Journal of Emergency Nursing最新文献

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IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01

引用次数: 0

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01

引用次数: 0

Psychosocial Care of Pregnancy Loss in the Emergency Department 急诊科流产妊娠的心理社会护理

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.10.005

Rebecca Mattson PhD, RN, PHN, Shandeigh N. Berry PhD, RN, CNE

Introduction

Emergency departments in the United States manage nearly 900,000 visits annually for early pregnancy loss. Patients frequently report limited emotional support, inadequate provider knowledge, and insufficient communication.

Methods

A pre- and postintervention design was used to assess ED staff knowledge, attitudes, and supportive care skills related to reproductive grief. Demographic data were collected. Paired t tests evaluated changes across 7 educational domains.

Results

The analytic sample (N = 39) consisted of chaplains (7.7%), nurses (61.6%), patient care assistants (7.7%), radiology technicians (5.1%), social workers (5.1%), and ED technicians (12.8%). Postintervention analyses demonstrated increased mean scores across all domains, including emotional support, patient-centered care, discharge planning, bereavement care, community resources, staff support, and communication (P < .0001).

Discussion

The findings suggest that staff education may improve miscarriage care. Additional research is necessary to confirm these results, establish validity, and assess generalizability across settings.

在美国，急诊部门每年处理近90万例早孕流产。患者经常报告情感支持有限，提供者知识不足，沟通不足。方法采用干预前和干预后设计，评估急诊科工作人员对生殖悲伤的知识、态度和支持性护理技能。收集了人口统计数据。配对检验评估了7个教育领域的变化。结果分析样本（N = 39）包括牧师（7.7%）、护士（61.6%）、病人护理助理（7.7%）、放射技师（5.1%）、社工（5.1%）和急诊科技师（12.8%）。干预后分析显示，所有领域的平均得分都有所提高，包括情感支持、以患者为中心的护理、出院计划、丧亲护理、社区资源、员工支持和沟通（P < 0.0001）。讨论本研究结果提示员工教育可改善流产护理。需要进一步的研究来证实这些结果，建立有效性，并评估跨设置的普遍性。

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引用次数: 0

Information for Readers 读者资讯

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/S0099-1767(25)00502-1

引用次数: 0

Application of Multistrategy Improvement Gray Wolf Algorithm to Optimize Extreme Gradient Boosting in Emergency Triage 应用多策略改进灰狼算法优化极值梯度增强在急诊分诊中的应用。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.07.015

Tichen Huang BMgmt, Yuyan Jiang MSc, Rumeijiang Gan MSc, Heping Wang PhD, Fuyu Wang PhD, Yan Li PhD

Introduction

Effective triage in the emergency department (ED) is essential for optimizing resource allocation, improving efficiency, and enhancing patient outcomes. Conventional systems rely heavily on clinical judgment and standardized guidelines, which may be insufficient under growing patient volumes and increasingly complex presentations.

Methods

We developed a machine learning triage model, MIGWO-XGBOOST, which incorporates a Multi-strategy Improved Gray Wolf Optimization (MIGWO) algorithm for parameter tuning. Missing data were processed, and the dataset was randomly split into 80 percent for training and 20 percent for testing. Model performance was evaluated against standard XGBOOST, GWO XGBOOST, AdaBoost, LSTM, and CNN-BiGRU.

Results

MIGWO-XGBOOST improved accuracy by 8.5 percent over unoptimized XGBOOST and reduced optimization time by 9,285 seconds relative to GWO-XGBOOST. Compared with other benchmarks, accuracy gains were 12.5 percent over AdaBoost, 3.3 percent over LSTM, and 1.9 percent over CNN-BiGRU. These results demonstrate both predictive strength and computational efficiency in complex data environments.

Discussion

MIGWO-XGBOOST provides a robust framework for rapid and precise triage decisions in the ED. By enhancing accuracy while substantially reducing computational time, this approach demonstrates the potential of advanced machine learning to support emergency decision-making and optimize patient care pathways.

