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Original Article

Emergency Medical Services

Oral anticoagulant use by emergency medical services patients: an observational study
Henry E. Wang, Mengda Yu, Ching Min Chu, Travis P. Sharkey-Toppen, J. Madison Hyer, Michelle Nassal, Alix Delamare, Jonathan Powell, Lai Wei, Robert Lowe, Kim Moeller, Alexander Keister, Ashish Panchal
Clin Exp Emerg Med 2025;12(4):350-357.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.369

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Oral anticoagulant use by emergency medical services patients: an observational study
Clin Exp Emerg Med. 2025;12(4):350-357.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.369
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Oral anticoagulant use by emergency medical services patients: an observational study
Clin Exp Emerg Med. 2025;12(4):350-357.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.369
Close
Objective
Oral anticoagulant (OAC) use increases the risk of death in conditions like hemorrhagic stroke, trauma, and traumatic brain injury. Early identification of OAC use is critical for timely interventions to mitigate hemorrhage risk and improve survival. We aimed to identify emergency medical services (EMS) care characteristics associated with patients using an OAC.
Methods
We analyzed prehospital data (2018–2020) from the ESO Data Collaborative, focusing on adult (≥18 years) 911 EMS calls. The administered OACs were warfarin, dabigatran, rivaroxaban, and apixaban. We compared EMS call characteristics, patient demographics, response times, and interventions between OAC and non-OAC users. We used univariate logistic regression to identify independent predictors of OAC use.
Results
Of 16,244,550 adult 911 EMS events, 906,575 involved OAC users (56 of 1,000 calls). Those using OAC were older (73.6 years vs. 56.9 years) and more often from nursing homes or long-term care facilities (17.0% vs. 9.2%) but less likely to have trauma (14.7% vs. 18.1%) or cardiac arrest (1.2% vs. 1.4%). The most common EMS primary clinical impressions for OAC users were chest pain (7.4%), altered mental status (7.3%), injury (6.5%), abdominal pain (4.3%), and brain injury (2.8%).
Conclusion
OAC users accounted for 1 in 18 adult EMS encounters. Specific patient and call characteristics were associated with OAC use. These findings should be incorporated into EMS training to facilitate recognition and appropriate management of OAC-related emergencies.
  • 2,928 View
  • 81 Download

Review Article

Public awareness of medical emergency telephone numbers: a scoping review
Alexei A. Birkun
Clin Exp Emerg Med 2026;13(1):28-36.   Published online January 14, 2025
DOI: https://doi.org/10.15441/ceem.24.289

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Public awareness of medical emergency telephone numbers: a scoping review
Clin Exp Emerg Med. 2026;13(1):28-36.   Published online January 14, 2025
DOI: https://doi.org/10.15441/ceem.24.289
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Public awareness of medical emergency telephone numbers: a scoping review
Clin Exp Emerg Med. 2026;13(1):28-36.   Published online January 14, 2025
DOI: https://doi.org/10.15441/ceem.24.289
Close
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.
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  • 106 Download

Original Article

Resuscitation

Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
Seung Hyo Lee, Won Pyo Hong, Young Su Kim, Jeseong Park, Hyouk Jae Lim
Clin Exp Emerg Med 2024;11(3):276-285.   Published online April 5, 2024
DOI: https://doi.org/10.15441/ceem.23.177

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Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
Clin Exp Emerg Med. 2024;11(3):276-285.   Published online April 5, 2024
DOI: https://doi.org/10.15441/ceem.23.177
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Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
Clin Exp Emerg Med. 2024;11(3):276-285.   Published online April 5, 2024
DOI: https://doi.org/10.15441/ceem.23.177
Close
Objective
The Korean National Fire Agency conducted a pilot project examining Advanced Life Support (ALS) protocols, including epinephrine administration, to improve survival among patients suffering out-of-hospital cardiac arrest (OHCA). In this study, we aimed to evaluate the effects of the Korean National Fire Agency ALS protocol on prehospital return of spontaneous circulation (ROSC) in patients with OHCA.
Methods
This study included patients with adult-presumed cardiac arrest between January and December 2020. The main factor of interest was ambulance type according to ALS protocol, which was divided into dedicated ALS ambulance (DA), smartphone-based ALS ambulance (SALS), and non-DA, and the main analysis factor was prehospital ROSC. Multivariate logistic regression analysis was performed.
Results
During the study period, a total of 18,031 adult patients with OHCA was treated by the emergency medical services, including 7,520 DAs (41.71%), 2,622 SALSs (14.54%), and 7,889 non-DAs (43.75%). The prehospital ROSC ratio was 13.19% for DA, 11.17% for SALS, and 7.91% for non-DA (P<0.01). Compared with that of the DA group, the odds ratios (95% confidence interval) for prehospital ROSC ratio were 0.97 (0.82–1.15) in the SALS group and 0.57 (0.50–0.65) in the non-DA group. The prehospital ROSC ratio of the DA group was higher than those of the non-DA group and the SALS group.
Conclusion
ALS protocol intervention was associated with prehospital ROSC rates. Therefore, continuous efforts to promote systemic implementation of the ALS protocol to improve OHCA outcomes are necessary.

Citations

Citations to this article as recorded by  Crossref logo
  • Video-vs audio-instructed dispatcher-assisted CPR and outcomes after out-of-hospital cardiac arrest: a nationwide registry-based cohort study
    Seung Hyo Lee, Tae Han Kim, Won Pyo Hong, Sang Do Shin, Kyoung Jun Song, Young Sun Ro, Jeong Ho Park, Goeun Kim, Seulki Choi
    Resuscitation.2026; 220: 111009.     CrossRef
  • Impact of bystander and patient sex on cardiopulmonary resuscitation provision in out-of-hospital cardiac arrest
    Seunggu Na, Kyung Hun Yoo, Jaehoon Oh, Yongil Cho, Juncheol Lee, Tae Ho Lim, Hyunggoo Kang, Byuk Sung Ko, Jinsoo Kim
    Emergency Medicine Journal.2026; 43(8): 479.     CrossRef
  • Temporal Evolution of Optic Nerve Sheath Diameter/Eyeball Ratio on CT and MRI for Neurological Prognostication After Cardiac Arrest
    Jiyoung Choi, So-Young Jeon, Jung Soo Park, Jin A Lim, Byung Kook Lee
    Journal of Clinical Medicine.2025; 14(19): 6891.     CrossRef
  • 7,823 View
  • 95 Download
  • 3 Web of Science
  • 3 Crossref

