Journal of Emergency Medicine最新文献

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IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-18 DOI: 10.1016/j.jemermed.2025.04.015

Edward J. Otten MD, FACMT, FAWM

引用次数: 0

Epidemiology of Boxing-Related Upper Extremity Injuries Presenting to Emergency Departments in the United States from 2014 to 2023 2014年至2023年美国急诊部门拳击相关上肢损伤的流行病学研究

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-14 DOI: 10.1016/j.jemermed.2025.10.003

Michael N. Megafu DO, MPH , Noelle Nerenberg BS , Hirshal Pandya MS , Omar Guerrero BS , Jacob Speechley DO , Samuelson E. Osifo MD , Paul Tornetta III MD , Robert L. Parisien MD , Antonio Cusano MD , Investigation performed by the Scientific Collaborative for Orthopaedic Research and Education (SCORE) Group

Background

The epidemiology of boxing-related upper extremity injuries in the United States (US) has been minimally described, with only one prior study examining data up to 2016.

Objective

To update and extend national estimates of these injuries through 2023, highlighting post-2016 trends and the impact of the COVID-19 pandemic.

Methods

The National Electronic Surveillance System database was queried for upper extremity boxing-related injuries presenting to US emergency departments from January 1, 2014, to December 31, 2023. Injuries were categorized by body part, diagnosis, and disposition. National estimates (NE) were calculated based on each hospital's assigned statistical sample weight. Linear regression assessed trends over time.

Results

A total of 106,903 boxing-related upper extremity injuries were identified. The hand (48.3%), wrist (18.9%), and shoulder (14.2%) were the most commonly affected areas. Fractures were the most frequent diagnosis (26.4%), followed by strains/sprains (24.1%), other injuries (21.3%), and contusions/abrasions (17.9%). Only 3.3% of cases required hospital admission. Injury counts dropped sharply in 2020 during the COVID-19 pandemic (NE = 7282; p < 0.01 compared to pre-COVID years of 2014–2019), followed by a rebound in subsequent years, peaking in 2023 (NE = 13,258). Linear regression showed a nonsignificant annual decrease of 76 injuries over 10 years (p = 0.70; coefficient = −75.6; 95% CI: −508.7 to 357.5).

Conclusion

Boxing-related upper extremities most commonly involve the hand, with fractures representing the most common diagnosis. In conclusion, the rebound in injury rates in 2023, which diverges from the pre-COVID trend of gradual decline, warrants attention.

背景：美国（US）拳击相关上肢损伤的流行病学描述很少，只有一项先前的研究检查了截至2016年的数据。目标：更新和扩展到2023年的国家对这些伤害的估计，突出2016年后的趋势和COVID-19大流行的影响。方法：查询2014年1月1日至2023年12月31日在美国急诊科就诊的上肢拳击相关损伤的国家电子监测系统数据库。损伤按身体部位、诊断和处置进行分类。全国估计（NE）是根据每个医院分配的统计样本权重计算的。线性回归评估了随时间变化的趋势。结果：共发现106,903例与拳击相关的上肢损伤。手（48.3%）、手腕（18.9%）和肩膀（14.2%）是最常见的受累部位。骨折是最常见的诊断（26.4%），其次是拉伤/扭伤（24.1%），其他损伤（21.3%）和挫伤/擦伤（17.9%）。只有3.3%的病例需要住院。在2019冠状病毒病大流行期间，受伤人数在2020年急剧下降（NE = 7282；与2014-2019冠状病毒病前的年份相比，p < 0.01），随后几年出现反弹，并在2023年达到峰值（NE = 13258）。线性回归显示，10年内76例损伤每年无显著减少（p = 0.70；系数= -75.6;95% CI: -508.7 ~ 357.5）。结论：与拳击相关的上肢最常涉及手部，骨折是最常见的诊断。综上所述，2023年受伤率的反弹与疫情前逐渐下降的趋势有所不同，值得关注。

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引用次数: 0

Does Point-of-Care Ultrasound-Guided Nerve Block for Geriatric Hip Fracture Analgesia in the Emergency Department Improve Outcomes? 急诊点超声引导神经阻滞治疗老年髋部骨折是否能改善疗效？

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-12 DOI: 10.1016/j.jemermed.2025.10.014

Alexander S. Finch MD , Samuel M. Keim MD, MS , Venkatesh R. Bellamkonda MD , Tobias Kummer MD , Larissa T. Shiue MD , Christopher R. Carpenter MD, MSC , Srikar R. Adhikari MD, MS

Background

Geriatric hip fractures are a commonly encountered in the emergency department (ED) with significant associated morbidity and mortality. Providing appropriate analgesia has many challenges, and the majority of patients require opioid medications for adequate pain control. Complications of opioids include delirium, respiratory depression, and constipation, among others. Ultrasound-guided nerve blocks for hip fractures have emerged as an additional modality to utilize as part of a multimodal approach to analgesia.

