Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff...Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff retention.[1,2]Emergency physicians(EPs)face unique pressures,including shift work,high patient volumes and acuities,overcrowding,and systemic inefficiencies that escalate their risk of burnout.As a result,EPs have reported the highest rates of burnout among physician specialties.展开更多
BACKGROUND:Airway management is a core competence in emergency medicine.International registries have described indications,techniques,and outcomes of endotracheal intubation,yet contemporary data from German emergenc...BACKGROUND:Airway management is a core competence in emergency medicine.International registries have described indications,techniques,and outcomes of endotracheal intubation,yet contemporary data from German emergency departments(EDs) are scarce.We conducted a multicenter prospective registry study in Thuringia,to characterize indications,techniques,success rates,and complications of ED intubations.METHODS:From February 2023 to January 2024,six Thuringian EDs participated in a prospective observational registry(www.airwayregistry.eu).All consecutive intubations were documented anonymously using a standardized digital form.Demographics,indications,methods,equipment,operator characteristics,first pass success(FPS),overall success,and complications were captured.Descriptive statistics were used.RESULTS:We analyzed 117 intubations(63.2% male;mean age 68.4 years,range 2–98 years).FPS was 88.9%(104/117),second pass success was 4.3% and third pass success was 6.8%;overall success was 100%.Rapid sequence intubation(RSI) was used in 77.8% of intubations and delayed sequence intubation(DSI) in 21.4%;10.3% were performed without medication.Direct laryngoscopy(DL) was used in 65.0% and videolaryngoscopy(VL) in 34.2%.FPS was higher with VL than DL(92.5% vs.88.2%).The most common indications were cardiopulmonary resuscitation(14.5%) and stroke/ischemia(13.7%);intracranial hemorrhage accounted for 13.7%.Complications occurred in 39% of cases,most frequently hypotension(23.9%) and catecholamine requirement(12.0%).A difficult airway was anticipated in 30.8%.CONCLUSION:In this multicenter snapshot from German EDs,overall intubation success was high but complications—especially peri-intubation hypotension—were common.VL yielded higher FPS yet was used less frequently than DL.Standardized protocols,hemodynamic optimization,and broader VL adoption may improve safety and performance.展开更多
Objective:To analyze the impact of improved emergency integrated nursing on the treatment effectiveness and safety of emergency trauma patients.Methods:Study duration:December 2024 to December 2025.Observation target:...Objective:To analyze the impact of improved emergency integrated nursing on the treatment effectiveness and safety of emergency trauma patients.Methods:Study duration:December 2024 to December 2025.Observation target:emergency trauma patients in our hospital.Sample size:92 cases.Using computer-based grouping,the 92 patients were divided into two equally sized groups:a control group of 46 patients who received conventional emergency nursing care,and an observation group of 46 patients who underwent an improved emergency integrated nursing model.The treatment-related indicators,treatment effectiveness,and incidence of adverse events were evaluated in both groups.Results:After intervention,the pre-hospital emergency care time,emergency diagnosis time,total emergency rescue duration,and examination waiting time in the control group were all longer than those in the observation group(p<0.05);the treatment effectiveness in the control group(effective rate:82.61%)was worse than that in the observation group(effective rate:95.65%),p<0.05;compared with the control group,the observation group had a lower incidence of adverse events,p<0.05.Conclusion:Implementing an improved emergency integrated nursing model for emergency trauma patients helps streamline the treatment process,enhance treatment effectiveness,and reduce the incidence of adverse events.展开更多
Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized ...Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized clinical trial,eligible patients presenting with epigastric pain were randomly assigned to receive intravenous pantoprazole or famotidine.Block randomization was used,and patients,treating physicians,and outcome assessors were blinded to treatment allocation.Pain intensity was assessed at baseline and at 30 and 60 minutes after drug administration.Results:Eighty patients were enrolled,with a mean age of 36.6 years(SD,15.0),and 42.5%were male.Mean pain scores decreased significantly over time in both treatment groups.In the pantoprazole group,pain scores declined from 8.02±1.28 at baseline to 4.75±1.31 at 30 minutes and 1.62±1.29 at 60 minutes,whereas in the famotidine group scores decreased from 8.12±1.48 to 5.37±1.23 and 2.35±1.54,respectively.There was no significant difference in baseline pain scores between groups(P=.92).Pantoprazole resulted in greater pain reduction compared with famotidine at both 30 minutes(P=.04)and 60 minutes(P=.05).Conclusions:Both medications were effective in relieving epigastric pain;however,pantoprazole provided greater and more sustained pain reduction,supporting its preferential use in emergency settings.展开更多
Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to...Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment(qSOFA)score with National Early Warning Score(NEWS)in prognosticating sepsis.Methods:This prospective observational study was conducted among patients>18 years old presenting with sepsis at B.J.Medical College.The SOFA,qSOFA and NEWS scores were calculated.The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis.Results:A total of 200 patients were evaluated(56%male)with a mean age of 51.7 years.The mortality rate was 23%.Patients categorized under high risk according to SOFA score>8,qSOFA score of 2-3 and NEWS>7 had a mortality rate of 33.3%,27.5%and 28.4%,respectively.AUC for mortality prediction was 0.695 using SOFA score,0.665 using qSOFA and 0.725 using NEWS.At a cut off of 7.50,NEWS demonstrated a sensitivity of 97.8%with a specificity of 28.0%and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5%and 91.3%and a specificity of 77.9%and 27.9%,respectively.Conclusions:The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients.However,qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.展开更多
BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suita...BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.展开更多
BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and...BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.展开更多
BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making ...BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.展开更多
Objective: To analyze the impact of whole-process nursing on the rescue of emergency critically ill patients by setting a control group and an experimental group and comparing their experimental results. Methods: A to...Objective: To analyze the impact of whole-process nursing on the rescue of emergency critically ill patients by setting a control group and an experimental group and comparing their experimental results. Methods: A total of 50 critically ill patients admitted to the Emergency Department from October 2022 to October 2023 were randomly divided into the experimental group (25 cases) and the control group (25 cases). The control group received routine nursing, while the experimental group received whole-process nursing. The rescue success rate and nursing satisfaction were compared between the two groups. Results: In the experimental group, 24 patients were rescued successfully, with a success rate of 96%;in the control group, 19 patients were rescued successfully, with a success rate of 76%, showing a significant difference (χ2 = 4.1528, p = 0.0415 < 0.05). The nursing satisfaction was 92% in the experimental group and 68% in the control group. Conclusion: Whole-process nursing can effectively improve the rescue success rate of critically ill patients, enhance the satisfaction of patients and their families, and improve patients’ quality of life.展开更多
Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching t...Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching the construction of an emergency care system based on the concept of“linkage”,delving into its theoretical foundations,exploring innovative construction models,and analyzing practical cases.The study indicates that an emergency care system under the“linkage”concept can effectively integrate resources and enhance efficiency,providing new insights for improving the construction of the emergency care system.It aims to promote the development of the emergency care system towards a more scientific,efficient,and collaborative direction.展开更多
Knowledge graphs,which combine structured representation with semantic modeling,have shown great potential in knowledge expression,causal inference,and automated reasoning,and are widely used in fields such as intelli...Knowledge graphs,which combine structured representation with semantic modeling,have shown great potential in knowledge expression,causal inference,and automated reasoning,and are widely used in fields such as intelligent question answering,decision support,and fault diagnosis.As high-speed train systems become increasingly intelligent and interconnected,fault patterns have grown more complex and dynamic.Knowledge graphs offer a promising solution to support the structured management and real-time reasoning of fault knowledge,addressing key requirements such as interpretability,accuracy,and continuous evolution in intelligent diagnostic systems.However,conventional knowledge graph construction relies heavily on domain expertise and specialized tools,resulting in high entry barriers for non-experts and limiting their practical application in frontline maintenance scenarios.To address this limitation,this paper proposes a fault knowledge modeling approach for high-speed trains that integrates structured logic diagrams with knowledge graphs.The method employs a seven-layer logic structure—comprising fault name,applicable vehicles,diagnostic logic,signal parameters,verification conditions,fault causes,and emergency measures—to transform unstructured knowledge into a visual and hierarchical representation.A semantic mapping mechanism is then used to automatically convert logic diagrams into machine-interpretable knowledge graphs,enabling dynamic reasoning and knowledge reuse.Furthermore,the proposed method establishes a three-layer architecture—logic structuring,knowledge graph transformation,and dynamic inference—to bridge human-expert logic with machinebased reasoning.Experimental validation and system implementation demonstrate that this approach not only improves knowledge interpretability and inference precision but also significantly enhances modeling efficiency and system maintainability.It provides a scalable and adaptable solution for intelligent operation and maintenance platforms in the high-speed rail domain.展开更多
Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances ...Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances in imaging and surgical techniques,ASE has high morbidity and mortality rates,particularly when diagnosis or intervention is delayed.Here,we report two patients admitted to our center to increase awareness among emergency physicians.展开更多
Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses...Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses,seizures,respiratory distress,and trauma.PEC calls for prompt,focused interventions to address each child's developmental and physiological needs.The literature was searched using Google Scholar,PubMed,and the Cochrane Library to retrieve studies assessing quality indicators and outcomes in pediatric emergencies.The search was limited to papers published in peer-reviewed journals between 01 Jan 2000 and 15 Dec 2024.This review evaluates current PEC standards such as patient safety,diagnostic precision,timeliness,and patient and family satisfaction.Patient safety is vital because children are particularly vulnerable to medical errors,such as inappropriate doses of medication.The provision of high-quality PEC is hampered by systemic issues such as inadequate training,a lack of re-sources,and restricted access to treatment.Telemedicine,pediatric transport units,artificial intelligence applications for diagnostics,and simulation-based training are suggested approaches to overcome these challenges.Research net-works and quality improvement initiatives are important steps to improve PEC care.展开更多
There is increasing research into the potential benefits of incorporating artificial intelligence(AI)and machine learning algorithms into emergency medical services.AI is finding new applications across a wide range o...There is increasing research into the potential benefits of incorporating artificial intelligence(AI)and machine learning algorithms into emergency medical services.AI is finding new applications across a wide range of sectors,one of which is healthcare,where it is being used to enhance clinical diagnostics.AI solutions have enormous untapped potential to improve healthcare efficiency and quality,thus researchers have focused heavily on emergency medicine(EM).Many individuals without prior experience with any physician often receive their initial medical care in the emergency room.Two areas that could benefit from the implementation of AI are reducing waiting times and enhancing diagnostic capabilities.This study provides further explanation of how AI is used in emergency rooms.Several machine learning‐based algorithms are also addressed.In this research,we summarise recent developments in the use of AI in EM.This research tries to summarise the usefulness of AI in EM by looking at recent developments in emergency department operations and clinical patient management.展开更多
Accessible communication based on sign language recognition(SLR)is the key to emergency medical assistance for the hearing-impaired community.Balancing the capture of both local and global information in SLR for emerg...Accessible communication based on sign language recognition(SLR)is the key to emergency medical assistance for the hearing-impaired community.Balancing the capture of both local and global information in SLR for emergency medicine poses a significant challenge.To address this,we propose a novel approach based on the inter-learning of visual features between global and local information.Specifically,our method enhances the perception capabilities of the visual feature extractor by strategically leveraging the strengths of convolutional neural network(CNN),which are adept at capturing local features,and visual transformers which perform well at perceiving global features.Furthermore,to mitigate the issue of overfitting caused by the limited availability of sign language data for emergency medical applications,we introduce an enhanced short temporal module for data augmentation through additional subsequences.Experimental results on three publicly available sign language datasets demonstrate the efficacy of the proposed approach.展开更多
Objective:To analyze the effect of optimizing the emergency nursing process on the nursing effect of patients with acute upper gastrointestinal bleeding(AUGB)in the emergency department.Methods:100 cases(Group A)were ...Objective:To analyze the effect of optimizing the emergency nursing process on the nursing effect of patients with acute upper gastrointestinal bleeding(AUGB)in the emergency department.Methods:100 cases(Group A)were randomly selected from AUGB patients who had undergone the routine emergency care process in the emergency department from January 2022 to December 2022,and 100 cases(Group B)were randomly selected from AUGB patients who had undergone the optimized emergency care process in the emergency department from January 2023 to December 2023.The nursing effects of the two groups were compared.Results:clinical indicators that include the emergency response time,time to open the infusion channel,time from diagnosis to specialty treatment,hospitalization time,resuscitation success rate,rebleeding rate,nursing satisfaction score,post-care SAS score,and SF-36 score in Group B were better than those in Group A(P<0.05).Conclusion:Optimization of the emergency care process for AUGB patients in the emergency department can improve the efficiency and success rate of resuscitation,reduce the risk of rebleeding,improve the mood and quality of life of patients,and make the patients more satisfied with the nursing service.展开更多
Meteor Burst Communication(MBC),a niche yet revolutionary wireless communication paradigm,exploits the transient ionized trails generated by meteors ablating in Earth’s atmosphere to enable sporadic yet resilient lon...Meteor Burst Communication(MBC),a niche yet revolutionary wireless communication paradigm,exploits the transient ionized trails generated by meteors ablating in Earth’s atmosphere to enable sporadic yet resilient long-distance radio links.Known for its exceptional resilience,robustness,and sustained connectivity,MBC holds significant promise for applications in emergency communications,remote area connectivity,military/defense systems,and environmental monitoring.However,the scientific exploration and application of MBC have long been highly challenging.In particular,under the combined influence of multiple physical field factors,the channel experiences superimposed multiple random fading effects,exhibiting bursty,highly time-varying,and strongly random characteristics.This persistent technical challenge has resulted in the absence of a practical statistical channel model for MBC to date.展开更多
