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
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
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
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
Peroxymonosulfate(PMS)-based advanced oxidation processes(AOPs)are an effective way to remove emerging contaminants(ECs)from water.The catalytic process involving PMS is hindered by the suboptimal electron trans-fer e...Peroxymonosulfate(PMS)-based advanced oxidation processes(AOPs)are an effective way to remove emerging contaminants(ECs)from water.The catalytic process involving PMS is hindered by the suboptimal electron trans-fer efficiency of current catalysts,the further application of AOPs technology is limited.Here,it is proposed that the interfacial electric field can be controlled by bor(B)-doped FeNC catalysts,which shows significant advantages in the efficient generation,release and participation of reactive oxygen species(ROS)in the reaction.The super exchange interaction between Fe sites and N and B sites is realized through the directional transfer of electrons in the interfacial electric field,which ensures the high efficiency and stability of the PMS catalytic process.B doping increases the d orbitals distribution at Fermi level,which facilitates enhanced electron transition activity,thereby promoting the effective generation of (1)^O_(2).At the same time,orbital hybridization causes the center of the d band to move to a lower energy level,which not only contributes to the desorption process of (1)^O_(2),but also accelerates its release.In addition,B-doping also improved the adsorption capacity of organic pollutants and shortened the migration distance of ROS,thereby significantly improving the degradation efficiency of ECs.The B-doping strategy outlined offers a novel approach to the development of FeNC catalysts,it lays a theoretical foundation and offers technical insights for the integration of PMS/AOPs technology in the ECs management.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
The BOPPPS teaching model is a student-centered teaching model that has been widely applied in various teaching fields.This paper summarizes the overview of the BOPPPS teaching model,its application in emergency teach...The BOPPPS teaching model is a student-centered teaching model that has been widely applied in various teaching fields.This paper summarizes the overview of the BOPPPS teaching model,its application in emergency teaching and training,as well as its advantages and disadvantages,aiming to provide references for the further promotion and application of the BOPPPS teaching model in emergency education.展开更多
BACKGROUND:Large language models(LLMs)are being explored for disease prediction and diagnosis;however,their effi cacy for early sepsis identifi cation in emergency departments(EDs)remains unexplored.This study aims to...BACKGROUND:Large language models(LLMs)are being explored for disease prediction and diagnosis;however,their effi cacy for early sepsis identifi cation in emergency departments(EDs)remains unexplored.This study aims to evaluate MedGo,a novel medical LLM,as a decision-support tool for clinicians managing patients with suspected sepsis.METHODS:This retrospective study included anonymized medical records of 203 patients(mean age 79.9±10.2 years)with confi rmed sepsis from a tertiary hospital ED between January 2023 and January 2024.MedGo performance across nine sepsis-related assessment tasks was compared with that of two junior(<3 years of experience)and two senior(>10 years of experience)ED physicians.Assessments were scored on a 5-point Likert scale for accuracy,comprehensiveness,readability,and case-analysis skills.RESULTS:MedGo demonstrated diagnostic performance comparable to that of senior physicians across most metrics,achieving a median Likert score of 4 in accuracy,comprehensiveness,and readability.MedGo signifi cantly outperformed junior physicians(P<0.001 for accuracy and case-analysis skills).MedGo assistance significantly enhanced both junior(P<0.001)and senior(P<0.05)physicians'diagnostic accuracy.Notably,MedGo-assisted junior physicians achieved accuracy levels comparable to those of unassisted senior physicians.MedGo maintained consistent performance across varying sepsis severities.CONCLUSION:MedGo shows significant diagnostic efficacy for sepsis and effectively supports clinicians in the ED,particularly enhancing junior physicians’performance.Our study highlights the potential of MedGo as a valuable decision-support tool for sepsis management,paving the way for specialized sepsis AI models.展开更多
Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medicati...Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.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
