transport protocol based on the shortest travel route was implemented in a metropolitan area in the Republic of Korea to minimize prehospital transport time; however, the [...] Read more.
Background/Objective: The optimal strategy for hospital transport of patients with out-of-hospital cardiac arrest is unclear. A transport protocol based on the shortest travel route was implemented in a metropolitan area in the Republic of Korea to minimize prehospital transport time; however, the protocol is frequently violated. This study evaluated whether protocol violations influenced the clinical outcomes of patients who experienced intra-arrest. Methods: This retrospective observational study included patients who experienced out-of-hospital cardiac arrest and were transported by emergency medical services between September 2021 and December 2022. We analyzed run sheets, the cardiac arrest registry, and Out-of-Hospital Cardiac Arrest Surveillance data, which contain patient demographics, time variables, Utstein factors, posthospital arrival treatments, and clinical outcomes. The primary outcome was emergency department mortality. The secondary outcome was poor neurological outcome (cerebral performance category scores 3–5). Logistic regression and mediation analyses assessed associations between protocol violations, transport times, and clinical outcomes. Results: Among the 3474 cardiac arrest cases, 1534 (44.2%) had transport protocol violations. Violations were associated with longer scene and transfer times. The emergency department survival rates for the protocol-violation and -nonviolation groups were 15.4% and 16.4%, respectively. Protocol violations were not associated with mortality (odds ratio [OR]: 1.04; 95% confidence interval [CI] 0.85–1.27, p = 0.70) or poor neurological outcomes (OR: 1.00; 95% CI 0.45–2.18, p = 0.99). Mediation analysis revealed that increased transfer time did not affect clinical outcomes. Conclusions: These results suggest that transport strategies should consider real-time availability of emergency resources and adopt an evidence-based approach. Full article
(This article belongs to the Special Issue Pre-Hospital and In-Hospital Emergency Care Research)
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Review

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18 pages, 1213 KB  
Review
Accelerating the Adoption of Best Practice Research in Resuscitation Through Implementation Science: Identifying Gaps and Pathways
by Shohreh Majd, Sze Ling Chan, Mojca Bizjak-Mikic and Marcus E. H. Ong
J. Clin. Med. 2026, 15(2), 648; https://doi.org/10.3390/jcm15020648 - 14 Jan 2026
Viewed by 587
Abstract
Translation of evidence-based resuscitation practices into clinical settings remains slow and inconsistent, a gap that significantly impacts survival and neurological outcomes. Implementation science offers a structured approach to accelerate adoption by identifying context-specific barriers—such as dispatcher workload, team choreography, and resource constraints—and tailoring [...] Read more.
Translation of evidence-based resuscitation practices into clinical settings remains slow and inconsistent, a gap that significantly impacts survival and neurological outcomes. Implementation science offers a structured approach to accelerate adoption by identifying context-specific barriers—such as dispatcher workload, team choreography, and resource constraints—and tailoring strategies to overcome them. This paper applies the Knowledge-to-Action (KTA) framework to resuscitation, emphasizing stakeholder engagement, iterative monitoring, and sustainability. We provide detailed guidance across key resuscitation settings, including dispatch-assisted cardiopulmonary resuscitation (DA-CPR), in-hospital code teams, and emergency medical services (EMS). The manuscript introduces a comprehensive outcomes framework encompassing implementation, service/system, and patient-level metrics, and illustrates practical application through case examples such as DA-CPR and real-time feedback devices. To enhance scientific utility, we also present a decision-oriented table for pilot testing, offering healthcare institutions a roadmap for sustainable integration of evidence-based resuscitation protocols. Full article
(This article belongs to the Special Issue Pre-Hospital and In-Hospital Emergency Care Research)
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