Case Report

Inappropriate use of intravenous epinephrine leading to atrial fibrillation during prehospital anaphylaxis treatment: a case report
Haewon Jung, Hyun Wook Ryoo, Jungbae Park, Seung Hyuk Choi, Jae Hyuk Lee, Sujeong Kim
Clin Exp Emerg Med 2024;11(3):304-308.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.129

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Inappropriate use of intravenous epinephrine leading to atrial fibrillation during prehospital anaphylaxis treatment: a case report
Clin Exp Emerg Med. 2024;11(3):304-308.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.129
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Inappropriate use of intravenous epinephrine leading to atrial fibrillation during prehospital anaphylaxis treatment: a case report
Clin Exp Emerg Med. 2024;11(3):304-308.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.129
Close
In a prehospital setting, the narrow therapeutic window of epinephrine necessitates its cautious administration to avoid anaphylaxis. In this case, a 46-year-old man presented severe anaphylactic symptoms. Following the standard protocol, the emergency medical technician (EMT) administered intramuscular epinephrine; however, symptoms persisted. Under the oversight of the emergency medical services (EMS) medical director, an additional intravenous bolus of epinephrine was administered, unfortunately leading to atrial fibrillation. This case underscores the potential risks of intravenous epinephrine, which is not typically recommended for anaphylaxis without continuous monitoring. Since 2019, Korea has initiated a pilot program to expand the EMT scope of practice, which gives them the authority to administer epinephrine for anaphylaxis. The ultimate decision regarding epinephrine use for anaphylaxis, emphasizing patient safety, rests with the EMS medical director. Proper training for EMTs, coupled with the EMS medical director’s comprehensive knowledge and meticulous protocol adherence, can ensure patient safety and optimal outcomes.

Citations

Citations to this article as recorded by  Crossref logo
  • Oral Cephalosporin-Induced Anaphylaxis Presenting With Severe Tachycardia: A Case of Microdosed Epinephrine Over Standard Protocols
    Anupama R S, Rohan Krishna NK, Sathya Lakshmi Mekkoth, N Sridhara, Shivaraj K
    Cureus.2025;[Epub]     CrossRef
  • Atrial Fibrillation in a Young Healthy Adult: A Case Report From Anaphylaxis to Arrhythmia
    Louis A Enchill, Eugene K Yeboah, Sergei Klokov, Ogheneakpobor E Ubogun, Suchith B Suresh
    Cureus.2025;[Epub]     CrossRef
  • 8,827 View
  • 132 Download
  • 2 Crossref

Original Articles

Cardiovascular | Imaging

Echocardiographic features of myocardial rupture after acute myocardial infarction on emergency echocardiography
Byung Wook Lee, Yong Sung Cha, Sung Oh Hwang, Yoon-Seop Kim, Sun Ju Kim
Clin Exp Emerg Med 2023;10(4):393-399.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.037

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Echocardiographic features of myocardial rupture after acute myocardial infarction on emergency echocardiography
Clin Exp Emerg Med. 2023;10(4):393-399.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.037
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Echocardiographic features of myocardial rupture after acute myocardial infarction on emergency echocardiography
Clin Exp Emerg Med. 2023;10(4):393-399.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.037
Close
Objective
Myocardial rupture is a fatal complication of acute myocardial infarction (AMI). Early diagnosis of myocardial rupture is feasible when emergency physicians (EPs) perform emergency transthoracic echocardiography (TTE). The purpose of this study was to report the echocardiographic features of myocardial rupture on emergency TTE performed by EPs in the emergency department (ED).
Methods
This was a retrospective and observational study involving consecutive adult patients presenting with AMI who underwent TTE performed by EPs in the ED of a single academic medical center from March 2008 to December 2019.
Results
Fifteen patients with myocardial rupture, including eight (53.3%) with free wall rupture (FWR), five (33.3%) with ventricular septal rupture (VSR), and two (13.3%) with FWR and VSR, were identified. Fourteen of the 15 patients (93.3%) were diagnosed on TTE performed by EPs. Diagnostic echocardiographic features were found in 100% of the patients with myocardial rupture, including pericardial effusion for FWR and a visible shunt on the interventricular septum for VSR. Additional echocardiographic features indicating myocardial rupture were thinning or aneurysmal dilatation in 10 patients (66.7%), undermined myocardium in six patients (40.0%), abnormal regional motions in six patients (40.0%), and pericardial hematoma in six patients (40.0%).
Conclusion
Early diagnosis of myocardial rupture after AMI is possible using echocardiographic features on emergency TTE performed by EPs.

Citations

Citations to this article as recorded by  Crossref logo
  • Can FoCUS Speed Up the Management of Acute Coronary Syndrome in the Emergency Department?
    Melina Karaolia, Sofia Bezati, Katerina Papasolomou, Estela Kiouri, Christos Verras, Effie Polyzogopoulou
    Medicina.2026; 62(6): 1013.     CrossRef
  • Desafios diagnósticos e terapêuticos da Comunicação Interventricular pós-infarto do miocárdio: relato de caso
    Mara Flávia Mamedio Avallone, Marcos Gradim Tiveron, Eraldo Antônio Pelloso, Sérgio Marques Pereira, Rodolfo de Oliveira Medeiros, Piero Bitelli, Carlos Eduardo Bueno, Dauane Cristine Orso Toscan Rodrigues, Viviane Canhizares Evangelista de Araújo, Jeffer
    Caderno Pedagógico.2025; 22(7): e16612.     CrossRef
  • 9,493 View
  • 202 Download
  • 1 Web of Science
  • 2 Crossref

COVID-19

The effect of regional distribution of isolation rooms in emergency departments on ambulance travel time during the COVID-19 pandemic
Soo In Lee, Saee Byel Kang, Sun Young Lee, Dong Sun Choi
Clin Exp Emerg Med 2023;10(2):191-199.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.355

