Seon Hee Woo, Chang Hee Lee, Mi Yeon Kim, Yongin Kim, Chang Je Park, Myung-Lyeol Lee, Taehun Lee, Kyeongmin Jang, Jun-Ho Jung, Hyun-Kyung Ji, Sung Phil Chung, Do Kyun Kim, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Chun Song Youn, Mi Jin Lee, Jisook Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S185-S194. Published online May 29, 2026
The 2025 Korean Guidelines for Cardiopulmonary Resuscitation include a first aid section developed through a systematic review and evidence appraisal. The revision aimed to strengthen prehospital first aid response capacity while reflecting the Korean healthcare system, field feasibility, and relevant legal and institutional contexts. The guidelines provide evidence-based recommendations for seven priority emergencies: adult chest pain suggestive of myocardial infarction, suspected acute ischemic stroke, asthma-related dyspnea, anaphylaxis, seizures, shock, and syncope. Core principles emphasize early recognition, prompt activation of emergency medical services, minimizing delays to definitive care, and safe condition-specific interventions. Key recommendations include assisting with patient-prescribed medications when appropriate (e.g., nitroglycerin, inhaled bronchodilators, and epinephrine autoinjectors), using structured stroke screening tools, preventing aspiration through proper positioning and withholding oral intake in patients at risk of dysphagia, administering oxygen only for hypoxemia, and initiating cardiopulmonary resuscitation in patients who are unconscious and not breathing normally. Seizure management focuses on safety and emergency medical services activation criteria, while care for shock and syncope emphasizes patient positioning and post-event assessment. These recommendations provide practical, evidence-based guidance for improving patient safety and outcomes in prehospital settings.
Objective Despite disparities in the availability and quality of emergency care, the extent to which countries with different incomes participate in research on emergency medicine (EM) remains understudied. This study evaluated productivity in EM research depending on national income.
Methods Research published since 2004 in Scopus-indexed journals dealing with EM was analyzed quantitatively. Publication, citation, journal impact, and national socioeconomic data were compared. Automated topic modeling was applied using a latent Dirichlet allocation model.
Results The analysis included 154,458 publications (89.7% in English) from 177 countries. The studies received 1,817,635 citations. High-income countries (HICs) outperformed upper-middle-income countries (UMICs), lower-middle-income countries (LMICs), and low-income countries (LICs) by 11-, 41-, and 72-fold, respectively, by the weighted number of publications (per million population per country) by 21-, 54-, and 171-fold, respectively, and by the weighted count of citations. The annual number of publications is predicted to rise considerably for HICs, to a lesser extent for UMICs, and to far less for LMICs, but not for LICs. Research productivity was significantly related to national socioeconomic indicators. Topic modeling revealed that HICs pay relatively more attention to advances in resuscitation, whereas LICs focus more on injuries.
Conclusion . While global research productivity for EM is rising, LICs lag far behind HICs. Priorities in EM research differ among countries with different incomes. The development of country-specific EM research agendas would help boost national academic productivity and determine context-appropriate interventions for improving outcomes in emergency care.
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Global patterns and regional disparities in library and information science research productivity Adebowale Jeremy Adetayo IFLA Journal.2026;[Epub] CrossRef
Prompt activation of emergency medical services (EMS) constitutes the fundamental component of bystander response to time-dependent health crises. A clear understanding of the public ability to access EMS can help to guide interventions aimed at enhancing community preparedness for emergencies. This review was conducted to summarize studies that examined public knowledge of emergency phone numbers. This scoping review encompassed articles published since 2004 that reported the proportion of subjects who knew emergency phone numbers. Data sources included PubMed, Google Scholar, and references of included articles. Relevant data from eligible publications were extracted manually to an author-developed data-charting sheet and analyzed descriptively. Forty-eight articles were analyzed. Reported studies, mostly cross-sectional surveys, were conducted in 26 countries, including 16 high-income, 9 middle-income, and 1 low-income country. The percentage of subjects who knew emergency numbers varied from 0% to 97.8% (median, 64.3%; interquartile range [IQR], 32.8%–80.0%). For high-income countries, the median was significantly higher than for low- and middle-income nations (69.6% [IQR, 54.1%–84.2%] vs. 34.6% [IQR, 19.4%–61.5%], P=0.003). The studies were generally inconsistent regarding the association of subjects’ sociodemographic factors with knowledge of emergency numbers, suggesting the existence of geography-specific patterns. Available studies observed low community knowledge of emergency numbers, especially in low- and middle-income countries, and suggest that the problem has a global scale. Further research efforts are required to determine the best strategies for enhancing the public ability to access EMS.