As drilling operations move into remote locations and extreme water depths, recoil analysis requires more careful considerations and the incidence of emergency disconnect is increased inevitably. To accurately capture...As drilling operations move into remote locations and extreme water depths, recoil analysis requires more careful considerations and the incidence of emergency disconnect is increased inevitably. To accurately capture the recoil dynamics of a deep-water riser in an emergency disconnect scenario, researchers typically focus on modelling the influential subsystems (e.g., the tensioner, the mud discharge and seawater refilling process) which can be solved in the preprocessing, and then the determined parameters are transmitted into an existing global riser analysis software. Distinctively, the current study devotes efforts into the coupling effects resulting from that the suspended riser reacts the platform heave motion via the tensioner system in the course of recoil and the discharging fluid column follows the oscillation of the riser in the mud discharge process. Four simulation models are established based on lumped mass method employing different formulas for the top boundary condition of the riser and the discharging flow acceleration. It demonstrates that the coupling effects discussed above can significantly affect the recoil behavior during the transition phase from initial disconnect to the final hang-off state. It is recommended to develop a fully- coupled integrated model for recoil analysis and anti-recoil control system design before extreme deep-water applications.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
BACKGROUND Artificial intelligence(AI)is increasingly being explored in radiology,including its potential role in emergency imaging settings.However,global perspectives on AI adoption,usefulness,and limitations among ...BACKGROUND Artificial intelligence(AI)is increasingly being explored in radiology,including its potential role in emergency imaging settings.However,global perspectives on AI adoption,usefulness,and limitations among emergency radiologists remain underexplored.AIM To assess awareness,usage,perceived benefits,and limitations of AI tools among radiologists practicing emergency radiology worldwide.METHODS A 16-question survey was distributed globally between October 24,2024,and August 4,2025,targeting radiologists working in academic,community,and private settings who practice emergency radiology as a primary or secondary subspecialty.The survey was disseminated via direct emails extracted using automated and manual methods from recent publications in major radiology journals.A total of 57 responses were collected.RESULTS AI awareness was high(93%),but frequent clinical use was reported by only 28%.Daily use of AI in emergent imaging was limited to 23%of respondents.The majority anticipated AI becoming essential within five years(68%),and 51%believed AI would replace certain radiological tasks.Image interpretation and acquisition were the most common AI applications.Key perceived benefits included improved diagnostic accuracy and increased efficiency,while concerns included limited accuracy,integration difficulties,and cost.Trust in AI varied by experience,with less experienced radiologists viewed as more trusting.CONCLUSION While emergency radiologists globally recognize AI’s potential,significant barriers to its routine adoption remain.Addressing issues of trust,cost,accuracy,and workflow integration is essential to unlock AI's full utility in emergency radiology.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
BACKGROUND:Sepsis-associated encephalopathy(SAE)is a diff use dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.Elderly individuals(≥65 years of age)constitute a p...BACKGROUND:Sepsis-associated encephalopathy(SAE)is a diff use dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.Elderly individuals(≥65 years of age)constitute a particularly vulnerable population comprised by a high burden of underlying diseases and complications,which frequently leads to underdiagnosis or misdiagnosis.These patients are at increased risk of long-term or permanent central nervous system impairment,making rapid and accurate diagnosis and treatment especially critical.The review is expected to promote improvements in the diagnosis and treatment of SAE in elderly patients,ultimately achieving more standardized and effi cient SAE management.METHODS:We performed a literature search in four databases-PubMed,Embase,China National Knowledge Infrastructure(CNKI),and Wanfang-from inception to April 2025 using bilinguals(Chinese and English).RESULTS:The diagnostic criteria for SAE in elderly individuals include the following:(1)sepsis;(2)new-onset neurological dysfunction;and(3)exclusion