BACKGROUND Acute upper gastrointestinal bleeding(AUGIB)is a common emergency critical illness that requires prompt assessment upon admission to prevent disease deterioration.As a resuscitation mode,the fast track for ...BACKGROUND Acute upper gastrointestinal bleeding(AUGIB)is a common emergency critical illness that requires prompt assessment upon admission to prevent disease deterioration.As a resuscitation mode,the fast track for emergency treatment increases the success rate and improves patient outcomes.However,misuse will consume resources.The Glasgow-Blatchford score(GBS)is considered to predict the clinical intervention needs for AUGIB patients,guiding diagnosis and treatment.Therefore,clinical research is needed to identify the recommended GBS thresholds that support effective use in AUGIB patients.AIM To validate the effectiveness of the GBS in establishing a fast track to reduce the time and cost of treatment for patients with AUGIB.METHODS A retrospective analysis was performed using the data of 124 cases of AUGIB patients with GBS≥6 treated at the University-Town Hospital of Chongqing Medical University from August 2020 to April 2023.Based on GBS risk stratification,patients were divided into moderate-risk(12>GBS≥6)and high-risk(GBS≥12)groups.Furthermore,depending on whether a fast track was established after the patients arrived in the emergency department,the patients were categorized into control and fast-track groups.The changes in various indicators,such as length of time in the emergency resuscitation room,door-to-endoscopy time,total blood transfusion volume,hospitalization duration,and hospitalization costs,were compared between the control and fast-track groups under each risk stratification level.RESULTS In the comparison of the aforementioned indicators,the moderate-risk fast-track group did not show any significant differences from the control group(P>0.05).However,in the high-risk fast-track group,the door-toendoscopy time,total blood transfusion volume,and hospitalization costs were significantly lower than those in the control group(P<0.05).CONCLUSION Establishing a fast track for emergency treatment based on GBS risk stratification has assessment value in reducing door-to-endoscopy time,decreasing total blood transfusion volume,and lowering hospitalization costs in patients with AUGIB.GBS≥12 is recommended as the threshold for implementing the fast track for emergency treatment,and its clinical promotion is advised.展开更多
Emergency resources play a vital role in the emergency rescue process.The adequate and timely supply of emergency resources can effectively control the development of accidents and reduce accident losses.However,the c...Emergency resources play a vital role in the emergency rescue process.The adequate and timely supply of emergency resources can effectively control the development of accidents and reduce accident losses.However,the current emergency resource allocation of chemical enterprises lacks scientific analysis of accident scenarios,and the individual allocation method of enterprises increases the cost of emergency resource allocation.Given the above problems,this paper proposes a regional collaborative allocation method of emergency resources for enterprises within the chemical industry park(CIP)based on the worst credible accident scenario(WCAS).Firstly,the concept and analysis method of the WCAS is proposed.Then,based on the characteristics and consequences of the accident,the mapping relationship between accident scenarios and emergency resources is established.Finally,an optimization model for regional collaborative allocation of emergency resources is constructed to determine the amount of emergency resource allocation for each enterprise.Through the case study,the emergency resource allocation method based on the WCAS analysis can better meet the demands of accident emergency rescue.Simultaneously,the regional collaborative allocation optimization model can strengthen the cooperation ability among enterprises,greatly reducing the cost of emergency resource allocation for each enterprise.展开更多
The consultation intention of emergency decision-makers in urban rail transit(URT)is input into the emergency knowledge base in the form of domain questions to obtain emergency decision support services.This approach ...The consultation intention of emergency decision-makers in urban rail transit(URT)is input into the emergency knowledge base in the form of domain questions to obtain emergency decision support services.This approach facilitates the rapid collection of complete knowledge and rules to form effective decisions.However,the current structured degree of the URT emergency knowledge base remains low,and the domain questions lack labeled datasets,resulting in a large deviation between the consultation outcomes and the intended objectives.To address this issue,this paper proposes a question intention recognition model for the URT emergency domain,leveraging knowledge graph(KG)and data enhancement technology.First,a structured storage of emergency cases and emergency plans is realized based on KG.Subsequently,a comprehensive question template is developed,and the labeled dataset of emergency domain questions in URT is generated through the KG.Lastly,data enhancement is applied by prompt learning and the NLP Chinese Data Augmentation(NLPCDA)tool,and the intention recognition model combining Generalized Auto-regression Pre-training for Language Understanding(XLNet)and Recurrent Convolutional Neural Network for Text Classification(TextRCNN)is constructed.Word embeddings are generated by XLNet,context information is further captured using Bidirectional Long Short-Term Memory Neural Network(BiLSTM),and salient features are extracted with Convolutional Neural Network(CNN).Experimental results demonstrate that the proposed model can enhance the clarity of classification and the identification of domain questions,thereby providing supportive knowledge for emergency decision-making in URT.展开更多
文摘Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff retention.[1,2]Emergency physicians(EPs)face unique pressures,including shift work,high patient volumes and acuities,overcrowding,and systemic inefficiencies that escalate their risk of burnout.As a result,EPs have reported the highest rates of burnout among physician specialties.
