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: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
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
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
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
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
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
Frequent flood disasters caused by climate change may lead to tremendous economic and human losses along inland waterways.Emergency response and rescue vessels(ERRVs)play an essential role in minimizing losses and pro...Frequent flood disasters caused by climate change may lead to tremendous economic and human losses along inland waterways.Emergency response and rescue vessels(ERRVs)play an essential role in minimizing losses and protecting lives and property.However,the path planning of ERRVs has mainly depended on expert experiences instead of rational decision making.This paper proposes an improved artificial potential field(APF)algorithm to optimize the shortest path for ERRVs in the rescue process.To verify the feasibility of the proposed model,eight tests were carried out in two water areas of the Yangtze River.The results showed that the improved APF algorithm was efficient with fewer iterations and that the response time of path planning was reduced to around eight seconds.The improved APF algorithm performed better in the ERRV’s goal achievement,compared with the traditional algorithm.The path planning method for ERRVs proposed in this paper has theoretical and practical value in flood relief.It can be applied in the emergency management of ERRVs to accelerate flood management efficiency and improve capacity to prevent,mitigate,and relieve flood disasters.展开更多
Objective:To explore the application effect of emergency rescue capability intervention among students in a university in Beijing.Methods:A total of 900 students from a university in Beijing in 2023 were selected as t...Objective:To explore the application effect of emergency rescue capability intervention among students in a university in Beijing.Methods:A total of 900 students from a university in Beijing in 2023 were selected as the research objects.Emergency rescue capability training was conducted from March 2023 to June 2023,once a month.The students’mastery of emergency rescue before and after the intervention was analyzed.Survey questionnaires were distributed to all college students to understand their channels and willingness to acquire emergency rescue knowledge.Results:A total of 886 valid questionnaires were collected in this study.The highest proportion of knowledge about China’s general emergency telephone number and how to dial the emergency rescue hotline was 100.00%.Among the strategies for dealing with cardiac arrest in CPR,the highest proportion was 336.34%.Among the four major first aid techniques of hemostasis,bandaging,fixation,transportation,the highest proportion of knowledge about the use of rubber band signs was 31.71%.Among the first aid techniques for heatstroke,poisoning,fire,and sharp instrument injuries,the principle of emergency treatment for severe gas poisoning had the highest proportion of 41.42%,showing significant differences.College students mainly acquire knowledge of emergency rescue capability through TV programs,health education lectures,and the internet.Around 61.40%of college students hope to learn more about prevention and control knowledge.Conclusion:After the intervention of emergency rescue capability,the emergency rescue capability of college students in this university has been significantly improved,showing a strong training effect,which is worthy of promotion.展开更多
BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practi...BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.展开更多
The rapid evolution of Fifth-Generation(5G)networks and the strategic development of Sixth-Generation(6G)technologies have significantly advanced the implementation of air-ground integrated networks with seamless cove...The rapid evolution of Fifth-Generation(5G)networks and the strategic development of Sixth-Generation(6G)technologies have significantly advanced the implementation of air-ground integrated networks with seamless coverage.Unmanned Aerial Vehicles(UAVs),serving as high-mobility aerial platforms,are extensively utilized to enhance coverage in long-distance emergency communication scenarios.The resource-constrained communication environments in emergencies by classifying UAVs into swarm UAVs and relay UAVs as aerial communication nodes is inversitgated.A horizontal deployment strategy for swarm UAVs is formulated through K-means clustering algorithm optimization,while a vertical deployment scheme is established using convex optimization methods.The minimum-path trajectory planning for relay UAVs is optimized via the Particle Swarm Optimization(PSO)algorithm,enhancing communication reliability between UAV swarms and terrestrial base stations.A three-dimensional heterogeneous network architecture is realized by modeling spatial multi-hop relay links.Experimental results demonstrate that the proposed joint UAV relay optimization framework outperforms conventional algorithms in both coverage performance and relay capability during video stream transmission,achieving significant improvements in coverage enhancement and relay efficiency.This work provides technical foundations for constructing high-reliability air-ground cooperative systems in emergency communications.展开更多
This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement ...This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement of intelligent emergency,further improving the effectiveness of intelligent emergency management.First,approximately 3,900 documents from the intelligent emergency field are analyzed to determine the future research trend in intelligent emergency management.The socio-technical theory concerning technical and social systems is introduced.The emergency management system concepts of“technology enabling”and“enabling value creation”are defined according to bibliometric analysis and socio-technical theory.Second,a research framework that includes technology enabling and enabling value creation for the decision-making paradigm in emergency management according to the big data environment is constructed.A detailed analysis approach from intelligent emergency technology enabling to enabling value creation in emergency management is proposed.Finally,earthquake disasters are taken as examples,and specific analyses of the intelligent emergency enabling and enabling value creation are explored;enabling value creation is discussed based on measurable indicators.The clear concept of emergency management system technology enabling and enabling value creation,as well as the detailed analysis approach from intelligent emergency technology enabling to enabling value creation,provide a theoretical bases for scholars and practitioners to evaluate the value(performance)of intelligent emergency for the first time.展开更多
Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the...Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.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.
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.
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.
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.