Bentazone is a widely used herbicide considered a moderate hazard. Fatalities associated with its use are rare, with deaths reported only after intake of ≥200 mL. In some studies, bentazone intoxication is accompanied by generalized rigidity. Malignant hyperthermia is a pharmacogenetic disease that presents a hypermetabolic response to anesthetic gases or depolarizing muscle relaxants due to calcium channel dysfunction. The classic symptoms of malignant hyperthermia include hyperthermia and muscle rigidity. We report the case of a 65-year-old man who died 4 hours after presenting to the emergency department after ingesting approximately 75 mL of Basagran M60 (bentazone 33.6%, 25.2 g). This is the smallest dose (364 mg/kg) reported in a fatal case to date. Electrocardiogram changes, including QRS widening and QT prolongation, were present, and hypocalcemia was confirmed. We propose that bentazone intoxication causes patient deterioration by a mechanism similar to that of malignant hyperthermia.
Wookjin Choi, Young Soon Cho, Young Rock Ha, Je Hyeok Oh, Heekyung Lee, Bo Seung Kang, Yong Won Kim, Chan Young Koh, Ji Han Lee, Euigi Jung, Youdong Sohn, Han Bit Kim, Su Jin Kim, Hohyun Kim, Dongbum Suh, Dong Hyun Lee, Ju Young Hong, Won Woong Lee, on behalf of the Society Emergency and Critical Care Imaging (SECCI)
Clin Exp Emerg Med 2023;10(4):363-381. Published online December 29, 2023
Point-of-care ultrasound (POCUS) is a rapidly developing technology that has the potential to revolutionize emergency and critical care medicine. The use of POCUS can improve patient care by providing real-time clinical information. However, appropriate usage and proper training are crucial to ensure patient safety and reliability. This article discusses the various applications of POCUS in emergency and critical care medicine, the importance of training and education, and the future of POCUS in medicine.
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Objective We aimed to investigate the characteristics of frequent emergency department (ED) users in Korea.
Methods We analyzed the Korea Health Panel Study data of a sampled population from the 2005 Population Census of Korea data, and adults (age ≥18 years) who visited the ED at least once a year between 2014 and 2017 were included in the study. People who visited three or more times a year were classified as frequent users. We compared demographic, socioeconomic, and health-related factors between nonfrequent and frequent users. We used a multivariable logistic regression analysis to determine factors related to frequent ED visits. We also compared the characteristics of ED use in both nonfrequent and frequent users.
Results A total of 5,090 panels were included, comprising 6,853 visits. Frequent users were 333 (6.5% of all panels), and their ED visits were 1,364 (19.9% of all ED visits). In the multivariable regression analysis, medical aid coverage (adjusted odds ratio [aOR] of the National Health Service coverage, 0.55; 95% confidence interval [CI], 0.40–0.75), unemployment (aOR of employment, 0.72; 95% CI, 0.56–0.91), prior ward admission in a year (aOR, 2.14; 95% CI, 1.67–2.75), and frequent outpatient department use (aOR, 1.72; 95% CI, 1.35–2.20) were associated with frequent use. Moreover, frequent users visited the ED of public hospitals more often than than nonfrequent users (19.2% vs. 9.8%). Medical problems rather than injury/poisoning were the more common reasons for visiting the ED (84.5% vs. 71.2%).
Conclusion We found that frequent ED users were likely to be those with socioeconomic disadvantage or with high demand for medical service. Based on this study, further studies on interventions to reduce frequent ED use are required for better ED services.
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Objective This study aimed to evaluate the change in length of stay (LOS) in the emergency department (ED) and outcomes during the coronavirus disease 2019 (COVID-19) pandemic.