of other causes of neurological dysfunction.Physicians should develop tailored empiric anti-infective plans for elderly SAE patients,considering comorbidities,organ function,infection site,local bacterial spectrum,and resistance.The treatment protocol can be adjusted once the pathogen is identifi ed.Stabilizing hemodynamics and ensuring cerebral perfusion are two fl uid resuscitation strategies used in elderly SAE patients.An individualized approach to fl uid resuscitation using restrictive fl uid volumes should be employed.Supportive treatment for elderly SAE patients focuses on improving tissue perfusion/oxygenation,controlling blood glucose levels,and correcting internal imbalances.Early rehabilitation,nutritional support,cognitive training,and family-based emotional support are important components of comprehensive care.CONCLUSION:The diagnosis and management of SAE in elderly patients support early recognition and timely intervention.展开更多
The building construction industry,recognized as one of the eight high-risk sectors,also serves as a crucial pillar of the national economy and a key source of employment.Major project advancements typically concentra...The building construction industry,recognized as one of the eight high-risk sectors,also serves as a crucial pillar of the national economy and a key source of employment.Major project advancements typically concentrate between April to June and September to November each year.However,construction progress tends to slow down during July and August due to increased rainfall associated with the flood season.The impact of the flood season on construction projects is primarily reflected in areas such as civil works,machinery and equipment,and temporary power supply.By establishing a dual-control emergency management system for the flood season,construction enterprises can enhance their emergency response capabilities,effectively reduce management challenges,and improve the overall efficiency of emergency handling.展开更多
BACKGROUND Chronic kidney disease(CKD)contributes significantly to emergency department(ED)presentations in low-and middle-income countries.These patients frequently have multiple comorbidities and face high in-hospit...BACKGROUND Chronic kidney disease(CKD)contributes significantly to emergency department(ED)presentations in low-and middle-income countries.These patients frequently have multiple comorbidities and face high in-hospital mortality.However,limited data exist on early predictors of mortality at ED admission.Identifying key clinical and laboratory features associated with adverse outcomes may support timely risk stratification and targeted interventions for acutely ill CKD patients.AIM To identify baseline predictors of in-hospital mortality in adult Indian patients with CKD admitted to the ED.METHODS This retrospective study was conducted from January 2021 to December 2022 at the Acute Care and Emergency Medicine Unit of the Postgraduate Institute of Medical Education and Research,Chandigarh,India.CKD was diagnosed and staged following the Kidney Disease:Improving Global Outcomes guidelines.Data were extracted from medical records using a structured form.All consecutive patients aged≥18 years were included.Independent mortality predictors were identified using multivariate Cox regression analysis.RESULTS Among 354 patients(mean age 49 years;58%males),60.5%had CKD stage 5,and 41.2%were on maintenance dialysis.Hypertension(74.9%)and diabetes(46.0%)were common comorbidities.Diabetic kidney disease was the primary etiology in 35.6%,while 43.2%had unknown causes.Infection(63.0%)was the most frequent cause for ED admission.In-hospital mortality was 29.1%(n=103).Independent mortality predictors were Glasgow coma scale(GCS)<15[hazard ratio(HR):1.822,P=0.017],hyperglycemia(HR:1.641,P=0.020),and low albumin(HR:1.270,P=0.028).Advanced age,Charlson comorbidity Index,quick Sequential Organ Failure Assessment,and neutrophilia were significant in univariate but not multivariate analysis.CKD stage,dialysis dependency,cardiovascular disease,and neutrophil-lymphocyte ratio were not predictive.CONCLUSION A low GCS,hyperglycemia,and low albumin levels at admission independently predict in-hospital mortality in CKD patients presenting to the ED,warranting early recognition and targeted interventions.展开更多