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The effect of regional distribution of isolation rooms in emergency departments on ambulance travel time during the COVID-19 pandemic
Clin Exp Emerg Med. 2023;10(2):191-199.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.355
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The effect of regional distribution of isolation rooms in emergency departments on ambulance travel time during the COVID-19 pandemic
Clin Exp Emerg Med. 2023;10(2):191-199.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.355
Close
Objective
The number and distribution of isolation rooms in Korea differ by region. The distribution of isolation beds in emergency departments may have affected ambulance travel time and burden on emergency medical service (EMS) during the COVID-19 pandemic.
Methods
This retrospective observational study analyzed EMS records in four regions of the Gyeonggi Province, Korea, from January 01, 2019 to December 31, 2020. The main exposure was the number of emergency department isolation rooms in each region. The primary outcome was call-to-return time for the EMS. The interaction effect of the number of regional isolation rooms on the call-to-return time during the COVID-19 pandemic was analyzed using a generalized linear model (GLM) and logistic regression.
Results
A total of 781,246 cases was included in the analyses. During the COVID-19 pandemic, the call-to-scene time (before 8 minutes vs. after 9 minutes, P<0.05) and call-to-return time (before 46 minutes vs. after 52 minutes, P<0.05) for emergency patients increased significantly compared to before the pandemic. As the number of regional isolation rooms increased, the effect of COVID-19 on the call-to-return time decreased significantly in the multivariable GLM with an interaction term (with 10.14 isolation rooms per million population: adjusted exponential β coefficient [exp(β)], 1.33; with 12.24 isolation rooms per million population: adjusted exp(β), 1.18). As the number of regional isolation rooms increased, the effect of COVID-19 on the call-to-scene time decreased significantly in the multivariable GLM with an interaction term (with 10.14 isolation rooms per million population: adjusted exp(β), 1.20; with 12.24 isolation rooms per million population: adjusted exp(β), 1.09).
Conclusion
During the pandemic, the increases in call-to-return time and call-to-scene time were smaller in regions with more isolation rooms per population.

Citations

Citations to this article as recorded by  Crossref logo
  • Chronic Obstructive Pulmonary Disease Mortality and Hospitalization during the COVID-19 Pandemic Compared with before the Pandemic: A Systematic Review and Meta-Analysis
    Chiwon Ahn, Yeonkyung Park
    Journal of Personalized Medicine.2024; 14(3): 296.     CrossRef
  • Clinical support system for triage based on federated learning for the Korea triage and acuity scale
    Hansol Chang, Jae Yong Yu, Geun Hyeong Lee, Sejin Heo, Se Uk Lee, Sung Yeon Hwang, Hee Yoon, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Taerim Kim
    Heliyon.2023; 9(8): e19210.     CrossRef
  • 8,232 View
  • 144 Download
  • 2 Web of Science
  • 2 Crossref

Emergency Medical Services | Neurology

Uncooperative patients suspected of acute stroke ineligible for prehospital stroke screening test by emergency medical service providers: final hospital diagnoses and characteristics
Sol Han, Sung Wook Song, Hansol Hong, Woo Jeong Kim, Young Joon Kang, Chang Bae Park, Jeong Ho Kang, Ji Hwan Bu, Sung Kgun Lee, Seo Young Ko, Soo Hoon Lee, Chul-Hoo Kang
Clin Exp Emerg Med 2023;10(2):213-223.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.372

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Uncooperative patients suspected of acute stroke ineligible for prehospital stroke screening test by emergency medical service providers: final hospital diagnoses and characteristics
Clin Exp Emerg Med. 2023;10(2):213-223.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.372
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Uncooperative patients suspected of acute stroke ineligible for prehospital stroke screening test by emergency medical service providers: final hospital diagnoses and characteristics
Clin Exp Emerg Med. 2023;10(2):213-223.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.372
Close
Objective
This study investigated the hospital diagnoses and characteristics of uncooperative prehospital patients suspected of acute stroke who could not undergo a prehospital stroke screening test (PHSST).
Methods
This retrospective observational study was conducted at a single academic hospital with a regional stroke center. We analyzed three scenario-based prehospital stroke screening performances using the final hospital diagnoses: (1) a conservative approach only in patients who underwent the PHSST, (2) a real-world approach that considered all uncooperative patients as screening positive, and (3) a contrapositive approach that all uncooperative patients were considered as negative.
Results
Of the 2,836 emergency medical services (EMS)-transported adult patients who met the prehospital criteria for suspicion of acute stroke, 486 (17.1%) were uncooperative, and 570 (20.1%) had a confirmed final diagnosis of acute stroke. The diagnosis in the uncooperative group did not differ from that in the cooperative group (22.0% vs. 19.7%, P=0.246). The diagnostic performances of the PHSST in the conservative approach were as follows: 79.5% sensitivity (95% confidence interval [CI], 75.5%–83.1%), 90.2% specificity (95% CI, 88.8%–91.6%), and 0.849 area under the receiver operating characteristic curve (AUC; 95% CI, 0.829–0.868). The sensitivity and specificity were 83.3% (95% CI, 80.0%–86.3%) and 75.2% (95% CI, 73.3%–76.9%), respectively, in the real-world approach and 64.6% (95% CI, 60.5%–68.5%) and 91.9% (95% CI, 90.7%–93.0%), respectively, in the contrapositive approach. No significant difference was evident in the AUC between the real-world approach and the contrapositive approach (0.792 [95% CI, 0.775–0.810] vs. 0.782 [95% CI, 0.762–0.803], P>0.05).
Conclusion
We found overestimation (false positive) and underestimation (false negative) in the uncooperative group depending on the scenario-based EMS stroke screening policy for uncooperative prehospital patients suspected of acute stroke.