Methods This is a single-center, retrospective observational study. We compared ED LOS and outcomes in patients aged ≥19 years who presented to the ED of Soonchunhyang University Bucheon Hospital, a single tertiary university hospital, between January and December in 2018, 2019, and 2020. We included patients who were diagnosed with fever, pneumonia, and sepsis in the ED, based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision. We also compared the LOS and outcomes of overall ED patients in 2019 (before COVID-19) and in 2020 (after COVID-19).
Results A total of 5,061 patients with fever, pneumonia, and sepsis were analyzed. The LOS in the ED in 2020 significantly increased compared with 2018 and 2019 (177.0±115.0 minutes in 2018, 154.0±85.0 minutes in 2019, and 208.0±239.0 minutes in 2020). The proportion of patients who were transferred to other hospitals in 2020 (2.1%) increased compared with 2018 (0.8%) and 2019 (0.7%). Intensive care unit admission significantly increased in 2020 (13.7%) compared with 2019 (10.3%). Among all ED patients, ED LOS in 2020 was longer than in 2019, particularly in patients who were admitted and then transferred to another hospital. Intensive care unit admission (4.4% vs. 5.0%), transfer rate (0.7% vs. 0.9%), and ED mortality (0.6% vs. 0.7%) also significantly increased.
Conclusion The ED LOS, time to intensive care unit admissions, time to transfer to other hospitals, and ED mortality significantly increased during the COVID-19 pandemic.
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Objective Team-based resuscitation in emergency departments (EDs) is an excellent opportunity for hot debriefs (HDBs). In creating a bespoke HDB model for emergency medicine resuscitations, we sought to optimize learning from clinical experience, identify team strengths, challenges, encourage honest reflection and focus on ways of improving future performance.
Methods Multidisciplinary ED focus groups reviewed existing models, identified benefits/barriers and created new frame works, testing and adapting further using fottage of a simulated complex resuscitation case. The new HDB tool was coined: “STOP5” (STOP for 5 minutes). Cases targeted were prehospital retrievals, major trauma, cardiac arrests, deaths in resuscitation, and staff-triggered. The framework details included a specifically scripted introduction followed by core elements that were S: summarize the case; T: things that went well; O: opportunities to improve; P: points to action and responsibilities. Staffs were surveyed at 1 month prior then 6 and 18 months post-introduction. Data collection forms were used to identify and track hard outcomes/system improvements resulting directly from HDBs.
Results Potential benefits identified by respondents included: improved staff morale; team cohesion; improved care for future patients; promoting a culture for learning, patient safety and quality improvement. Ten process and equipment changes resulted directly from STOP5 over 12 months.
Conclusion We anticipate the STOP5 framework to be globally generalizable and effective for many ED teams.
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Emergency management of stroke has been directed at the delivery of recombinant tissue plasminogen activator (tPA) in a timely fashion. Because of the many limitations attached to the delivery of tPA and the perceived benefits accrued to tPA, its use has been limited. Mechanical thrombectomy, a far superior therapy for the largest and most disabling strokes, large vessel occlusions (LVOs), has changed the way acute strokes are managed. Aside from the rush to deliver tPA, there is now a need to identify LVO and refer those patients with LVO to physicians and facilities capable of delivering urgent thrombectomy. Other parts of emergency department management of stroke are directed at identifying and mitigating risk factors for future strokes and at preventing further damage from occurring. We review here the most recent literature supporting these advances in stroke care and present a framework for understanding the role that emergency physicians play in acute stroke care.
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Objective Few studies have prospectively evaluated the diagnostic accuracy and temporal impact of ultrasound in the emergency department (ED) in a randomized manner. In this study, we aimed to perform a randomized, standard therapy controlled evaluation of the diagnostic accuracy and temporal impact of a standardized ultrasound strategy, versus standard care, in patients presenting to the ED with acute dyspnea.
