BMC Emergency Medicine最新文献

Background: Effective disaster response requires both well-prepared medical rescue teams and resilient early-phase logistics.

Objectives: This study examined how medical rescue teams' personnel prepared, mobilized, and maintained field living conditions after the 6 February 2023 earthquakes, aiming to generate practice- and policy-oriented recommendations.

Methods: A qualitative phenomenological design with purposive maximum-variation sampling (n = 12) was utilized. Semi-structured online interviews underwent thematic analysis. Reporting adhered to COREQ standards. Ethical approval was obtained and informed consent secured.

Results: Three themes emerged. (A) Team Structure and Personnel Characteristics: Professional diversity enhanced capacity only when roles were explicit and leadership was visible; inconsistent training and leader ambiguity created tension. (B) Assignment, Preparedness, and Deployment Process: Notification and assembly often relied on informal channels (e.g., messaging apps); mission orders and destinations were unclear; winter hazards and traffic impeded deployment; initial 3-7 day rotations were perceived as most effective. (C) Base-of-operations and logistics: Early shelter, heating, nutrition, and hygiene support were inadequate, with privacy and sanitation being major challenges, but these improved as institutional logistics scaled up.

Conclusions: The performance in the early phase can be strengthened by standardized pre-deployment checklists and mission orders, dual leadership including an experienced member, short initial rotations, and minimum living-condition standards. Competency-based modular training, regular drills, and mandatory after-action reviews are further recommended to institutionalize learning.

Background: CBRNE (Chemical, Biological, Radiological, Nuclear, and Explosive) incidents can significantly disrupt the natural order of human life and pose serious psychosocial challenges. This study aims to identify the components of psychosocial support available to citizens and frontline personnel during such events.

Methods: A systematic review was conducted by searching PubMed, Scopus, Web of Science, and Embase databases up to July 2024. All articles that met the inclusion criteria and passed the screening process were included in the review. The screening process followed PRISMA guidelines. Thematic content analysis was conducted using Braun and Clarke's six-step framework. Extracted data were coded, categorized, and synthesized into key psychosocial support themes.

Results: A total of 14,365 articles were initially identified. After the screening process, 29 studies were included, and 11 additional relevant studies from Google Scholar were added, resulting in a final sample of 40 studies. Thematic analysis revealed four primary categories of psychosocial support: behavioral, emotional, cognitive, and spiritual, further divided into 12 subcategories.

Conclusions: Psychosocial support measures in CBRNE incidents encompass a broad range of individual, community-based, and organizational strategies implemented during and after events. Effective risk reduction planning in all identified dimensions is essential to prevent psychosocial disorders and enhance resilience in the face of such complex emergencies.

Background: Interfacility transfer (IFT) of neonates and infants is common in South Africa, with many needing respiratory support. Recently, interest in non-invasive ventilation, particularly nasal continuous positive airway pressure (nCPAP), during IFTs has increased; however, local evidence is limited. This study aimed to describe the characteristics of neonates and infants requiring respiratory support and to evaluate the introduction of nCPAP during IFTs by the South African Red Cross Air Mercy Service (AMS) in the Western Cape between 2017 and 2019.

Methods: A retrospective descriptive review of all neonates (≤ 28 days) and infants ( > 28 days to ≤ 1 year) requiring respiratory support during AMS IFTs was conducted between 2017 and 2019.

Results: Respiratory support was required for 70.4% (435/618) of all neonates and infants transported during the study period. Of the 435 IFTs, 61.4% (n = 267) were neonates and 51.9% (n = 224) males. Approximately two-thirds (n = 296, 68.0%) were transported by rotor-wing (RW) aircraft, and Emergency Care Practitioners (n = 344, 79.1%) were the most common primary crew member. The median stabilisation time for RW and fixed-wing (FW) aircraft IFTs was > 60 mins, with median RW mission times approximately 3 hrs and > 5.5 hrs for FW. Common diagnoses included respiratory distress syndrome in neonates and pneumonia in infants. During IFTs, 174 (40.0%) patients received oxygen (O₂) therapy, 141 (32.4%) nCPAP, and 120 (27.6%) positive pressure ventilation, predominantly mechanical ventilation (n = 116, 26.6%). Neonates more commonly received nCPAP during IFTs and infants' oxygen therapy (p < 0.001). Additionally, in neonates, the use of nCPAP increased over the three years, while O₂ therapy declined (p < 0.001).