Citations

Citations to this article as recorded by  Crossref logo
  • LncRNA MCM3AP-AS1 protects against cerebral ischemia-reperfusion injury via targeting miR-27b-3p
    Rouli Dai, Wei Li, Bin Han
    Neurological Research.2026; 48(2): 229.     CrossRef
  • Impact of snoring on the risk of stroke in patients with diabetes mellitus
    Eujene Jung, U Chul Ju, Hyun Ho Ryu, Hyun Lee Kim
    Sleep and Breathing.2024; 28(6): 2675.     CrossRef
  • Epidemiology of stroke in emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Sung Eun Lee, Hyo Jin Kim, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S48.     CrossRef
  • 7,583 View
  • 122 Download
  • 3 Web of Science
  • 3 Crossref

Cardiovascular

Predicting in-hospital mortality in pulmonary embolism patients: development and external validation of the PATHOS score
Michele Domenico Spampinato, Marcello Covino, Angelina Passaro, Marcello Benedetto, Luca D’Angelo, Giorgio Galizia, Irma Sofia Fabbri, Teresa Pagano, Andrea Portoraro, Matteo Guarino, Rita Previati, Gianluca Tullo, Antonio Gasbarrini, Roberto De Giorgio, Francesco Franceschi
Clin Exp Emerg Med 2023;10(1):26-36.   Published online November 17, 2022
DOI: https://doi.org/10.15441/ceem.22.369

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Predicting in-hospital mortality in pulmonary embolism patients: development and external validation of the PATHOS score
Clin Exp Emerg Med. 2023;10(1):26-36.   Published online November 17, 2022
DOI: https://doi.org/10.15441/ceem.22.369
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Predicting in-hospital mortality in pulmonary embolism patients: development and external validation of the PATHOS score
Clin Exp Emerg Med. 2023;10(1):26-36.   Published online November 17, 2022
DOI: https://doi.org/10.15441/ceem.22.369
Close
Objective
According to the 2019 European Society of Cardiology (ESC) guidelines on pulmonary embolism (PE), prognosis is calculated using the Pulmonary Embolism Severity Index (PESI), a complex score with debated validity, or simplified PESI (sPESI). We have developed and validated a new risk score for in-hospital mortality (IHM) of patients with PE in the emergency department.
Methods
This retrospective, dual-center cohort study was conducted in the emergency departments of two third-level university hospitals. Patients aged >18 years with a contrast-enhanced computed tomography-confirmed PE were included. Clinical variables and laboratory tests were evaluated blindly to IHM. Multivariable logistic regression was performed to identify the new score’s predictors, and the new score was compared with the PESI, sPESI, and shock index.
Results
A total of 1,358 patients were included in this study: 586 in the derivation cohort and 772 in the validation cohort, with a global 10.6% of IHM. The PATHOS scores were developed using independent variables to predict mortality: platelet count, age, troponin, heart rate, oxygenation, and systolic blood pressure. The PATHOS score showed good calibration and high discrimination, with an area under the receiver operating characteristics curve of 0.83 (95% confidence interval [CI], 0.77–0.89) in the derivation population and 0.74 (95% CI, 0.68–0.80) in the validation cohort, which is significantly higher than the PESI, sPESI, and shock index in both cohorts (P<0.01 for all comparisons).
Conclusion
PATHOS is a simple and effective prognostic score for predicting IHM in patients with PE in an emergency setting.

Citations

Citations to this article as recorded by  Crossref logo
  • Comparison of easy-to-use clinical prognostic models to identify low-risk normotensive patients with pulmonary embolism
    Manuel Gloor, Odile Stalder, Tobias Tritschler, Marie Méan, Nicolas Rodondi, Marc Righini, Drahomir Aujesky
    Journal of Thrombosis and Haemostasis.2026; 24(3): 1056.     CrossRef
  • PATHOS–Lactate score: A novel prognostic tool for predicting in-hospital mortality in acute pulmonary embolism
    Ekrem Taha Sert, Kamil Kokulu, Oğuz Yürük, Emin Hüseyin Akar
    Heart & Lung.2026; 78: 102755.     CrossRef
  • Prognostic Performance of the PATHOS Score Compared with CURB-65 and A-DROP in Emergency Department Patients with Community-acquired Pneumonia
    Kamil Kokulu, Ekrem Taha Sert
    Medical Bulletin of Haseki.2026; 64(2): 101.     CrossRef
  • Comparative Prognostic Value of the Shock Index, Modified Shock Index, and Simplified Pulmonary Embolism Severity Index in Predicting Short-Term Outcomes in Patients with Acute Pulmonary Embolism
    Selim Değirmenci, Hasan Kara
    Archives of Current Medical Research.2026; 7(2): 268.     CrossRef
  • External validation of the PE-SCORE for predicting early clinical deterioration in acute pulmonary embolism using real-world data
    Melis Efeoğlu Saçak, Arzu Denizbaşı
    Journal of Thrombosis and Thrombolysis.2026;[Epub]     CrossRef
  • Performance of the PATHOS score in predicting in-hospital mortality in patients aged 65 years and older admitted to the intensive care unit from the emergency department
    Ekrem Taha Sert, Kamil Kokulu
    Cukurova Medical Journal.2025; 50(1): 99.     CrossRef
  • Prognostic Impact of Albumin/Globulin and Lactate/Globulin Ratios Combined With sPESI and BOVA Scores in Pulmonary Embolism Mortality
    Abdullah Şen, Cahfer Güloğlu, Nikhat Kaura
    International Journal of Clinical Practice.2025;[Epub]     CrossRef
  • The Hidden Signal: P Wave Morphology and In-Hospital Mortality in Acute Pulmonary Embolism
    Corina Cinezan, Alexandra Manuela Buzle, Maria Luiza Hiceag, Camelia Bianca Rus
    Diagnostics.2025; 15(20): 2636.     CrossRef
  • The prognostic value of HALP score and sPESI in predicting in-hospital mortality in patients with pulmonary thromboembolism
    Mahmut Yaman, Murat Orak, Hasan Mansur Durgun, Veysi Tekin, Şilan Göger Ülgüt, Sema Belek, Berçem Tugay Günel, Mehmet Üstündağ, Cahfer Güloğlu, Ercan Gündüz
    Postgraduate Medical Journal.2024; 101(1191): 60.     CrossRef
  • A new model for estimating in-hospital mortality in patients with pulmonary embolism: PATHOS score
    Halil ALIŞKAN, Mazlum KILIÇ
    Anatolian Current Medical Journal.2023; 5(3): 237.     CrossRef
  • 13,438 View
  • 312 Download
  • 12 Web of Science
  • 10 Crossref

Emergency Medical Services | Resuscitation

The number and level of first-contact emergency medical services crew and clinical outcomes in out-of-hospital cardiac arrest with dual dispatch response
Young Su Kim, Ki Hong Kim, Kyoung Jun Song, Sang Do Shin, Jeong Ho Park
Clin Exp Emerg Med 2022;9(4):314-322.   Published online October 7, 2022
DOI: https://doi.org/10.15441/ceem.22.205