简介：在急诊科（ED）有效的分诊对于优化资源分配、提高效率和提高患者预后至关重要。传统系统在很大程度上依赖于临床判断和标准化指南，在患者数量不断增加和症状日益复杂的情况下，这可能是不够的。方法：我们开发了一个机器学习分类模型MIGWO- xgboost，该模型采用了多策略改进灰狼优化（MIGWO）算法进行参数调整。缺失的数据被处理，数据集被随机分成80%用于训练，20%用于测试。模型性能根据标准XGBOOST、GWO XGBOOST、AdaBoost、LSTM和CNN-BiGRU进行评估。结果：与未优化的XGBOOST相比，MIGWO-XGBOOST的精度提高了8.5%，优化时间比GWO-XGBOOST减少了9285秒。与其他基准相比，准确度比AdaBoost提高12.5%，比LSTM提高3.3%，比CNN-BiGRU提高1.9%。这些结果证明了在复杂数据环境下的预测强度和计算效率。讨论：MIGWO-XGBOOST为急诊科快速准确的分诊决策提供了一个强大的框架。通过提高准确性，同时大幅减少计算时间，这种方法展示了先进机器学习在支持紧急决策和优化患者护理途径方面的潜力。

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Brain Edema After Cosmetic Botulinum Toxin Injection: A Case Report 美容用肉毒毒素注射后脑水肿1例报告。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.08.013

Lan Lai BSN, RN, Zhongxiang Wang MSN, RN, Yajun Sun MSN, RN

A 26-year-old woman presented to the emergency department with progressive symptoms including fever, pharyngeal pain, dysphagia, bilateral ptosis, and generalized weakness after cosmetic botulinum toxin injections to the neck. This case report aimed to describe an unusual presentation of botulinum neurotoxin-associated central nervous system involvement. This manuscript is a case review describing the clinical course, diagnostic challenges, and management strategies of brain edema after botulinum toxin type A exposure. Key points include the importance of recognizing nontraditional presentations of botulism in emergency settings, the potential for central neurologic complications after cosmetic procedures, and the critical role of emergency nurses in early symptom recognition, airway management, and multidisciplinary coordination for antitoxin administration and intensive care support.

一名26岁女性在颈部注射美容肉毒杆菌毒素后出现进行性症状，包括发烧、咽部疼痛、吞咽困难、双侧上睑下垂和全身无力。本病例报告旨在描述肉毒杆菌神经毒素相关中枢神经系统受累的不寻常表现。这篇手稿是一个病例回顾，描述了a型肉毒杆菌毒素暴露后脑水肿的临床过程、诊断挑战和管理策略。重点包括在紧急情况下识别非传统肉毒杆菌中毒表现的重要性，美容手术后中枢神经并发症的可能性，以及急诊护士在早期症状识别、气道管理、抗毒素给药和重症监护支持的多学科协调方面的关键作用。

引用次数: 0

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01

引用次数: 0

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01

引用次数: 0

The Power of Positive Self-Affirmation 积极自我肯定的力量

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.10.014

Michael Dustin Bass DNP, MHA, RN, CEN, NEA-BC

引用次数: 0

Heatstroke: The Nurse’s Pivotal Role in the Emergency Department 中暑：急诊科护士的关键作用。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.08.017

Beth Tremblay PhD, RN, CCRN, TNCC, Lynn Wiles PhD, RN, CEN, ANEF, Janice E. Hawkins PhD, RN, CNS, FAAN

With record-setting temperature increases, emergency nurses must rapidly recognize and manage life-threatening heat illnesses such as heatstroke. Reaching the core temperature cooling target of 39 °C (102.2 °F) within 30 minutes of heatstroke recognition is critical and directly affects morbidity and mortality. Sequelae of heatstroke may include neurologic and vital organ damage, particularly in cases of delayed cooling. This article summarizes evidence-based strategies and nursing considerations for heatstroke, including recommendations for total body immersion without the need for specialized equipment. Emergency nurses should work collaboratively to ensure that up-to-date protocols are in place and engage in training to identify and treat individuals with heatstroke rapidly.

随着创纪录的气温上升，急诊护士必须迅速识别和处理危及生命的高温疾病，如中暑。在中暑识别后的30分钟内达到39°C（102.2°F）的核心温度冷却目标至关重要，并直接影响发病率和死亡率。中暑的后遗症可能包括神经系统和重要器官的损害，特别是在延迟降温的情况下。本文总结了中暑的循证策略和护理注意事项，包括不需要专门设备的全身浸泡的建议。急诊护士应协同工作，确保最新的协议到位，并参与培训，以迅速识别和治疗中暑患者。

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