Pub Date : 2026-02-01Epub Date: 2026-01-13DOI: 10.1016/j.ienj.2025.101740
John Ramos
The oculocardiac reflex, a variant of the trigeminocardiac reflex, is a brainstem-mediated vagal response to stimulation of the trigeminal nerve’s ophthalmic branch. In orbital trauma, particularly fractures with extraocular muscle entrapment, the oculocardiac reflex can present as bradycardia, arrhythmia, or asystole. While the oculocardiac reflex has an established association with “trapdoor” fractures in pediatric patients and is increasingly reported in adults. Entrapment-related oculocardiac reflex is an accepted but under recognized indication for urgent surgical release. This clinical practice update synthesizes current evidence on oculocardiac reflex and other indications for surgical consultation in adults with orbital fractures, as well as modern perspectives on the impact of surgery on diplopia resolution.
{"title":"Oculocardiac reflex: An underrecognized indication for surgical orbital fracture repair","authors":"John Ramos","doi":"10.1016/j.ienj.2025.101740","DOIUrl":"10.1016/j.ienj.2025.101740","url":null,"abstract":"<div><div>The oculocardiac reflex, a variant of the trigeminocardiac reflex, is a brainstem-mediated vagal response to stimulation of the trigeminal nerve’s ophthalmic branch. In orbital trauma, particularly fractures with extraocular muscle entrapment, the oculocardiac reflex can present as bradycardia, arrhythmia, or asystole. While the oculocardiac reflex has an established association with “trapdoor” fractures in pediatric patients and is increasingly reported in adults. Entrapment-related oculocardiac reflex is an accepted but under recognized indication for urgent surgical release. This clinical practice update synthesizes current evidence on oculocardiac reflex and other indications for surgical consultation in adults with orbital fractures, as well as modern perspectives on the impact of surgery on diplopia resolution.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101740"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Access to quality healthcare in rural and remote Australia remains a significant challenge, with registered nurses (RNs) often the sole face-to-face healthcare provider. Emergency care in these settings requires adaptable, highly skilled RNs capable of managing critical and deteriorating patients with limited support. A gap remains in preparing RNs for these complex demands. The aim of this research was to explore the experiences and preparedness of non-emergency trained RNs, new to the rural and remote environment in managing emergency care.
Methods
A qualitative exploratory descriptive design was used to explore the experiences of non-emergency trained RNs in rural and remote settings. Semi-structured interviews were conducted and transcribed verbatim. Data was analysed using thematic analysis. COREQ guidelines were followed.
Results
23 RNs were divided into two cohorts: experienced rural and remote RNs and those new to the rural and remote context. Thematic analysis revealed three core themes: (1) It is more complex than preparedness, (2) Securing the future success of rural and remote RNs and (3) The good, the bad and finding the ‘in between’. Participants highlighted a disconnect between metropolitan and rural healthcare expectations and emphasised the need for context-specific training, ongoing professional growth, and a culturally responsive, community integrated approach. Findings indicate unpreparedness extends beyond clinical skills to include confidence, community engagement, and cultural competence. This lack of preparedness impacts job satisfaction, confidence, and the ability to manage rural healthcare complexities, ultimately influencing nursing retention rates globally.
Conclusion
Rural and remote RNs face challenges including limited resources and professional isolation. Findings underline the importance of tailored education, self-reflection and realistic recruitment strategies to support and retain RNs in rural and remote settings and ensure sustainable healthcare in rural and remote communities.