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The number and level of first-contact emergency medical services crew and clinical outcomes in out-of-hospital cardiac arrest with dual dispatch response
Clin Exp Emerg Med. 2022;9(4):314-322.   Published online October 7, 2022
DOI: https://doi.org/10.15441/ceem.22.205
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The number and level of first-contact emergency medical services crew and clinical outcomes in out-of-hospital cardiac arrest with dual dispatch response
Clin Exp Emerg Med. 2022;9(4):314-322.   Published online October 7, 2022
DOI: https://doi.org/10.15441/ceem.22.205
Close
Objective
This study aimed to evaluate the association between the number and level of emergency medical technicians (EMTs) in the first-contact emergency medical services (EMS) unit and the clinical outcomes of out-of-hospital cardiac arrest (OHCA) with a dual dispatch response.
Methods
Adult nontraumatic EMS-treated OHCAs between 2015 and 2018 in a nationwide database, were enrolled. The main exposure was the number and certification level of first-contact EMS crew: three versus two members, proportion of EMT intermediate level (EMT-I) over 50% versus under or equal to 50%. Good neurologic recovery was selected as the primary outcome. Multilevel multivariable logistic regression analysis was conducted to calculate adjusted odds ratios and confidence intervals.
Results
A total of 26,867 patients were enrolled and analyzed. Good neurologic recovery was different across the study groups: 5.4% in the two-member crews, 7.2% in the three-member crews, 5.9% in the low EMT-I proportion crews, and 6.8% in the high EMT-I proportion crews. In the main analysis, statistically significant differences for favorable outcomes were found between the three-member and two-member crews, and the high EMT-I proportion and low EMT-I proportion crews; for good neurologic recovery, adjusted odds ratios (95% confidence interval) were 1.23 (1.06–1.43) for three-member crews, and 1.28 (1.17–1.40) for a high EMT-I proportion.
Conclusion
The higher number and level of first-contact EMS crew was associated with better neurologic recovery in adult nontraumatic OHCA with a dual-dispatched EMS response.

Citations

Citations to this article as recorded by  Crossref logo
  • Assessing the need for quality control in direct medical oversight: a survey of emergency medical services providers and medical directors
    Daesung Lim, Sun Hyu Kim, Seong Chun Kim, Song Yi Park, Bongkyu Jeong
    Journal of EMS Medicine.2026; 5(1): 1.     CrossRef
  • Association between multiple‐ambulance dispatches and clinical outcomes for patients with dispatcher‐unrecognized out‐of‐hospital cardiac arrests
    Min Seol Seo, Ki Hong Kim, Tae Han Kim, Jeong Ho Park, Joo Jeong, Young Sun Ro, Ki Jeong Hong, Kyoung Jun Song, Sang Do Shin
    Hong Kong Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Influence of team size on the efficiency of time-critical ALS interventions in prehospital cardiac arrest – A prospective randomised multicentre simulation study
    Sophie Franziska L’habitant, Alina Schenk, Marcus Thudium, Mark Coburn, Alexander Lechleuthner, Florian Piekarski
    Resuscitation Plus.2026; 30: 101384.     CrossRef
  • Association Between the Number of Emergency Medical Services and the Chest Compression Quality in Out-of-Hospital Cardiac Arrest
    Sang A. Yoon, Ki Hong Kim, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee, Ki Jeong Hong, Young Sun Ro, Kyoung Jun Song, Sang Do Shin
    The Journal of Emergency Medicine.2025; 75: 89.     CrossRef
  • European Resuscitation Council Guidelines 2025 Adult Advanced Life Support
    Jasmeet Soar, Bernd W. Böttiger, Pierre Carli, Francesc Carmona Jiménez, Diana Cimpoesu, Gareth Cole, Keith Couper, Sonia D’Arrigo, Charles D. Deakin, Jacqueline Eleonora Ek, Mathias J. Holmberg, Aurora Magliocca, Nikolaos Nikolaou, Peter Paal, Helen Poco
    Resuscitation.2025; 215: 110769.     CrossRef
  • Part 4: Systems of Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
    Cameron Dezfulian, José G. Cabañas, Jason R. Buckley, Rebecca E. Cash, Remle P. Crowe, Ian R. Drennan, Melissa Mahgoub, Candace N. Mannarino, Teresa May, David D. Salcido, Anezi I. Uzendu, Melissa A. Vogelsong, Joshua A. Worth, Saket Girotra
    Circulation.2025;[Epub]     CrossRef
  • Impact of intravenous accessibility and prehospital epinephrine use on survival outcomes of adult nontraumatic out-of-hospital cardiac arrest patients
    Song Yi Park, Byungho Choi, Sun Hyu Kim
    BMC Emergency Medicine.2024;[Epub]     CrossRef
  • Modification of termination of resuscitation rule with compression time interval in South Korea
    Song Yi Park, Daesung Lim, Ji Ho Ryu, Yong Hwan Kim, Byungho Choi, Sun Hyu Kim
    Scientific Reports.2023;[Epub]     CrossRef
  • Impact of COVID-19 on Out-of-Hospital Cardiac Arrest in Korea
    Young Su Kim, Seung Hyo Lee, Hyouk Jae Lim, Won Pyo Hong
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Interaction effects between insomnia and depression on risk of out-of-hospital cardiac arrest: Multi-center study
    Eujene Jung, Hyun Ho Ryu, Sung Wan Kim, Jung Ho Lee, Kyoung Jun Song, Young Sun Ro, Kyoung Chul Cha, Sung Oh Hwang, Billy Morara Tsima
    PLOS ONE.2023; 18(8): e0287915.     CrossRef
  • 8,398 View
  • 209 Download
  • 9 Web of Science
  • 10 Crossref

COVID-19 | Emergency Medicine Practice and Administration

Comparison of emergency department workloads before and during the COVID-19 pandemic as assessed using relative value units
Yu Jin Lee, Song Yi Park
Clin Exp Emerg Med 2022;9(4):354-360.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.277