文摘BACKGROUND:Airway management is a core competence in emergency medicine.International registries have described indications,techniques,and outcomes of endotracheal intubation,yet contemporary data from German emergency departments(EDs) are scarce.We conducted a multicenter prospective registry study in Thuringia,to characterize indications,techniques,success rates,and complications of ED intubations.METHODS:From February 2023 to January 2024,six Thuringian EDs participated in a prospective observational registry(www.airwayregistry.eu).All consecutive intubations were documented anonymously using a standardized digital form.Demographics,indications,methods,equipment,operator characteristics,first pass success(FPS),overall success,and complications were captured.Descriptive statistics were used.RESULTS:We analyzed 117 intubations(63.2% male;mean age 68.4 years,range 2–98 years).FPS was 88.9%(104/117),second pass success was 4.3% and third pass success was 6.8%;overall success was 100%.Rapid sequence intubation(RSI) was used in 77.8% of intubations and delayed sequence intubation(DSI) in 21.4%;10.3% were performed without medication.Direct laryngoscopy(DL) was used in 65.0% and videolaryngoscopy(VL) in 34.2%.FPS was higher with VL than DL(92.5% vs.88.2%).The most common indications were cardiopulmonary resuscitation(14.5%) and stroke/ischemia(13.7%);intracranial hemorrhage accounted for 13.7%.Complications occurred in 39% of cases,most frequently hypotension(23.9%) and catecholamine requirement(12.0%).A difficult airway was anticipated in 30.8%.CONCLUSION:In this multicenter snapshot from German EDs,overall intubation success was high but complications—especially peri-intubation hypotension—were common.VL yielded higher FPS yet was used less frequently than DL.Standardized protocols,hemodynamic optimization,and broader VL adoption may improve safety and performance.
文摘Objective:To analyze the impact of improved emergency integrated nursing on the treatment effectiveness and safety of emergency trauma patients.Methods:Study duration:December 2024 to December 2025.Observation target:emergency trauma patients in our hospital.Sample size:92 cases.Using computer-based grouping,the 92 patients were divided into two equally sized groups:a control group of 46 patients who received conventional emergency nursing care,and an observation group of 46 patients who underwent an improved emergency integrated nursing model.The treatment-related indicators,treatment effectiveness,and incidence of adverse events were evaluated in both groups.Results:After intervention,the pre-hospital emergency care time,emergency diagnosis time,total emergency rescue duration,and examination waiting time in the control group were all longer than those in the observation group(p<0.05);the treatment effectiveness in the control group(effective rate:82.61%)was worse than that in the observation group(effective rate:95.65%),p<0.05;compared with the control group,the observation group had a lower incidence of adverse events,p<0.05.Conclusion:Implementing an improved emergency integrated nursing model for emergency trauma patients helps streamline the treatment process,enhance treatment effectiveness,and reduce the incidence of adverse events.
文摘Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized clinical trial,eligible patients presenting with epigastric pain were randomly assigned to receive intravenous pantoprazole or famotidine.Block randomization was used,and patients,treating physicians,and outcome assessors were blinded to treatment allocation.Pain intensity was assessed at baseline and at 30 and 60 minutes after drug administration.Results:Eighty patients were enrolled,with a mean age of 36.6 years(SD,15.0),and 42.5%were male.Mean pain scores decreased significantly over time in both treatment groups.In the pantoprazole group,pain scores declined from 8.02±1.28 at baseline to 4.75±1.31 at 30 minutes and 1.62±1.29 at 60 minutes,whereas in the famotidine group scores decreased from 8.12±1.48 to 5.37±1.23 and 2.35±1.54,respectively.There was no significant difference in baseline pain scores between groups(P=.92).Pantoprazole resulted in greater pain reduction compared with famotidine at both 30 minutes(P=.04)and 60 minutes(P=.05).Conclusions:Both medications were effective in relieving epigastric pain;however,pantoprazole provided greater and more sustained pain reduction,supporting its preferential use in emergency settings.