{"title":"Unprepared and under pressure: Transitioning experiences to emergency nursing in rural and remote areas","authors":"Danielle Rogers , Pauline Calleja , Amy-Louise Byrne , Ashlyn Sahay","doi":"10.1016/j.ienj.2025.101733","DOIUrl":"10.1016/j.ienj.2025.101733","url":null,"abstract":"<div><h3>Introduction</h3><div>Access to quality healthcare in rural and remote Australia remains a significant challenge, with registered nurses (RNs) often the sole face-to-face healthcare provider. Emergency care in these settings requires adaptable, highly skilled RNs capable of managing critical and deteriorating patients with limited support. A gap remains in preparing RNs for these complex demands. The aim of this research was to explore the experiences and preparedness of non-emergency trained RNs, new to the rural and remote environment in managing emergency care.</div></div><div><h3>Methods</h3><div>A qualitative exploratory descriptive design was used to explore the experiences of non-emergency trained RNs in rural and remote settings. Semi-structured interviews were conducted and transcribed verbatim. Data was analysed using thematic analysis. COREQ guidelines were followed.</div></div><div><h3>Results</h3><div>23 RNs were divided into two cohorts: experienced rural and remote RNs and those new to the rural and remote context. Thematic analysis revealed three core themes: (1) It is more complex than preparedness, (2) Securing the future success of rural and remote RNs and (3) The good, the bad and finding the ‘in between’. Participants highlighted a disconnect between metropolitan and rural healthcare expectations and emphasised the need for context-specific training, ongoing professional growth, and a culturally responsive, community integrated approach. Findings indicate unpreparedness extends beyond clinical skills to include confidence, community engagement, and cultural competence. This lack of preparedness impacts job satisfaction, confidence, and the ability to manage rural healthcare complexities, ultimately influencing nursing retention rates globally.</div></div><div><h3>Conclusion</h3><div>Rural and remote RNs face challenges including limited resources and professional isolation. Findings underline the importance of tailored education, self-reflection and realistic recruitment strategies to support and retain RNs in rural and remote settings and ensure sustainable healthcare in rural and remote communities.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101733"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-18DOI: 10.1016/j.ienj.2025.101715
Tahani Khalil , Andaleeb M. Abu Kamel , Alaa Saad , Hani al-Najjar , Ahmad R. Al-Qudimat , Mohammad Alrahahleh , Abdulqadir J. Nashwan
Background
Domestic Violence (DV) is a worldwide problem that negatively impacts women’s health, family, and community. For that, improving emergency nurses’ competencies and preparedness regarding the care of Domestic Violence (DV) victims is crucial in nursing education. The purpose of the study was to investigate the effect of an educational program on the emergency nurses’ preparedness, perceived preparation and knowledge, actual knowledge, attitude, and practice regarding caring for DV women victims.
Methods
A quasi-experimental pretest-posttest one-group design was used, and the data were collected from 43 emergency nurses working in two private hospitals in Amman. The participants filled out the DV Preparedness Questionnaire (DVPQ) as a pre-test, then enrolled in a one-day educational program regarding the DV nurse’s preparedness program, and finally, again, participants filled out the DVPQ as a post-test.
Results
A total number of 43 nurses from two private hospitals were invited to participate in this study. All the invited nurses attended the educational program. Therefore, the response rate was 100%, and there were no attrition or withdrawal cases during the study. The results of this study showed that emergency nurses’ mean scores of DVPQ subscales regarding care of DV women victims improved after attending an educational program about DV preparedness. A significant difference in the score pre-test and post-test for emergency nurses’ DVPQ subscales was reported; this result revealed that when an educational program applies, it effectively improves emergency nurses’ care of DV victims.
Conclusion
There was a significant improvement in nurses’ perceived preparation and knowledge, actual knowledge, and attitude regarding caring for DV Women Victims.
{"title":"The impact of an educational program on emergency nurses’ preparedness to care for domestic violence women victims","authors":"Tahani Khalil , Andaleeb M. Abu Kamel , Alaa Saad , Hani al-Najjar , Ahmad R. Al-Qudimat , Mohammad Alrahahleh , Abdulqadir J. Nashwan","doi":"10.1016/j.ienj.2025.101715","DOIUrl":"10.1016/j.ienj.2025.101715","url":null,"abstract":"<div><h3>Background</h3><div>Domestic Violence (DV) is a worldwide problem that negatively impacts women’s health, family, and community. For that, improving emergency nurses’ competencies and preparedness regarding the care of Domestic Violence (DV) victims is crucial in nursing education. The purpose of the study was to investigate the effect of an educational program on the emergency nurses’ preparedness, perceived preparation and knowledge, actual knowledge, attitude, and practice regarding caring for DV women victims.</div></div><div><h3>Methods</h3><div>A quasi-experimental pretest-posttest one-group design was used, and the data were collected from 43 emergency nurses working in two private hospitals in Amman. The participants filled out the DV Preparedness Questionnaire (DVPQ) as a pre-test, then enrolled in a one-day educational program regarding the DV nurse’s preparedness program, and finally, again, participants filled out the DVPQ as a post-test.</div></div><div><h3>Results</h3><div>A total number of 43 nurses from two private hospitals were invited to participate in this study. All the invited nurses attended the educational program. Therefore, the response rate was 100%, and there were no attrition or withdrawal cases during the study. The results of this study showed that emergency nurses’ mean scores of DVPQ subscales regarding care of DV women victims improved after attending an educational program about DV preparedness. A significant difference in the score pre-test and post-test for emergency nurses’ DVPQ subscales was reported; this result revealed that when an educational program applies, it effectively improves emergency nurses’ care of DV victims.</div></div><div><h3>Conclusion</h3><div>There was a significant improvement in nurses’ perceived preparation and knowledge, actual knowledge, and attitude regarding caring for DV Women Victims.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101715"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-22DOI: 10.1016/j.ienj.2025.101717