Personalized nursing is a necessary means to improve the satisfaction of emergency pediatric nursing.It can enhance the responsiveness of nursing services,strengthen the emotional connection between nurses and patient...Personalized nursing is a necessary means to improve the satisfaction of emergency pediatric nursing.It can enhance the responsiveness of nursing services,strengthen the emotional connection between nurses and patients,and provide a theoretical basis for clinical practice.Therefore,in the context of the new era,it is necessary to deeply analyze the essence and connotation of personalized nursing,and analyze the existing deficiencies in current emergency pediatric personalized nursing,so as to develop effective improvement plans.Research shows that personalized nursing can significantly improve the satisfaction of emergency pediatric nursing,largely avoid nursing risks,and has strong clinical application value.This article summarizes and explores the research on the influence of personalized nursing on improving the satisfaction of emergency pediatric nursing,and puts forward corresponding views.展开更多
Objective:To explore the application effect of group cooperative learning combined with flipped classroom in standardized training of emergency surgery resident physicians.Methods:95 resident physicians undergoing eme...Objective:To explore the application effect of group cooperative learning combined with flipped classroom in standardized training of emergency surgery resident physicians.Methods:95 resident physicians undergoing emergency surgery standardized training in our hospital were randomly divided into an experimental group(46,group cooperative learning+flipped classroom)and a control group(49,traditional teaching).The training period was 2 months.Results:The graduation assessment scores of the experimental group were higher than those of the control group(P<0.05).The improvement in critical thinking ability and self-learning ability was better than that of the control group(P<0.05).The response rate of“yes”to all items of course teaching satisfaction was significantly higher than that of the control group(P<0.05).The satisfaction scores for training teachers were higher than those of the control group(P<0.05).Conclusion:The teaching model of group cooperative learning combined with flipped classroom,through reconstructing the learning process and activating interactive participation,can significantly improve the clinical operation and theoretical foundation of emergency surgery standardized training students.It also cultivates core professional qualities such as critical thinking,self-learning,and team collaboration,providing a feasible paradigm for integrated medical education in this discipline.展开更多
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 National Natural Science Foundation of China(No.22278156)the Guangdong Special Support Program Project(No.2021JC060580)+1 种基金the Young Elite Scientists Sponsorship Program by CAST-Doctoral Student Special Plan,the China Scholarship Council Program(No.202406150148)the Natural Science Foundation of Guangdong Province(No.2023A1515011186).
文摘Peroxymonosulfate(PMS)-based advanced oxidation processes(AOPs)are an effective way to remove emerging contaminants(ECs)from water.The catalytic process involving PMS is hindered by the suboptimal electron trans-fer efficiency of current catalysts,the further application of AOPs technology is limited.Here,it is proposed that the interfacial electric field can be controlled by bor(B)-doped FeNC catalysts,which shows significant advantages in the efficient generation,release and participation of reactive oxygen species(ROS)in the reaction.The super exchange interaction between Fe sites and N and B sites is realized through the directional transfer of electrons in the interfacial electric field,which ensures the high efficiency and stability of the PMS catalytic process.B doping increases the d orbitals distribution at Fermi level,which facilitates enhanced electron transition activity,thereby promoting the effective generation of (1)^O_(2).At the same time,orbital hybridization causes the center of the d band to move to a lower energy level,which not only contributes to the desorption process of (1)^O_(2),but also accelerates its release.In addition,B-doping also improved the adsorption capacity of organic pollutants and shortened the migration distance of ROS,thereby significantly improving the degradation efficiency of ECs.The B-doping strategy outlined offers a novel approach to the development of FeNC catalysts,it lays a theoretical foundation and offers technical insights for the integration of PMS/AOPs technology in the ECs management.
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.
基金Scientific Research Program of Tianjin Municipal Education Commission(2023SK011)。
文摘The BOPPPS teaching model is a student-centered teaching model that has been widely applied in various teaching fields.This paper summarizes the overview of the BOPPPS teaching model,its application in emergency teaching and training,as well as its advantages and disadvantages,aiming to provide references for the further promotion and application of the BOPPPS teaching model in emergency education.
