Annals of emergency medicine最新文献

{"title":"Teenage Girl With a Sore Throat","authors":"Taylor Marks DO , Benjamin Ho-Shing MD , Wesley Eilbert MD","doi":"10.1016/j.annemergmed.2025.08.016","DOIUrl":"10.1016/j.annemergmed.2025.08.016","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 259-260"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis","authors":"Qiangqiang Zhang MMed, Hua Bi BMed, Shuai Zhang MMed, Zhonghu Li MD","doi":"10.1016/j.annemergmed.2025.08.022","DOIUrl":"10.1016/j.annemergmed.2025.08.022","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 281-282"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Traumatic Intracranial Hemorrhage in Older Adults Sustaining a Head Injury in Ground-Level Falls: A Systematic Review and Meta-analysis","authors":"Xavier Dubucs MD, MSc , Véronique Gingras MD , Valérie Boucher MSc , Pierre-Hugues Carmichael MSc , Marianne Ruel MSc , Kerstin De Wit MD, MSc , Keerat Grewal MD, MSc , Éric Mercier MD, MSc , Pierre-Gilles Blanchard MD, PhD , Axel Benhamed MD, MSc , Sandrine Charpentier MD, PhD , Marcel Émond MD, MSc","doi":"10.1016/j.annemergmed.2025.05.021","DOIUrl":"10.1016/j.annemergmed.2025.05.021","url":null,"abstract":"<div><h3>Study objective</h3><div>Ground-level falls have become the leading cause of head injury in older adults. However, the risk factors for traumatic intracranial hemorrhage (ICH) in this population remain unclear. We aimed to identify risk factors for traumatic ICH in older patients who sustained a ground-level fall-related head injury presenting in the emergency department.</div></div><div><h3>Methods</h3><div>A systematic search of Medline (Ovid), Embase (<span><span>Embase.com</span><svg><path></path></svg></span>), Cochrane Library (Wiley), CINAHL (EBSCO), and Web of Science Core Collection was performed on December 9, 2024. The studies' eligibility criteria included patients aged 65 years and over who consulted in an emergency department following a ground-level fall-related head trauma and who presented with a Glasgow Coma Scale score of at least 13. Head injury was defined as any trauma to the head, including the face. Odds ratios (ORs) for each risk factor were pooled from the selected studies. For each potential risk factor, a random-effects model was used to compare the risk of traumatic ICH between patients with and without the risk factor. We restricted sensitivity analyses to studies providing adjusted odds ratios (AORs) and high-quality studies according to the Newcastle-Ottawa quality assessment Scale (defined as Newcastle-Ottawa quality assessment Scale score ≥7).</div></div><div><h3>Results</h3><div>A total of 17 observational studies involving 22,520 patients were included in this systematic review with meta-analysis. Seven were prospective (11,501 individuals), and 8 were multicenter studies (14,376 individuals). The prevalence of traumatic ICH was 6.8% (95% confidence interval [CI]: 6.5 to 7.2), occurring in 1,538 patients. Among patients with traumatic ICH, urgent neurosurgery intervention prevalence was 8.0% (95% CI: 5.0 to 12.0). The unadjusted ORs indicate that the risk factors of traumatic ICH were suspected open or depressed skull fracture (OR: 10.9 [95% CI 6.4 to 18.7]), signs of basal skull fracture (OR: 4.7 [95% CI 3.4 to 6.5]), reduced baseline Glasgow Coma Scale score (OR: 4.0 [95% CI 3.4 to 4.7]), focal neurologic signs (OR: 3.8 [95% CI 3.2 to 4.5]), seizure (OR: 3.2, [95% CI 1.5 to 7.0]), vomiting (OR: 2.7 [95% CI 2.1 to 3.5]), amnesia (OR: 2.4 [95% CI 2.0 to 3.0]), loss of consciousness (OR: 2.3 [95% CI 1.9 to 2.8]), headache (OR: 2.1 [95% CI 1.6 to 2.9]), external sign of head trauma (OR: 2.0 [95% CI 1.7 to 2.3]), male sex (OR: 1.5 [95% CI 1.3 to 1.6]), chronic kidney disease (OR: 1.4 [95% CI 1.0 to 1.9]), preinjury single antiplatelet (OR: 1.2 [95% CI 1.0 to 1.3]), and dual antiplatelet medication (OR: 2.3 [95% CI 1.5 to 3.5]). Preinjury anticoagulant was not a significant risk factor (OR: 0.8 [95% CI 0.7 to 1.0]).</div><div>Based on AOR, only focal neurologic signs (AOR: 4.4 [95% CI 3.0 to 6.5]), external sign of head trauma (AOR: 2.7 [95% CI 2.1 to 3.5]), loss of consciousness (AOR: 1.6 [95% CI 1.2 to 2","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 181-191"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Angioedema","authors":"Brit Long MD , Megan A. Rech PharmD, MS , Michael Gottlieb MD","doi":"10.1016/j.annemergmed.2025.07.002","DOIUrl":"10.1016/j.annemergmed.2025.07.002","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 219-228"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnant Woman With Abdominal Pain And Vomiting","authors":"Brianna Klucher MD , Natasha Tobarran DO","doi":"10.1016/j.annemergmed.2025.07.026","DOIUrl":"10.1016/j.annemergmed.2025.07.026","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 253-254"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on ICARUS-ED","authors":"Ningbo Luo MD, Haoxin Zhou PhD","doi":"10.1016/j.annemergmed.2025.08.024","DOIUrl":"10.1016/j.annemergmed.2025.08.024","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 285-286"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Adding Intravenous Saline Solution to Nonsteroidal Anti-Inflammatory Drug-Based Treatment of Acute Migraine in the Emergency Department","authors":"Yusuf