Ahmet Kağan Özkaya , Elif Nur İldeş
{"title":"Letter to the editor regarding “The effect on intra-hospital transfer success of checklist in the pediatric emergency department: An interventional observational study”","authors":"Ahmet Kağan Özkaya , Elif Nur İldeş","doi":"10.1016/j.ienj.2025.101717","DOIUrl":"10.1016/j.ienj.2025.101717","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101717"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-14DOI: 10.1016/j.ienj.2025.101738
Christina Østervang , Geurt van de Glind , Niek Galenkamp , Petra Brysiewicz , Joan Carlini , Lente Werner , Camilla Lykke Møller , Rachel Muir
{"title":"Lessons learnt from patient and public involvement in emergency care research: Emerging insights from three research projects in Denmark, the Netherlands and Australia","authors":"Christina Østervang , Geurt van de Glind , Niek Galenkamp , Petra Brysiewicz , Joan Carlini , Lente Werner , Camilla Lykke Møller , Rachel Muir","doi":"10.1016/j.ienj.2025.101738","DOIUrl":"10.1016/j.ienj.2025.101738","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101738"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-25DOI: 10.1016/j.ienj.2025.101712
Aslı Alaca , Hatice Yıldırım Sarı
Background
Peripheral intravenous catheter insertion is one of the most common procedures in pediatric emergency departments. Inappropriate placement of a peripheral intravenous catheter and the associated management can lead to patient harm, which is considered a patient safety issue. The patient’s safety could be compromised if a peripheral intravenous catheter is not properly placed and managed.
Purpose
This study was conducted to examine how nurses’ use of the Broselow tape affects patient safety during peripheral intravenous catheterization.
Materials and methods
In this study, the selection of peripheral intravenous catheters was based on a randomized controlled trial. The study was registered on ClinicalTrials.gov under the registration number NCT06165003. Using the Stepped Wedge design, data from the control group were collected first, followed by data from the experimental group. The two groups were compared on a variety of criteria, including the number of attempts, extravasation, accidental dislodgement, dwell time of catheter, and reasons for removal of catheter.
Results
The study found no significant difference between the experimental and control groups in terms of “the nurses’ success in performing the procedure” and “catheter dwell time” during peripheral intravenous catheterization. The patients’ estimated weights in the experimental group were found to be consistent with both the Broselow tape estimates and parents’ weight estimates.
Conclusions
The study indicates that using the Broselow tape for cannula selection during peripheral intravenous catheterization could serve as a novel alternative method.
{"title":"An examination of how nurses’ use of the Broselow tape affects patient safety during peripheral intravenous catheterization","authors":"Aslı Alaca , Hatice Yıldırım Sarı","doi":"10.1016/j.ienj.2025.101712","DOIUrl":"10.1016/j.ienj.2025.101712","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral intravenous catheter insertion is one of the most common procedures in pediatric emergency departments. Inappropriate placement of a peripheral intravenous catheter and the associated management can lead to patient harm, which is considered a patient safety issue. The patient’s safety could be compromised if a peripheral intravenous catheter is not properly placed and managed.</div></div><div><h3>Purpose</h3><div>This study was conducted to examine how nurses’ use of the Broselow tape affects patient safety during peripheral intravenous catheterization.</div></div><div><h3>Materials and methods</h3><div>In this study, the selection of peripheral intravenous catheters was based on a randomized controlled trial. The study was registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> under the registration number NCT06165003. Using the Stepped Wedge design, data from the control group were collected first, followed by data from the experimental group. The two groups were compared on a variety of criteria, including the number of attempts, extravasation, accidental dislodgement, dwell time of catheter, and reasons for removal of catheter.</div></div><div><h3>Results</h3><div>The study found no significant difference between the experimental and control groups in terms of “the nurses’ success in performing the procedure” and “catheter dwell time” during peripheral intravenous catheterization. The patients’ estimated weights in the experimental group were found to be consistent with both the Broselow tape estimates and parents’ weight estimates.</div></div><div><h3>Conclusions</h3><div>The study indicates that using the Broselow tape for cannula selection during peripheral intravenous catheterization could serve as a novel alternative method.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101712"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-11DOI: 10.1016/j.ienj.2026.101747
Weiwei Zhang , Weisi Peng , Xiufen Yang , Rui Sun , Jiaxiu Deng , Yueming Peng , Di Huang
Background
Missed nursing care remains a major patient safety concern in emergency departments, where high workloads and limited staffing frequently lead to omissions in fundamental care. Yet the impact of nurses’ caring ability and team collaboration on missed care has received limited empirical attention.