基金supported by grants from the National Natural Science Foundation of China(82470074 to LT)the municipal Natural Science Foundation of Shanghai Scientific Committee of China(22ZR1451000 to LT)+6 种基金the Peak Supporting Clinical Discipline of Shanghai Health Bureau(2023ZDFC0104 to LT)the Medical Discipline Construction Program of Shanghai Pudong New Area Health Commission(the Key Disciplines Program,PWZxk2022-17 to LT)the Scientifi c Research Program of Shanghai Pudong New Area Health Commission(the Joint Research and Development Program,PW2023D-07 to LT)the Healthcare Talents Elite Program of Shanghai Pudong New Area(2025PDWSYCBJ-03 to LT)the Youth Science and Technology Program of Shanghai Pudong New Area(PW2024B-11 to CX)the People’s Livelihood Research Project of Shanghai Pudong Science and Economy Commission(PKJ2023-Y39 to DZ)the Scientifi c Research Program of Shanghai Pudong New Area Health Commission(the Science Popularization Program,PWKP2024B-19 to XL).
文摘BACKGROUND:Large language models(LLMs)are being explored for disease prediction and diagnosis;however,their effi cacy for early sepsis identifi cation in emergency departments(EDs)remains unexplored.This study aims to evaluate MedGo,a novel medical LLM,as a decision-support tool for clinicians managing patients with suspected sepsis.METHODS:This retrospective study included anonymized medical records of 203 patients(mean age 79.9±10.2 years)with confi rmed sepsis from a tertiary hospital ED between January 2023 and January 2024.MedGo performance across nine sepsis-related assessment tasks was compared with that of two junior(<3 years of experience)and two senior(>10 years of experience)ED physicians.Assessments were scored on a 5-point Likert scale for accuracy,comprehensiveness,readability,and case-analysis skills.RESULTS:MedGo demonstrated diagnostic performance comparable to that of senior physicians across most metrics,achieving a median Likert score of 4 in accuracy,comprehensiveness,and readability.MedGo signifi cantly outperformed junior physicians(P<0.001 for accuracy and case-analysis skills).MedGo assistance significantly enhanced both junior(P<0.001)and senior(P<0.05)physicians'diagnostic accuracy.Notably,MedGo-assisted junior physicians achieved accuracy levels comparable to those of unassisted senior physicians.MedGo maintained consistent performance across varying sepsis severities.CONCLUSION:MedGo shows significant diagnostic efficacy for sepsis and effectively supports clinicians in the ED,particularly enhancing junior physicians’performance.Our study highlights the potential of MedGo as a valuable decision-support tool for sepsis management,paving the way for specialized sepsis AI models.
文摘Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.
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financially supported by the National Natural Science Foundation of China(Grant No.51879161)
文摘As drilling operations move into remote locations and extreme water depths, recoil analysis requires more careful considerations and the incidence of emergency disconnect is increased inevitably. To accurately capture the recoil dynamics of a deep-water riser in an emergency disconnect scenario, researchers typically focus on modelling the influential subsystems (e.g., the tensioner, the mud discharge and seawater refilling process) which can be solved in the preprocessing, and then the determined parameters are transmitted into an existing global riser analysis software. Distinctively, the current study devotes efforts into the coupling effects resulting from that the suspended riser reacts the platform heave motion via the tensioner system in the course of recoil and the discharging fluid column follows the oscillation of the riser in the mud discharge process. Four simulation models are established based on lumped mass method employing different formulas for the top boundary condition of the riser and the discharging flow acceleration. It demonstrates that the coupling effects discussed above can significantly affect the recoil behavior during the transition phase from initial disconnect to the final hang-off state. It is recommended to develop a fully- coupled integrated model for recoil analysis and anti-recoil control system design before extreme deep-water applications.
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.