Turan MD,&nbsp;Haldun Akoglu MD, PhDc,&nbsp;Emir Unal MD,&nbsp;Emre Kudu MD,&nbsp;Erhan Altunbas MD,&nbsp;Melis Efeoglu Sacak MD,&nbsp;Cigdem Ozpolat MD,&nbsp;Erkman Sanri MD,&nbsp;Sinan Karacabey MD, PhD,&nbsp;Ozge Ecmel Onur MD,&nbsp;Arzu Denizbasi MD, PhD","doi":"10.1016/j.annemergmed.2025.09.013","DOIUrl":"10.1016/j.annemergmed.2025.09.013","url":null,"abstract":"<div><h3>Study objective</h3><div>Intravenous fluid administration is frequently used alongside nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of acute migraine in emergency departments (EDs), despite a lack of clear evidence supporting its benefit. The objective of this study was to evaluate whether the addition of 1,000 mL intravenous normal saline solution to standard NSAID-based treatment improves clinical outcomes in adults presenting to the ED with acute migraine.</div></div><div><h3>Methods</h3><div>It was a double-blind, parallel-group, randomized controlled trial in single tertiary care academic ED (June 2020 to June 2021). Adults aged ≥18 years with migraine per International Classification of Headache Disorders, 3rd edition criteria, presenting with an acute attack. Patients with dehydration, recent intravenous fluid use, or contraindications were excluded. Of 955 screened patients, 128 were randomized; 125 were analyzed. All patients received 75 mg intramuscular diclofenac. The intervention group received 1,000 mL intravenous saline solution over 1 hour; the control group received 10 mL intravenous saline solution over 1 hour. The primary outcome was change in headache severity (100-mm visual analog scale [VAS]) at 2 hours. Secondary outcomes included rescue medication use, ED length of stay, adverse events, and functional disability.</div></div><div><h3>Results</h3><div>Median VAS reduction was 62.0 mm (IQR 37.5-82.0) in the intervention group vs 48.0 mm (26.0-74.0) in controls; the Hodges-Lehmann estimated between-group difference was 10.0 mm (95% CI −2.0 to 20.0). We found no between-group differences in nausea VAS or functional disability across time points. Rescue medication use was lower in the intervention group (23.8%) than in controls (42.5%) (absolute difference 18.6%, 95% CI 2.1% to 35.0%). Median ED length of stay was shorter in the intervention group (150 vs 168 minutes; difference 19 minutes, 95% CI 0 to 39). No serious adverse events occurred; 24-hour survey outcomes were similar between groups.</div></div><div><h3>Conclusion</h3><div>Adding 1,000 mL intravenous saline solution to NSAID-based therapy did not produce a clear improvement in pain relief at 2 hours. Lower rescue medication use and shorter ED length of stay in the intervention group are secondary findings that may be influenced by unblinded administering staff and should be interpreted cautiously. Routine intravenous fluids should be considered selectively, particularly for patients with clinical signs of dehydration.</div></div>","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 157-166"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Readiness in the Emergency Department: Policy Statement","authors":"Katherine E. Remick MD, FAAP, FACEP, FAEMS ,&nbsp;Ashley A. Foster MD, FAAP, FACEP ,&nbsp;Aaron R. Jensen MD, MEd, MS, FACS, FAAP ,&nbsp;Regan F. Williams MD, MS, FACS, FAAP ,&nbsp;Elizabeth Stone PhD, RN, CHSE, FAEN ,&nbsp;Madeline Joseph MD, FAAP, FACEP ,&nbsp;Gregory P. Conners MD, MPH, MBA, FAAP ,&nbsp;Kathleen Brown MD, FAAP, FACEP ,&nbsp;Marianne Gausche-Hill MD, FAAP, FACEP, FAEMS ,&nbsp;AMERICAN ACADEMY OF PEDIATRICS,&nbsp;Committee on Pediatric Emergency Medicine,&nbsp;Section on Surgery,&nbsp;AMERICAN COLLEGE OF EMERGENCY PHYSICIANS,&nbsp;Pediatric Emergency Medicine Committee,&nbsp;EMERGENCY NURSES ASSOCIATION,&nbsp;Pediatric Committee,&nbsp;AMERICAN COLLEGE OF SURGEONS,&nbsp;Committee on Trauma,&nbsp;Policy Statement,&nbsp;Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children","doi":"10.1016/j.annemergmed.2025.11.016","DOIUrl":"10.1016/j.annemergmed.2025.11.016","url":null,"abstract":"<div><div>This is a revision of the previous joint policy statement titled “Pediatric Readiness in the Emergency Department.” This is a joint policy statement from the American Academy of Pediatrics, the American College of Emergency Physicians, the American College of Surgeons, and the Emergency Nurses Association. These updated recommendations are intended to serve as a resource for clinical and administrative leadership of emergency departments as they strive to improve their readiness for the emergency care of children of all ages.</div></div>","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages e11-e24"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Color of Invisible","authors":"Sreeja Natesan MD","doi":"10.1016/j.annemergmed.2025.09.015","DOIUrl":"10.1016/j.annemergmed.2025.09.015","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 263-264"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Prognostic Scores for Emergency Department Patients With Upper Gastrointestinal Bleeding","authors":"Qiangqiang Zhang MD","doi":"10.1016/j.annemergmed.2025.08.023","DOIUrl":"10.1016/j.annemergmed.2025.08.023","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 283-284"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}