Aim
To examine the independent and interactive effects of nurses’ caring ability and team collaboration on missed nursing care in emergency departments, and to assess potential bidirectional mediation mechanisms.
Method
A cross-sectional study was conducted among 643 emergency nurses in five tertiary hospitals in Guangdong Province, China. Participants completed the Missed Nursing Care Scale, the Nursing Teamwork Survey, and the Caring Ability Inventory. Data were analysed using descriptive statistics, Pearson’s correlation, multiple linear regression, and structural equation modelling.
Results
Both nurses’ caring ability and team collaboration were significantly associated with reduced missed nursing care. Trust, support, courage, and cognition were identified as protective factors. Mediation modelling revealed a bidirectional mechanism in which each factor partially mediated the effect of the other on missed care.
Conclusion
This study highlights the reciprocal relationship between interpersonal competencies and missed nursing care. Interventions targeting both individual and team-level capacities may enhance care quality and patient safety in high-intensity emergency settings.
{"title":"Team collaboration and caring ability as reciprocal predictors of missed nursing care: A cross-sectional study among emergency nurses in China","authors":"Weiwei Zhang , Weisi Peng , Xiufen Yang , Rui Sun , Jiaxiu Deng , Yueming Peng , Di Huang","doi":"10.1016/j.ienj.2026.101747","DOIUrl":"10.1016/j.ienj.2026.101747","url":null,"abstract":"<div><h3>Background</h3><div>Missed nursing care remains a major patient safety concern in emergency departments, where high workloads and limited staffing frequently lead to omissions in fundamental care. Yet the impact of nurses’ caring ability and team collaboration on missed care has received limited empirical attention.</div></div><div><h3>Aim</h3><div>To examine the independent and interactive effects of nurses’ caring ability and team collaboration on missed nursing care in emergency departments, and to assess potential bidirectional mediation mechanisms.</div></div><div><h3>Method</h3><div>A cross-sectional study was conducted among 643 emergency nurses in five tertiary hospitals in Guangdong Province, China. Participants completed the Missed Nursing Care Scale, the Nursing Teamwork Survey, and the Caring Ability Inventory. Data were analysed using descriptive statistics, Pearson’s correlation, multiple linear regression, and structural equation modelling.</div></div><div><h3>Results</h3><div>Both nurses’ caring ability and team collaboration were significantly associated with reduced missed nursing care. Trust, support, courage, and cognition were identified as protective factors. Mediation modelling revealed a bidirectional mechanism in which each factor partially mediated the effect of the other on missed care.</div></div><div><h3>Conclusion</h3><div>This study highlights the reciprocal relationship between interpersonal competencies and missed nursing care. Interventions targeting both individual and team-level capacities may enhance care quality and patient safety in high-intensity emergency settings.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101747"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-12-15DOI: 10.1016/j.ienj.2025.101735
Ariel Braverman , Amit Frenkel , Dan Schwarzfuchs , Eli Jaffe , Yuval Bitan
Background
Although effective information exchange during emergency medical services (EMS)-to-emergency department (ED) patient handovers is critical for care continuity and patient safety, handover communication patterns and information gaps remain poorly characterized.
Objective
To characterize verbal and visual information exchange patterns in EMS-to-ED handovers while comparing EMS and ED staff perceptions of handover quality.