文摘BACKGROUND Artificial intelligence(AI)is increasingly being explored in radiology,including its potential role in emergency imaging settings.However,global perspectives on AI adoption,usefulness,and limitations among emergency radiologists remain underexplored.AIM To assess awareness,usage,perceived benefits,and limitations of AI tools among radiologists practicing emergency radiology worldwide.METHODS A 16-question survey was distributed globally between October 24,2024,and August 4,2025,targeting radiologists working in academic,community,and private settings who practice emergency radiology as a primary or secondary subspecialty.The survey was disseminated via direct emails extracted using automated and manual methods from recent publications in major radiology journals.A total of 57 responses were collected.RESULTS AI awareness was high(93%),but frequent clinical use was reported by only 28%.Daily use of AI in emergent imaging was limited to 23%of respondents.The majority anticipated AI becoming essential within five years(68%),and 51%believed AI would replace certain radiological tasks.Image interpretation and acquisition were the most common AI applications.Key perceived benefits included improved diagnostic accuracy and increased efficiency,while concerns included limited accuracy,integration difficulties,and cost.Trust in AI varied by experience,with less experienced radiologists viewed as more trusting.CONCLUSION While emergency radiologists globally recognize AI’s potential,significant barriers to its routine adoption remain.Addressing issues of trust,cost,accuracy,and workflow integration is essential to unlock AI's full utility in emergency radiology.
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 by the Beijing Clinical Key Specialty Project(2023).
文摘BACKGROUND:Sepsis-associated encephalopathy(SAE)is a diff use dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.Elderly individuals(≥65 years of age)constitute a particularly vulnerable population comprised by a high burden of underlying diseases and complications,which frequently leads to underdiagnosis or misdiagnosis.These patients are at increased risk of long-term or permanent central nervous system impairment,making rapid and accurate diagnosis and treatment especially critical.The review is expected to promote improvements in the diagnosis and treatment of SAE in elderly patients,ultimately achieving more standardized and effi cient SAE management.METHODS:We performed a literature search in four databases-PubMed,Embase,China National Knowledge Infrastructure(CNKI),and Wanfang-from inception to April 2025 using bilinguals(Chinese and English).RESULTS:The diagnostic criteria for SAE in elderly individuals include the following:(1)sepsis;(2)new-onset neurological dysfunction;and(3)exclusion of other causes of neurological dysfunction.Physicians should develop tailored empiric anti-infective plans for elderly SAE patients,considering comorbidities,organ function,infection site,local bacterial spectrum,and resistance.The treatment protocol can be adjusted once the pathogen is identifi ed.Stabilizing hemodynamics and ensuring cerebral perfusion are two fl uid resuscitation strategies used in elderly SAE patients.An individualized approach to fl uid resuscitation using restrictive fl uid volumes should be employed.Supportive treatment for elderly SAE patients focuses on improving tissue perfusion/oxygenation,controlling blood glucose levels,and correcting internal imbalances.Early rehabilitation,nutritional support,cognitive training,and family-based emotional support are important components of comprehensive care.CONCLUSION:The diagnosis and management of SAE in elderly patients support early recognition and timely intervention.
文摘The building construction industry,recognized as one of the eight high-risk sectors,also serves as a crucial pillar of the national economy and a key source of employment.Major project advancements typically concentrate between April to June and September to November each year.However,construction progress tends to slow down during July and August due to increased rainfall associated with the flood season.The impact of the flood season on construction projects is primarily reflected in areas such as civil works,machinery and equipment,and temporary power supply.By establishing a dual-control emergency management system for the flood season,construction enterprises can enhance their emergency response capabilities,effectively reduce management challenges,and improve the overall efficiency of emergency handling.