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Comparison of emergency department workloads before and during the COVID-19 pandemic as assessed using relative value units
Clin Exp Emerg Med. 2022;9(4):354-360.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.277
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Comparison of emergency department workloads before and during the COVID-19 pandemic as assessed using relative value units
Clin Exp Emerg Med. 2022;9(4):354-360.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.277
Close
Objective
This study aimed to assess and compare emergency department (ED) workloads by using relative value units (RVUs) before and during the COVID-19 pandemic.
Methods
This retrospective observational study investigated the RVUs of a single ED from 2019 to 2021. We calculated the mean number of patients per day (PPD) for each year and selected the days when the number of patients was equal to the yearly mean PPD for each of the three years. We calculated the total RVUs per day and RVUs per patient and compared them.
Results
We analyzed the RVUs of 12 days in 2019 (mean PPD, 88), 10 days in 2020 (mean PPD, 75), and 14 days in 2021 (mean PPD, 83). The mean of the total RVUs per day were as follows: 533,057.5±66,239.1 in 2019, 505,994.6±48,935.4 in 2020, and 634,219.6±64,024.2 in 2021 (P<0.001). The RVUs per patient in the three year-groups were significantly different (6,057.5± 752.7 in 2019, 6,746.6±652.5 in 2020, and 7,641.2±771.4 in 2021; P<0.001). Post hoc analyses indicated that the total RVUs per day and the RVUs per patient in 2021 were significantly higher than in 2019 or 2020, although the mean PPD in 2019 was the highest.
Conclusion
Since the onset of the COVID-19 pandemic, the mean RVUs per patient have increased, suggesting that the workload per patient may also have increased in the regional emergency medical center.
  • 7,338 View
  • 201 Download

Trauma

Survival benefit of direct transport to trauma centers among patients with unintentional injuries in Korea: a propensity score-matched analysis
Dong Jun Lee, Seok Hoon Ko, Jongkyeong Kang, Myung Chun Kim, Han Zo Choi
Clin Exp Emerg Med 2023;10(1):37-43.   Published online September 29, 2022
DOI: https://doi.org/10.15441/ceem.22.318

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Survival benefit of direct transport to trauma centers among patients with unintentional injuries in Korea: a propensity score-matched analysis
Clin Exp Emerg Med. 2023;10(1):37-43.   Published online September 29, 2022
DOI: https://doi.org/10.15441/ceem.22.318
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Survival benefit of direct transport to trauma centers among patients with unintentional injuries in Korea: a propensity score-matched analysis
Clin Exp Emerg Med. 2023;10(1):37-43.   Published online September 29, 2022
DOI: https://doi.org/10.15441/ceem.22.318
Close
Objective
This study investigated the characteristics and survival rates of patients with unintentional severe trauma who visited a regional trauma center (TC) or a non-TC.
Methods
This retrospective, national, population-based, observational, case-control study included patients with abnormal Revised Trauma Score from January 2018 to December 2018. We divided hospitals into two types, TC and non-TC, and compared several variables, including in-hospital mortality. Propensity score matching was used to reduce the effect of confounding variables that influence survival outcome variables.
Results
Of the 25,743 patients, 5,796 visited a TC and 19,947 visited a non-TC. Compared to patients treated at non-TCs, patients treated at TCs were more likely to have a higher Injury Severity Score (TC, 11.5; non-TC, 7.4; P<0.001), higher rate of surgery or transcatheter arterial embolization (TC, 39.2%; non-TC, 17.6%; P<0.001), and higher admission rate (TC, 64.7%; non-TC, 36.9%; P<0.001) through the emergency department. After propensity score matching, 2,800 patients from both groups were analyzed. Patients in the TC had a higher survival rate than patients that were not treated in the TC (TC, 83.0%; non-TC, 78.6%; P=0.003).
Conclusion
This study using Korean emergency medical services data showed that initial transport to trauma centers was associated with mortality reduction. Further research is required because of limitations with use of single-year data and retrospective design.

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  • Intentionally self-injured patients have lower mortality when treated at trauma centers versus non-trauma centers in South Korea
    Jin Woo, Han Zo Choi, Jongkyeong Kang
    Trauma Surgery & Acute Care Open.2024; 9(1): e001258.     CrossRef
  • The Association Between Inter-Hospital Transfers and the Prognosis of Pediatric Injury in the Emergency Department
    Darjin Jung, Jin Hee Jung, Jin Hee Kim, Jie Hee Jue, Joong Wan Park, Do Kyun Kim, Jae Yun Jung, Eui Jun Lee, Jin Hee Lee, Dongbum Suh, Hyuksool Kwon
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • 7,982 View
  • 231 Download
  • 2 Web of Science
  • 2 Crossref

Resuscitation | Airway

Interactive effect of multi-tier response and advanced airway management on clinical outcomes after out-of-hospital cardiac arrest: a nationwide population-based observational study
Hyouk Jae Lim, Kyoung Jun Song, Sang Do Shin, Ki Hong Kim, Young Sun Ro, Hanna Yoon
Clin Exp Emerg Med 2022;9(3):187-197.   Published online September 26, 2022
DOI: https://doi.org/10.15441/ceem.21.169

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Interactive effect of multi-tier response and advanced airway management on clinical outcomes after out-of-hospital cardiac arrest: a nationwide population-based observational study
Clin Exp Emerg Med. 2022;9(3):187-197.   Published online September 26, 2022
DOI: https://doi.org/10.15441/ceem.21.169
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Interactive effect of multi-tier response and advanced airway management on clinical outcomes after out-of-hospital cardiac arrest: a nationwide population-based observational study
Clin Exp Emerg Med. 2022;9(3):187-197.   Published online September 26, 2022
DOI: https://doi.org/10.15441/ceem.21.169
Close
Objective
We hypothesized that a multi-tier response (MTR) will provide high-quality cardiopulmonary resuscitation including airway management. However, the type of tier response system and airway management will have different interactive effects resulting in varying outcomes following out-of-hospital cardiac arrest (OHCA). This study aimed to determine whether the advanced airway management method has an effect on OHCA outcomes and to compare the size of the effect across MTR types.
Methods
This is a retrospective population-based observational study using the Korea OHCA Registry. Airway management methods were categorized into endotracheal intubation (ETI) and supraglottic airway (SGA) groups. The tier system was categorized into single-tier response (STR) or two types of MTR: ambulance-ambulance MTR or fire engine-ambulance MTR.
Results
In total, 45,264 patients were analyzed among the 89,087 emergency medical service assessed OHCAs. The SGA group was significantly associated with a lower prehospital return of spontaneous circulation (ROSC) rate compared to the ETI group (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI], 0.72–0.88). Both MTR with an ambulance or fire engine were significantly associated with higher prehospital ROSC rates compared to STR (STR vs. MTR with an ambulance: aOR, 1.33; 95% CI, 1.21–1.47; STR vs. MTR with a fire engine: aOR, 1.43; 95% CI, 1.20–1.71). Prehospital SGA was significantly associated with poor neurological outcomes in MTR with fire engine (aOR, 0.71; 95% CI, 0.53–0.96).
Conclusion
In this nationwide observational study, we observed that MTR was associated with higher prehospital ROSC than STR. Moreover, SGA is associated with a lower prehospital ROSC rate regardless of tier response type compared to ETI.