Methods
This was a dual-methods study conducted at a tertiary medical center in Israel (June–November 2024) in which 83 EMS-to-ED handovers [35 advanced life support (ALS), 48 basic life support (BLS)] were directly observed. We documented information elements, duration, and communication patterns via a structured checklist. In addition, an electronic survey (Qualtrics) of 103 participants (62 EMS, 41 ED staff) was used to assess perceptions with 6-point Likert scales. Statistical analyses utilized Mann-Whitney U tests, effect sizes (Cohen’s d), and 95 % confidence intervals (CIs).
Results
The handovers were dominated by verbal communication (97.6 %, 95 % CI: 91.6–99.3 %) of brief duration [ALS: Median = 40 s, interquartile range (IQR) 35–45; BLS: Median = 25 s, IQR 25–35]. Significant information gaps included: pre-hospital treatment details, which were absent in 36.1 % of the handovers (95 % CI: 26.6–46.9 %), allergy details in 55.4 %, and demographic details in 61.4 %. The ALS teams provided more complete information than did BLS teams (treatment: 94 % vs. 46 %, p < 0.001; allergies: 60 % vs. 33 %, p = 0.02). EMS documentation was available in only 7.2 % of handovers (95 % CI: 3.4–14.9 %). Patient background documents were valued more by ED staff than by EMS personnel (Median = 4.84 vs. 3.44, p < 0.001, d = 0.98), and they reported higher confidence in using received information (Median = 4.12 vs. 3.15, p < 0.001, d = 0.78).
Conclusions
Because EMS-to-ED handovers rely almost exclusively on brief verbal communication, they are vulnerable to information loss. Critical safety-relevant information (allergies, medications) is frequently omitted, with BLS teams showing greater gaps than ALS teams. Structured handover protocols may improve information completeness and continuity of care by incorporating digital tools to complement verbal communication.
{"title":"Verbal and visual information exchange in EMS-to-ED patient handovers: An observational and attitudinal study","authors":"Ariel Braverman , Amit Frenkel , Dan Schwarzfuchs , Eli Jaffe , Yuval Bitan","doi":"10.1016/j.ienj.2025.101735","DOIUrl":"10.1016/j.ienj.2025.101735","url":null,"abstract":"<div><h3>Background</h3><div>Although effective information exchange during emergency medical services (EMS)-to-emergency department (ED) patient handovers is critical for care continuity and patient safety, handover communication patterns and information gaps remain poorly characterized.</div></div><div><h3>Objective</h3><div>To characterize verbal and visual information exchange patterns in EMS-to-ED handovers while comparing EMS and ED staff perceptions of handover quality.</div></div><div><h3>Methods</h3><div>This was a dual-methods study conducted at a tertiary medical center in Israel (June–November 2024) in which 83 EMS-to-ED handovers [35 advanced life support (ALS), 48 basic life support (BLS)] were directly observed. We documented information elements, duration, and communication patterns via a structured checklist. In addition, an electronic survey (Qualtrics) of 103 participants (62 EMS, 41 ED staff) was used to assess perceptions with 6-point Likert scales. Statistical analyses utilized Mann-Whitney U tests, effect sizes (Cohen’s d), and 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The handovers were dominated by verbal communication (97.6 %, 95 % CI: 91.6–99.3 %) of brief duration [ALS: Median = 40 s, interquartile range (IQR) 35–45; BLS: Median = 25 s, IQR 25–35]. Significant information gaps included: pre-hospital treatment details, which were absent in 36.1 % of the handovers (95 % CI: 26.6–46.9 %), allergy details in 55.4 %, and demographic details in 61.4 %. The ALS teams provided more complete information than did BLS teams (treatment: 94 % vs. 46 %, p < 0.001; allergies: 60 % vs. 33 %, p = 0.02). EMS documentation was available in only 7.2 % of handovers (95 % CI: 3.4–14.9 %). Patient background documents were valued more by ED staff than by EMS personnel (Median = 4.84 vs. 3.44, p < 0.001, d = 0.98), and they reported higher confidence in using received information (Median = 4.12 vs. 3.15, p < 0.001, d = 0.78).</div></div><div><h3>Conclusions</h3><div>Because EMS-to-ED handovers rely almost exclusively on brief verbal communication, they are vulnerable to information loss. Critical safety-relevant information (allergies, medications) is frequently omitted, with BLS teams showing greater gaps than ALS teams. Structured handover protocols may improve information completeness and continuity of care by incorporating digital tools to complement verbal communication.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101735"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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