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.
基金The National Natural Science Foundation of China(Grant No.72274052)the National Natural Science Foundation of China(Grant No.72174173).
文摘Frequent flood disasters caused by climate change may lead to tremendous economic and human losses along inland waterways.Emergency response and rescue vessels(ERRVs)play an essential role in minimizing losses and protecting lives and property.However,the path planning of ERRVs has mainly depended on expert experiences instead of rational decision making.This paper proposes an improved artificial potential field(APF)algorithm to optimize the shortest path for ERRVs in the rescue process.To verify the feasibility of the proposed model,eight tests were carried out in two water areas of the Yangtze River.The results showed that the improved APF algorithm was efficient with fewer iterations and that the response time of path planning was reduced to around eight seconds.The improved APF algorithm performed better in the ERRV’s goal achievement,compared with the traditional algorithm.The path planning method for ERRVs proposed in this paper has theoretical and practical value in flood relief.It can be applied in the emergency management of ERRVs to accelerate flood management efficiency and improve capacity to prevent,mitigate,and relieve flood disasters.
文摘Objective:To explore the application effect of emergency rescue capability intervention among students in a university in Beijing.Methods:A total of 900 students from a university in Beijing in 2023 were selected as the research objects.Emergency rescue capability training was conducted from March 2023 to June 2023,once a month.The students’mastery of emergency rescue before and after the intervention was analyzed.Survey questionnaires were distributed to all college students to understand their channels and willingness to acquire emergency rescue knowledge.Results:A total of 886 valid questionnaires were collected in this study.The highest proportion of knowledge about China’s general emergency telephone number and how to dial the emergency rescue hotline was 100.00%.Among the strategies for dealing with cardiac arrest in CPR,the highest proportion was 336.34%.Among the four major first aid techniques of hemostasis,bandaging,fixation,transportation,the highest proportion of knowledge about the use of rubber band signs was 31.71%.Among the first aid techniques for heatstroke,poisoning,fire,and sharp instrument injuries,the principle of emergency treatment for severe gas poisoning had the highest proportion of 41.42%,showing significant differences.College students mainly acquire knowledge of emergency rescue capability through TV programs,health education lectures,and the internet.Around 61.40%of college students hope to learn more about prevention and control knowledge.Conclusion:After the intervention of emergency rescue capability,the emergency rescue capability of college students in this university has been significantly improved,showing a strong training effect,which is worthy of promotion.
基金National Natural Science Foundation of China(U24A20714 to XMF and 82102238 to PC)。
文摘BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.
文摘The rapid evolution of Fifth-Generation(5G)networks and the strategic development of Sixth-Generation(6G)technologies have significantly advanced the implementation of air-ground integrated networks with seamless coverage.Unmanned Aerial Vehicles(UAVs),serving as high-mobility aerial platforms,are extensively utilized to enhance coverage in long-distance emergency communication scenarios.The resource-constrained communication environments in emergencies by classifying UAVs into swarm UAVs and relay UAVs as aerial communication nodes is inversitgated.A horizontal deployment strategy for swarm UAVs is formulated through K-means clustering algorithm optimization,while a vertical deployment scheme is established using convex optimization methods.The minimum-path trajectory planning for relay UAVs is optimized via the Particle Swarm Optimization(PSO)algorithm,enhancing communication reliability between UAV swarms and terrestrial base stations.A three-dimensional heterogeneous network architecture is realized by modeling spatial multi-hop relay links.Experimental results demonstrate that the proposed joint UAV relay optimization framework outperforms conventional algorithms in both coverage performance and relay capability during video stream transmission,achieving significant improvements in coverage enhancement and relay efficiency.This work provides technical foundations for constructing high-reliability air-ground cooperative systems in emergency communications.
基金the National Natural Science Foundation of China(Grant No.:71771061).
文摘This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement of intelligent emergency,further improving the effectiveness of intelligent emergency management.First,approximately 3,900 documents from the intelligent emergency field are analyzed to determine the future research trend in intelligent emergency management.The socio-technical theory concerning technical and social systems is introduced.The emergency management system concepts of“technology enabling”and“enabling value creation”are defined according to bibliometric analysis and socio-technical theory.Second,a research framework that includes technology enabling and enabling value creation for the decision-making paradigm in emergency management according to the big data environment is constructed.A detailed analysis approach from intelligent emergency technology enabling to enabling value creation in emergency management is proposed.Finally,earthquake disasters are taken as examples,and specific analyses of the intelligent emergency enabling and enabling value creation are explored;enabling value creation is discussed based on measurable indicators.The clear concept of emergency management system technology enabling and enabling value creation,as well as the detailed analysis approach from intelligent emergency technology enabling to enabling value creation,provide a theoretical bases for scholars and practitioners to evaluate the value(performance)of intelligent emergency for the first time.
基金the financial support from the Fujian Science Foundation for Outstanding Youth(2023J06039)the National Natural Science Foundation of China(Grant No.41977259,U2005205,41972268)the Independent Research Project of Technology Innovation Center for Monitoring and Restoration Engineering of Ecological Fragile Zone in Southeast China(KY-090000-04-2022-019)。
文摘Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.