文摘Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment(qSOFA)score with National Early Warning Score(NEWS)in prognosticating sepsis.Methods:This prospective observational study was conducted among patients>18 years old presenting with sepsis at B.J.Medical College.The SOFA,qSOFA and NEWS scores were calculated.The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis.Results:A total of 200 patients were evaluated(56%male)with a mean age of 51.7 years.The mortality rate was 23%.Patients categorized under high risk according to SOFA score>8,qSOFA score of 2-3 and NEWS>7 had a mortality rate of 33.3%,27.5%and 28.4%,respectively.AUC for mortality prediction was 0.695 using SOFA score,0.665 using qSOFA and 0.725 using NEWS.At a cut off of 7.50,NEWS demonstrated a sensitivity of 97.8%with a specificity of 28.0%and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5%and 91.3%and a specificity of 77.9%and 27.9%,respectively.Conclusions:The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients.However,qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.
基金supported by the special fund of the National Clinical Key Specialty Construction Program[(2022)301-2305].
文摘BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.
文摘BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.
文摘BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.
文摘Objective: To analyze the impact of whole-process nursing on the rescue of emergency critically ill patients by setting a control group and an experimental group and comparing their experimental results. Methods: A total of 50 critically ill patients admitted to the Emergency Department from October 2022 to October 2023 were randomly divided into the experimental group (25 cases) and the control group (25 cases). The control group received routine nursing, while the experimental group received whole-process nursing. The rescue success rate and nursing satisfaction were compared between the two groups. Results: In the experimental group, 24 patients were rescued successfully, with a success rate of 96%;in the control group, 19 patients were rescued successfully, with a success rate of 76%, showing a significant difference (χ2 = 4.1528, p = 0.0415 < 0.05). The nursing satisfaction was 92% in the experimental group and 68% in the control group. Conclusion: Whole-process nursing can effectively improve the rescue success rate of critically ill patients, enhance the satisfaction of patients and their families, and improve patients’ quality of life.
文摘Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching the construction of an emergency care system based on the concept of“linkage”,delving into its theoretical foundations,exploring innovative construction models,and analyzing practical cases.The study indicates that an emergency care system under the“linkage”concept can effectively integrate resources and enhance efficiency,providing new insights for improving the construction of the emergency care system.It aims to promote the development of the emergency care system towards a more scientific,efficient,and collaborative direction.
基金support from the Scientific Funding for the Center of National Railway Intelligent Transportation System Engineering and Technology,China Academy of Railway Sciences Corporation Limited(Grant No.2023YJ354)。
文摘Knowledge graphs,which combine structured representation with semantic modeling,have shown great potential in knowledge expression,causal inference,and automated reasoning,and are widely used in fields such as intelligent question answering,decision support,and fault diagnosis.As high-speed train systems become increasingly intelligent and interconnected,fault patterns have grown more complex and dynamic.Knowledge graphs offer a promising solution to support the structured management and real-time reasoning of fault knowledge,addressing key requirements such as interpretability,accuracy,and continuous evolution in intelligent diagnostic systems.However,conventional knowledge graph construction relies heavily on domain expertise and specialized tools,resulting in high entry barriers for non-experts and limiting their practical application in frontline maintenance scenarios.To address this limitation,this paper proposes a fault knowledge modeling approach for high-speed trains that integrates structured logic diagrams with knowledge graphs.The method employs a seven-layer logic structure—comprising fault name,applicable vehicles,diagnostic logic,signal parameters,verification conditions,fault causes,and emergency measures—to transform unstructured knowledge into a visual and hierarchical representation.A semantic mapping mechanism is then used to automatically convert logic diagrams into machine-interpretable knowledge graphs,enabling dynamic reasoning and knowledge reuse.Furthermore,the proposed method establishes a three-layer architecture—logic structuring,knowledge graph transformation,and dynamic inference—to bridge human-expert logic with machinebased reasoning.Experimental validation and system implementation demonstrate that this approach not only improves knowledge interpretability and inference precision but also significantly enhances modeling efficiency and system maintainability.It provides a scalable and adaptable solution for intelligent operation and maintenance platforms in the high-speed rail domain.
文摘Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances in imaging and surgical techniques,ASE has high morbidity and mortality rates,particularly when diagnosis or intervention is delayed.Here,we report two patients admitted to our center to increase awareness among emergency physicians.