Conclusion: This study highlights the frequency of neonatal and infant aeromedical IFTs requiring respiratory support and the increasing adoption of nCPAP during aeromedical IFTs in one South African province. The findings suggest that nCPAP is a feasible respiratory support modality in the aeromedical IFT context; however, the safe and effective implementation relies on careful patient selection, adequately trained personnel, and appropriate equipment. Further research is warranted to evaluate the overall safety and clinical outcomes of nCPAP during IFTs and develop robust protocols and guidelines tailored to the South African context.

Purpose: This study aimed to determine the cognitive, affective, and behavioral attitudes of healthcare professionals involved in the initial intervention, treatment, and reporting of electric vehicle accidents (EVAs) and to compare these attitudes on the basis of their individual characteristics.

Design and methods: A descriptive cross-sectional design was employed. The sample consisted of 402 healthcare workers in Turkey. Data were collected via a survey that included demographic questions and the Electric Vehicle Accident Attitude Scale, a 27-item instrument developed by Kayhan et al. Attitudes were measured across cognitive, affective, and behavioral dimensions. Descriptive statistics (frequency, percentage, mean, and standard deviation) were used alongside t tests and ANOVA, and MANOVA to compare attitudes by personal and professional variables. Cluster analysis was used to group participants according to their EVA-related attitudes.

Results: The participants demonstrated moderate overall attitudes toward EVAs. While cognitive and affective attitudes were low, behavioral attitudes were relatively high. No significant differences were found profession, marital status, age, or years of experience (p > 0.05); however, attitudes varied significantly by work unit and gender (p < 0.05). Compared with dispatch and emergency department staff, ambulance teams had more favorable behavioral (M = 3.77) and overall (M = 3.15) attitudes.

Conclusions: EVAs pose unique risks due to their battery structure and limited control, distinguishing them from conventional vehicle incidents. Knowledge gaps and emotional hesitation among healthcare workers highlight the need for targeted training programs that extend beyond healthcare providers to include other frontline responders, such as firefighters and traffic police. In addition, forensic specialists involved in injury assessment and cause-of-death determination should receive EVA-specific awareness training to enhance their preparedness for such cases. Furthermore, the implementation of structured EVA-specific training programs-shaped by the attitudes identified in this study-may not only improve the quality of emergency care but also serve a preventive function in potential future legal risks related to patient care.

Introduction: Acute spinal cord injury (ASCI) often leads to severe disability and post-traumatic stress disorder (PTSD), yet evidence on early psychological prevention during the emergency stage is limited.

Aim: This study aimed to evaluate whether emergency psychological intervention can effectively prevent PTSD in ASCI patients and improve rehabilitation outcomes, addressing a key gap in current trauma management research.

Methods: A retrospective cohort study was conducted among 191 ASCI patients admitted to the emergency department of the Affiliated Hospital of Xuzhou Medical University from June 2023 to December 2024. Patients were divided by injury severity (ISS ≥ 16 or ISS < 16) and exposure to emergency psychological intervention. Primary outcome was PTSD incidence; secondary outcomes included exercise compliance, muscle strength recovery, emergency stay time, readmission rate, and medical costs.

Results: The incidence of PTSD was significantly lower in the severe intervention group than in controls (26.7% vs. 51.8%, P = 0.024). Exercise compliance and muscle strength recovery were higher in intervention groups, and average medical expenses per patient decreased by ¥3,953 in the severe group.

Conclusion: Early emergency psychological intervention can effectively prevent PTSD and enhance rehabilitation outcomes in ASCI patients, while reducing healthcare costs and improving efficiency in emergency care. These findings support integrating a "physiological-psychological" management model into routine trauma practice.

Clinical trial number: Not applicable.