Methods The patients underwent a standardized ultrasound examination that was blinded to the team caring for the patient. Ultrasound results remained blinded in patients randomized to the treating team but were unblinded in the interventional cohort. Scans were performed by trained emergency physicians. The gold standard diagnosis (GSDx) was determined by two physicians blinded to the ultrasound results. The same two physicians reviewed all data >30 days after the index visit.
Results Fifty-nine randomized patients were enrolled. The mean±standard deviation age was 54.4±11 years, and 37 (62%) were male. The most common GSDx was acute heart failure with reduced ejection fraction in 13 (28.3%) patients and airway diseases such as acute exacerbation of asthma or chronic obstructive pulmonary disease in 10 (21.7%). ED diagnostic accuracy, as compared to the GSDx, was 76% in the ultrasound cohort and 79% in the standard care cohort (P=0.796). Compared with the standard care cohort, the final diagnosis was obtained much faster in the ultrasound cohort (mean±standard deviation: 12±3.2 minutes vs. 270 minutes, P<0.001).
Conclusion A standardized ultrasound approach is equally accurate, but enables faster ED diagnosis of acute dyspnea than standard care.
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Objective To determine the factors associated with unmet needs in immigrant patients complaining of abdominal pain, by analyzing those associated with the time from symptom onset to emergency room visit.
Methods We retrospectively reviewed the medical records of immigrants with abdominal pain who visited a tertiary hospital emergency department from January to December 2016. The dependent variable was the time from symptom onset to emergency room visit. The independent variables were age, sex, vital signs, disposition, health insurance status, date of visit, time of visit, level of education, employment status, economic satisfaction, marital status, living with family, duration of residence, having a native spouse, and subjective proficiency in Korean. We analyzed the association of the dependent variable with each independent variable.
Results In total, 102 immigrant patients with abdominal pain were enrolled in this study. The patients who had earlier visits had good subjective proficiency in Korean, high economic satisfaction, longer durations of residence, a tendency to have a native spouse, and a high employment rate. After linear regression analysis, the time from symptom onset to emergency room visit was negatively associated with employment (adjusted odds ratio, -13.67; 95% confidence interval, -23.25 to -4.09; P=0.006) and having a native spouse (adjusted odds ratio, -11.7; 95% confidence interval, -20.61 to -2.8; P=0.011).
Conclusion The factors influencing the time from symptom onset to emergency room visit in immigrant patients with abdominal pain are associated with social capital, which improves access to emergency care. Policies that improve immigrant access to emergency care should be considered.
Dural sinus thrombosis (DST), or cerebral venous thrombosis, is an uncommon cause of stroke. It has a variable presentation, and the symptoms and signs can be non-specific. The diagnosis of DST can be difficult to make and is often delayed or missed. Computed tomography venography or magnetic resonance venography are the typical imaging modalities used to diagnose DST. However, computed tomography venography and magnetic resonance venography both have limitation for emergency department patients. In this article, we report the use of point-of-care ultrasound to facilitate the diagnosis of DST.
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Objective Our objective was to determine the utility of point-of-care ultrasound (POCUS) to identify and guide treatment of tamponade or clinically significant pericardial effusions in the emergency department (ED). Methods This was a retrospective cohort study of non-trauma patients who were diagnosed with large pericardial effusions or tamponade by the ED physician using POCUS. The control group was composed of those patients later diagnosed on the medical wards or incidentally in the ED by other means such as a computed tomography. The following data were abstracted from the patient’s file: demographics, medical background, electrocardiogram results, chest radiograph readings, echocardiogram results, and patient outcomes. Results There were 18 patients in the POCUS arm and 55 in the control group. The POCUS arm had a decreased time to pericardiocentesis (11.3 vs. 70.2 hours, P=0.055) as well as a shorter length of stay (5.1 vs. 7.0 days, P=0.222). A decreased volume of pericardial fluid was drained (661 vs. 826 mL, P=0.139) in the group diagnosed by POCUS. Conclusion This study suggests that POCUS may effectively identify pericardial effusions and guide appropriate treatment, leading to a decreased time to pericardiocentesis and decreased length of hospital stay. Pericardial tamponade or a large pericardial effusion should be considered in all patients presenting to the ED with clinical, radiographic, or electrocardiographic signs of cardiovascular compromise.
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