文摘Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses,seizures,respiratory distress,and trauma.PEC calls for prompt,focused interventions to address each child's developmental and physiological needs.The literature was searched using Google Scholar,PubMed,and the Cochrane Library to retrieve studies assessing quality indicators and outcomes in pediatric emergencies.The search was limited to papers published in peer-reviewed journals between 01 Jan 2000 and 15 Dec 2024.This review evaluates current PEC standards such as patient safety,diagnostic precision,timeliness,and patient and family satisfaction.Patient safety is vital because children are particularly vulnerable to medical errors,such as inappropriate doses of medication.The provision of high-quality PEC is hampered by systemic issues such as inadequate training,a lack of re-sources,and restricted access to treatment.Telemedicine,pediatric transport units,artificial intelligence applications for diagnostics,and simulation-based training are suggested approaches to overcome these challenges.Research net-works and quality improvement initiatives are important steps to improve PEC care.
文摘There is increasing research into the potential benefits of incorporating artificial intelligence(AI)and machine learning algorithms into emergency medical services.AI is finding new applications across a wide range of sectors,one of which is healthcare,where it is being used to enhance clinical diagnostics.AI solutions have enormous untapped potential to improve healthcare efficiency and quality,thus researchers have focused heavily on emergency medicine(EM).Many individuals without prior experience with any physician often receive their initial medical care in the emergency room.Two areas that could benefit from the implementation of AI are reducing waiting times and enhancing diagnostic capabilities.This study provides further explanation of how AI is used in emergency rooms.Several machine learning‐based algorithms are also addressed.In this research,we summarise recent developments in the use of AI in EM.This research tries to summarise the usefulness of AI in EM by looking at recent developments in emergency department operations and clinical patient management.
基金supported by the National Natural Science Foundation of China(No.62376197)the Tianjin Science and Technology Program(No.23JCYBJC00360)the Tianjin Health Research Project(No.TJWJ2025MS045).
文摘Accessible communication based on sign language recognition(SLR)is the key to emergency medical assistance for the hearing-impaired community.Balancing the capture of both local and global information in SLR for emergency medicine poses a significant challenge.To address this,we propose a novel approach based on the inter-learning of visual features between global and local information.Specifically,our method enhances the perception capabilities of the visual feature extractor by strategically leveraging the strengths of convolutional neural network(CNN),which are adept at capturing local features,and visual transformers which perform well at perceiving global features.Furthermore,to mitigate the issue of overfitting caused by the limited availability of sign language data for emergency medical applications,we introduce an enhanced short temporal module for data augmentation through additional subsequences.Experimental results on three publicly available sign language datasets demonstrate the efficacy of the proposed approach.
文摘Objective:To analyze the effect of optimizing the emergency nursing process on the nursing effect of patients with acute upper gastrointestinal bleeding(AUGB)in the emergency department.Methods:100 cases(Group A)were randomly selected from AUGB patients who had undergone the routine emergency care process in the emergency department from January 2022 to December 2022,and 100 cases(Group B)were randomly selected from AUGB patients who had undergone the optimized emergency care process in the emergency department from January 2023 to December 2023.The nursing effects of the two groups were compared.Results:clinical indicators that include the emergency response time,time to open the infusion channel,time from diagnosis to specialty treatment,hospitalization time,resuscitation success rate,rebleeding rate,nursing satisfaction score,post-care SAS score,and SF-36 score in Group B were better than those in Group A(P<0.05).Conclusion:Optimization of the emergency care process for AUGB patients in the emergency department can improve the efficiency and success rate of resuscitation,reduce the risk of rebleeding,improve the mood and quality of life of patients,and make the patients more satisfied with the nursing service.
文摘Meteor Burst Communication(MBC),a niche yet revolutionary wireless communication paradigm,exploits the transient ionized trails generated by meteors ablating in Earth’s atmosphere to enable sporadic yet resilient long-distance radio links.Known for its exceptional resilience,robustness,and sustained connectivity,MBC holds significant promise for applications in emergency communications,remote area connectivity,military/defense systems,and environmental monitoring.However,the scientific exploration and application of MBC have long been highly challenging.In particular,under the combined influence of multiple physical field factors,the channel experiences superimposed multiple random fading effects,exhibiting bursty,highly time-varying,and strongly random characteristics.This persistent technical challenge has resulted in the absence of a practical statistical channel model for MBC to date.
基金Supported by the Key Discipline of Pathology at Chongqing Medical and Pharmaceutical College,No.ygz2021303.