Citations

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  • Assessing the need for quality control in direct medical oversight: a survey of emergency medical services providers and medical directors
    Daesung Lim, Sun Hyu Kim, Seong Chun Kim, Song Yi Park, Bongkyu Jeong
    Journal of EMS Medicine.2026; 5(1): 1.     CrossRef
  • Association Between the Number of Emergency Medical Services and the Chest Compression Quality in Out-of-Hospital Cardiac Arrest
    Sang A. Yoon, Ki Hong Kim, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee, Ki Jeong Hong, Young Sun Ro, Kyoung Jun Song, Sang Do Shin
    The Journal of Emergency Medicine.2025; 75: 89.     CrossRef
  • Current trends in emergency airway management: a clinical review
    Sangun Nah, Yonghee Lee, Sol Ji Choi, Jeongwoo Lee, Soyun Hwang, Seongmi Lim, Inhye Lee, Young Soon Cho, Hyun Soo Chung
    Clinical and Experimental Emergency Medicine.2024; 11(3): 243.     CrossRef
  • Interaction effects between insomnia and depression on risk of out-of-hospital cardiac arrest: Multi-center study
    Eujene Jung, Hyun Ho Ryu, Sung Wan Kim, Jung Ho Lee, Kyoung Jun Song, Young Sun Ro, Kyoung Chul Cha, Sung Oh Hwang, Billy Morara Tsima
    PLOS ONE.2023; 18(8): e0287915.     CrossRef
  • 6,723 View
  • 213 Download
  • 3 Web of Science
  • 4 Crossref

Emergency Medical Services | Cardiovascular

Association between prehospital recognition of acute myocardial infarction and length of stay in the emergency department
So Ra Song, Ki Hong Kim, Jeong Ho Park, Kyoung Jun Song, Sang Do Shin
Clin Exp Emerg Med 2022;9(4):323-332.   Published online September 16, 2022
DOI: https://doi.org/10.15441/ceem.22.330

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Association between prehospital recognition of acute myocardial infarction and length of stay in the emergency department
Clin Exp Emerg Med. 2022;9(4):323-332.   Published online September 16, 2022
DOI: https://doi.org/10.15441/ceem.22.330
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Association between prehospital recognition of acute myocardial infarction and length of stay in the emergency department
Clin Exp Emerg Med. 2022;9(4):323-332.   Published online September 16, 2022
DOI: https://doi.org/10.15441/ceem.22.330
Close
Objective
This study aimed to evaluate the association between prehospital recognition of acute myocardial infarction (AMI) and length of stay (LOS) in the emergency department (ED) of emergency medical service (EMS)-transported AMI patients.
Methods
A multicenter retrospective observational study was conducted using prehospital and hospital data from three tertiary emergency departments. Patients diagnosed with AMI between January 2015 and December 2018 were enrolled. Study groups were categorized according to prehospital recognition and prehospital 12-lead electrocardiography (ECG) into three groups based on an EMS cardiovascular registry: group A, no prehospital recognition (reference group); group B, prehospital recognition without 12-lead ECG; and group C, prehospital recognition with 12-lead ECG. The primary outcome was an ED LOS of less than 4 hours.
Results
Among 1,237 study participants, 722 (58.4%) were in group A, 325 (26.3%) were in group B, and 190 (15.4%) were in group C. Multivariable logistic regression showed that groups B and C had a higher likelihood of a short ED LOS (adjusted odds ratio [95% confidence interval]: group B, 1.64 [1.21–2.22] and group C, 1.88 [1.30–2.71]) than group A. There was no significant difference in ED LOS according to whether prehospital 12-lead ECG was conducted.
Conclusion
Prehospital recognition of AMI by EMS personnel, with or without 12-lead ECG, was associated with a short ED LOS.

Citations

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  • Emergency Medical Service Identification and Prehospital Care of Acute Coronary Syndrome Among Culturally and Linguistically Diverse Immigrants: Statewide Linkage Study
    Ararso Baru Olani, Stuart Howell, Kathryn Eastwood, Ziad Nehme, Emily Mahony, Emily Nehme, Dion Stub, Janet E. Bray
    Journal of the American Heart Association.2026;[Epub]     CrossRef
  • 9,518 View
  • 284 Download
  • 1 Web of Science
  • 1 Crossref

Resuscitation | Emergency Medical Services

Neurologic outcomes of prehospital mechanical chest compression device use during transportation of out-of-hospital cardiac arrest patients: a multicenter observational study
Chanhong Min, Dong Eun Lee, Hyun Wook Ryoo, Haewon Jung, Jae Wan Cho, Yun Jeong Kim, Jae Yun Ahn, Jungbae Park, You Ho Mun, Tae Chang Jang, Sang-chan Jin
Clin Exp Emerg Med 2022;9(3):207-215.   Published online August 31, 2022
DOI: https://doi.org/10.15441/ceem.21.142