Clinical Question

In older adults diagnosed with hip fractures in the ED, do ultrasound-guided nerve blocks improve patient-centered outcomes when compared with standard interventions, such as opioid analgesia?

Evidence Review

Three studies were reviewed: a systematic review and meta-analysis, a randomized controlled trial, and a prospective feasibility study.

Conclusion

Compared with standard ED management strategies for analgesia after hip fractures in adults, fascia iliaca compartment blocks do not reduce mortality. Single injection fascia iliaca compartment blocks appeared to improve delirium rates, though this effect was not seen on the included randomized controlled trial. Hospital length-of-stay and opioid use were decreased in patients who received nerve blocks for hip fractures. Some ED literature also supports using femoral nerve blocks as the blocks are feasible, effective, and safe.

背景：老年髋部骨折是急诊科（ED）的常见病，具有显著的发病率和死亡率。提供适当的镇痛有许多挑战，大多数患者需要阿片类药物来充分控制疼痛。阿片类药物的并发症包括谵妄、呼吸抑制和便秘等。超声引导神经阻滞治疗髋部骨折已成为多模式镇痛方法的一部分。临床问题：在急诊科诊断为髋部骨折的老年人中，与阿片类药物镇痛等标准干预措施相比，超声引导下的神经阻滞是否能改善以患者为中心的结果？证据回顾：回顾了三项研究：一项系统回顾和荟萃分析，一项随机对照试验和一项前瞻性可行性研究。结论：与成人髋部骨折后镇痛的标准ED管理策略相比，髂筋膜隔室阻滞不能降低死亡率。单次注射髂筋膜腔室阻滞似乎可以改善谵妄率，尽管在纳入的随机对照试验中没有看到这种效果。髋部骨折接受神经阻滞治疗的患者住院时间和阿片类药物使用减少。一些ED文献也支持使用股神经阻滞，因为这种阻滞是可行、有效和安全的。

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引用次数: 0

If Depression Leads to the Emergency Department, the Pathway is Broken: Rethinking Integrated Care For Mental Health 如果抑郁症导致急诊科，途径被打破：重新思考心理健康的综合护理

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-11 DOI: 10.1016/j.jemermed.2025.07.043

Waseem Jerjes MBBS MSc MDres PhD MRCGP FHEA FAcadMed

引用次数: 0

Comment On “The Interfascial Plane Block: an Adjunctive Ultrasound-Guided Block for Proximal Humerus Fracture and Fracture Dislocation Anesthesia and Analgesia” “筋膜间平面阻滞：超声引导下肱骨近端骨折及骨折脱位的辅助阻滞”评论

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-11 DOI: 10.1016/j.jemermed.2025.07.016

Anju Gupta MD , Chitta Ranjan Mohanty MD , Amiya Kumar Barik DM , Rakesh Vadakkethil Radhakrishnan MSN , Ranganatha Praveen DM

引用次数: 0

Reply to Letter to the Editor 回复给编辑的信

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-11 DOI: 10.1016/j.jemermed.2025.08.006

Drew Castleberry MD , Michael P. Wilson MD, PhD , Kimberly Nordstrom MD, JD

引用次数: 0

American Academy of Emergency Medicine 美国急诊医学学会

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-11 DOI: 10.1016/S0736-4679(25)00398-1

引用次数: 0

Beyond the Alert: Specialist Models Are Essential for Effective Inpatient Diabetes Management 超越警报：专家模型对有效的住院糖尿病患者管理至关重要

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-11 DOI: 10.1016/j.jemermed.2025.07.046

Megan Dharma MD , Rahul D. Barmanray PhD , Mervyn Kyi PhD , Spiros Fourlanos PhD

引用次数: 0

Reply to: “Ways to Explore Further:” The Role of Ultrasound for Cricothyroid Membrane Identification in the Prehospital Setting 回复：“进一步探索的途径：超声在院前环甲膜鉴定中的作用”

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-11 DOI: 10.1016/j.jemermed.2025.07.028

Brit Long , Philip W. Walker , Jason C. Wagner , James L. Li , Aaron J. Lacy

引用次数: 0

Comments on Ultrasound-Guided Serratus Anterior Plane Block for Acute Zoster Pain in an Immunocompromised Heart Transplant Patient in the Emergency Department 超声引导下锯肌前平面阻滞治疗急诊科免疫功能低下心脏移植患者急性带状疱疹

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine

Pub Date : 2025-10-11 DOI: 10.1016/j.jemermed.2025.03.026

Amiya Kumar Barik DM , Chitta Ranjan Mohanty MD , Rakesh Vadakkethil Radhakrishnan MSN , Anju Gupta MD

引用次数: 0

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