文摘BACKGROUND Acute upper gastrointestinal bleeding(AUGIB)is a common emergency critical illness that requires prompt assessment upon admission to prevent disease deterioration.As a resuscitation mode,the fast track for emergency treatment increases the success rate and improves patient outcomes.However,misuse will consume resources.The Glasgow-Blatchford score(GBS)is considered to predict the clinical intervention needs for AUGIB patients,guiding diagnosis and treatment.Therefore,clinical research is needed to identify the recommended GBS thresholds that support effective use in AUGIB patients.AIM To validate the effectiveness of the GBS in establishing a fast track to reduce the time and cost of treatment for patients with AUGIB.METHODS A retrospective analysis was performed using the data of 124 cases of AUGIB patients with GBS≥6 treated at the University-Town Hospital of Chongqing Medical University from August 2020 to April 2023.Based on GBS risk stratification,patients were divided into moderate-risk(12>GBS≥6)and high-risk(GBS≥12)groups.Furthermore,depending on whether a fast track was established after the patients arrived in the emergency department,the patients were categorized into control and fast-track groups.The changes in various indicators,such as length of time in the emergency resuscitation room,door-to-endoscopy time,total blood transfusion volume,hospitalization duration,and hospitalization costs,were compared between the control and fast-track groups under each risk stratification level.RESULTS In the comparison of the aforementioned indicators,the moderate-risk fast-track group did not show any significant differences from the control group(P>0.05).However,in the high-risk fast-track group,the door-toendoscopy time,total blood transfusion volume,and hospitalization costs were significantly lower than those in the control group(P<0.05).CONCLUSION Establishing a fast track for emergency treatment based on GBS risk stratification has assessment value in reducing door-to-endoscopy time,decreasing total blood transfusion volume,and lowering hospitalization costs in patients with AUGIB.GBS≥12 is recommended as the threshold for implementing the fast track for emergency treatment,and its clinical promotion is advised.
基金support provided by the Qingdao Science and Technology Benefits People Demonstration and Guidance Project(21-1-4-sf-4-nsh).
文摘Emergency resources play a vital role in the emergency rescue process.The adequate and timely supply of emergency resources can effectively control the development of accidents and reduce accident losses.However,the current emergency resource allocation of chemical enterprises lacks scientific analysis of accident scenarios,and the individual allocation method of enterprises increases the cost of emergency resource allocation.Given the above problems,this paper proposes a regional collaborative allocation method of emergency resources for enterprises within the chemical industry park(CIP)based on the worst credible accident scenario(WCAS).Firstly,the concept and analysis method of the WCAS is proposed.Then,based on the characteristics and consequences of the accident,the mapping relationship between accident scenarios and emergency resources is established.Finally,an optimization model for regional collaborative allocation of emergency resources is constructed to determine the amount of emergency resource allocation for each enterprise.Through the case study,the emergency resource allocation method based on the WCAS analysis can better meet the demands of accident emergency rescue.Simultaneously,the regional collaborative allocation optimization model can strengthen the cooperation ability among enterprises,greatly reducing the cost of emergency resource allocation for each enterprise.
基金supported in part by the National Natural Science Foundation of China.The funding numbers 62433005,62272036,62132003,and 62173167.
文摘The consultation intention of emergency decision-makers in urban rail transit(URT)is input into the emergency knowledge base in the form of domain questions to obtain emergency decision support services.This approach facilitates the rapid collection of complete knowledge and rules to form effective decisions.However,the current structured degree of the URT emergency knowledge base remains low,and the domain questions lack labeled datasets,resulting in a large deviation between the consultation outcomes and the intended objectives.To address this issue,this paper proposes a question intention recognition model for the URT emergency domain,leveraging knowledge graph(KG)and data enhancement technology.First,a structured storage of emergency cases and emergency plans is realized based on KG.Subsequently,a comprehensive question template is developed,and the labeled dataset of emergency domain questions in URT is generated through the KG.Lastly,data enhancement is applied by prompt learning and the NLP Chinese Data Augmentation(NLPCDA)tool,and the intention recognition model combining Generalized Auto-regression Pre-training for Language Understanding(XLNet)and Recurrent Convolutional Neural Network for Text Classification(TextRCNN)is constructed.Word embeddings are generated by XLNet,context information is further captured using Bidirectional Long Short-Term Memory Neural Network(BiLSTM),and salient features are extracted with Convolutional Neural Network(CNN).Experimental results demonstrate that the proposed model can enhance the clarity of classification and the identification of domain questions,thereby providing supportive knowledge for emergency decision-making in URT.