文摘BACKGROUND Chronic kidney disease(CKD)contributes significantly to emergency department(ED)presentations in low-and middle-income countries.These patients frequently have multiple comorbidities and face high in-hospital mortality.However,limited data exist on early predictors of mortality at ED admission.Identifying key clinical and laboratory features associated with adverse outcomes may support timely risk stratification and targeted interventions for acutely ill CKD patients.AIM To identify baseline predictors of in-hospital mortality in adult Indian patients with CKD admitted to the ED.METHODS This retrospective study was conducted from January 2021 to December 2022 at the Acute Care and Emergency Medicine Unit of the Postgraduate Institute of Medical Education and Research,Chandigarh,India.CKD was diagnosed and staged following the Kidney Disease:Improving Global Outcomes guidelines.Data were extracted from medical records using a structured form.All consecutive patients aged≥18 years were included.Independent mortality predictors were identified using multivariate Cox regression analysis.RESULTS Among 354 patients(mean age 49 years;58%males),60.5%had CKD stage 5,and 41.2%were on maintenance dialysis.Hypertension(74.9%)and diabetes(46.0%)were common comorbidities.Diabetic kidney disease was the primary etiology in 35.6%,while 43.2%had unknown causes.Infection(63.0%)was the most frequent cause for ED admission.In-hospital mortality was 29.1%(n=103).Independent mortality predictors were Glasgow coma scale(GCS)<15[hazard ratio(HR):1.822,P=0.017],hyperglycemia(HR:1.641,P=0.020),and low albumin(HR:1.270,P=0.028).Advanced age,Charlson comorbidity Index,quick Sequential Organ Failure Assessment,and neutrophilia were significant in univariate but not multivariate analysis.CKD stage,dialysis dependency,cardiovascular disease,and neutrophil-lymphocyte ratio were not predictive.CONCLUSION A low GCS,hyperglycemia,and low albumin levels at admission independently predict in-hospital mortality in CKD patients presenting to the ED,warranting early recognition and targeted interventions.
文摘Personalized nursing is a necessary means to improve the satisfaction of emergency pediatric nursing.It can enhance the responsiveness of nursing services,strengthen the emotional connection between nurses and patients,and provide a theoretical basis for clinical practice.Therefore,in the context of the new era,it is necessary to deeply analyze the essence and connotation of personalized nursing,and analyze the existing deficiencies in current emergency pediatric personalized nursing,so as to develop effective improvement plans.Research shows that personalized nursing can significantly improve the satisfaction of emergency pediatric nursing,largely avoid nursing risks,and has strong clinical application value.This article summarizes and explores the research on the influence of personalized nursing on improving the satisfaction of emergency pediatric nursing,and puts forward corresponding views.
基金Key Research and Development Program of Shaanxi Province,“Exploring the Changes and Mechanisms of Cerebral Microcirculation in Patients with Cerebral Small Vessel Disease and Mild Cognitive Impairment Based on OCTA Assessment”(Project No.:2023-YBSF-569)Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund,“Early Identification of Cognitive Impairment in Cerebral Small Vessel Disease Based on Eye Tracking Technology”(Project No.:2023YJY-72)Key Research and Development Program of Shaanxi Province,“Study on the Correlation between Deep Medullary Veins and Cognitive Dysfunction in Cerebral Small Vessel Disease”(Project No.:2023-YBSF-033)。
文摘Objective:To explore the application effect of group cooperative learning combined with flipped classroom in standardized training of emergency surgery resident physicians.Methods:95 resident physicians undergoing emergency surgery standardized training in our hospital were randomly divided into an experimental group(46,group cooperative learning+flipped classroom)and a control group(49,traditional teaching).The training period was 2 months.Results:The graduation assessment scores of the experimental group were higher than those of the control group(P<0.05).The improvement in critical thinking ability and self-learning ability was better than that of the control group(P<0.05).The response rate of“yes”to all items of course teaching satisfaction was significantly higher than that of the control group(P<0.05).The satisfaction scores for training teachers were higher than those of the control group(P<0.05).Conclusion:The teaching model of group cooperative learning combined with flipped classroom,through reconstructing the learning process and activating interactive participation,can significantly improve the clinical operation and theoretical foundation of emergency surgery standardized training students.It also cultivates core professional qualities such as critical thinking,self-learning,and team collaboration,providing a feasible paradigm for integrated medical education in this discipline.