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Neurologic outcomes of prehospital mechanical chest compression device use during transportation of out-of-hospital cardiac arrest patients: a multicenter observational study
Clin Exp Emerg Med. 2022;9(3):207-215.   Published online August 31, 2022
DOI: https://doi.org/10.15441/ceem.21.142
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Neurologic outcomes of prehospital mechanical chest compression device use during transportation of out-of-hospital cardiac arrest patients: a multicenter observational study
Clin Exp Emerg Med. 2022;9(3):207-215.   Published online August 31, 2022
DOI: https://doi.org/10.15441/ceem.21.142
Close
Objective
High-quality cardiopulmonary resuscitation with chest compression is important for good neurologic outcomes during out-of-hospital cardiac arrest (OHCA). Several types of mechanical chest compression devices have recently been implemented in Korean emergency medical services. This study aimed to identify the effect of prehospital mechanical chest compression device use on the outcomes of OHCA patients.
Methods
We retrospectively analyzed data drawn from the regional cardiac arrest registry in Daegu, Korea. This registry prospectively collected data from January 2017 to December 2020. Patients aged 18 years or older who experienced cardiac arrest presumed to have a medical etiology were included. The exposure variable was the use of a prehospital mechanical device during transportation by emergency medical technicians. The outcomes measured were neurologic outcomes and survival to discharge. Logistic regression analysis was used.
Results
Among 3,230 OHCA patients, 1,111 (34.4%) and 2,119 (65.6%) were managed with manual chest compression and with a mechanical chest compression device, respectively. The mechanical chest compression group showed poorer neurologic outcomes than the manual chest compression group (adjusted odds ratio, 0.12; 95% confidence interval, 0.04–0.33) and decreased survival to discharge (adjusted odds ratio, 0.39; 95% confidence interval, 0.19–0.82) after adjustment for confounding variables.
Conclusion
Prehospital mechanical chest compression device use in OHCA was associated with poorer neurologic outcomes and survival to discharge compared to manual chest compression.

Citations

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  • Adjusting on-scene CPR duration based on transport time interval in out-of-hospital cardiac arrest: a nationwide multicenter study
    Daseul Kim, Jae Yong Yu, Minha Kim, Gun Tak Lee, Sang Do Shin, Sung Yeon Hwang, Daun Jeong
    Scientific Reports.2025;[Epub]     CrossRef
  • Mechanical versus manual cardiopulmonary resuscitation (CPR): an umbrella review of contemporary systematic reviews and more
    Ayman El-Menyar, Mashhood Naduvilekandy, Sandro Rizoli, Salvatore Di Somma, Basar Cander, Sagar Galwankar, Fatimah Lateef, Mohamed Alwi Abdul Rahman, Prabath Nanayakkara, Hassan Al-Thani
    Critical Care.2024;[Epub]     CrossRef
  • Impact of the life-sustaining treatment decision act on organ donation in out-of-hospital cardiac arrests in South Korea: a multi-centre retrospective study
    Min Jae Kim, Dong Eun Lee, Jong Kun Kim, In Hwan Yeo, Haewon Jung, Jung Ho Kim, Tae Chang Jang, Sang-Hun Lee, Jinwook Park, Deokhyeon Kim, Hyun Wook Ryoo
    BMC Medical Ethics.2024;[Epub]     CrossRef
  • Individualized decision making in on-scene resuscitation time for out-of-hospital cardiac arrest using reinforcement learning
    Dong Hyun Choi, Min Hyuk Lim, Ki Jeong Hong, Young Gyun Kim, Jeong Ho Park, Kyoung Jun Song, Sang Do Shin, Sungwan Kim
    npj Digital Medicine.2024;[Epub]     CrossRef
  • Pediatric Chest Compression Improvement Via Augmented Reality Cardiopulmonary Resuscitation Feedback in Community General Emergency Departments: A Mixed-Methods Simulation-Based Pilot Study
    Keith Kleinman, Tai Hairston, Brittany Smith, Emma Billings, Sean Tackett, Eisha Chopra, Nicholas Risko, Daniel Swedien, Blake A. Schreurs, James L. Dean, Brandon Scott, Therese Canares, Justin M. Jeffers
    The Journal of Emergency Medicine.2023; 64(6): 696.     CrossRef
  • 9,270 View
  • 287 Download
  • 7 Web of Science
  • 5 Crossref

Emergency Medical Services | Airway

Association of transport time interval with neurologic outcome in out-of-hospital cardiac arrest patients without return of spontaneous circulation on scene and the interaction effect according to prehospital airway management
Yonghoon Jang, Tae Han Kim, Sun Young Lee, Young Sun Ro, Ki Jeong Hong, Kyoung Jun Song, Sang Do Shin
Clin Exp Emerg Med 2022;9(2):93-100.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.21.074

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Association of transport time interval with neurologic outcome in out-of-hospital cardiac arrest patients without return of spontaneous circulation on scene and the interaction effect according to prehospital airway management
Clin Exp Emerg Med. 2022;9(2):93-100.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.21.074
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Association of transport time interval with neurologic outcome in out-of-hospital cardiac arrest patients without return of spontaneous circulation on scene and the interaction effect according to prehospital airway management
Clin Exp Emerg Med. 2022;9(2):93-100.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.21.074
Close
Objective
This study analyzed the association of transport time interval (TTI) with survival rate and neurologic outcome in out-of-hospital cardiac arrest (OHCA) patients without return of spontaneous circulation (ROSC) and the interaction effect of TTI according to prehospital airway management.
Methods
A retrospective observational study based on the nationwide OHCA database from January 2013 to December 2017 was designed. Emergency medical service (EMS)-treated OHCA patients aged ≥18 years were included. TTI was categorized into four groups of quartiles (≤4, 5–7, 8–11, ≥12 minutes). The primary outcome was favorable neurologic outcome at discharge. The secondary outcome was survival to discharge from the hospital. Multivariable logistic regression was used to analyze outcomes according to TTI. A different effect of TTI according to the administration of prehospital EMS advanced airway was evaluated.
Results
In total, 83,470 patients were analyzed. Good neurologic recovery decreased as TTI increased (1.0% for TTI ≤4 minutes, 0.9% for TTI 5–7 minutes, 0.6% for TTI 8–11 minutes, and 0.5% for TTI ≥12 minutes; P for trend <0.05). The adjusted odds ratio of prolonged TTI (≥12 minutes) was 0.73 (95% confidence interval, 0.57–0.93; P<0.01) for good neurologic recovery. However, the negative effect of prolonged TTI on neurological outcome was insignificant when advanced airway or entotracheal intubation were performed by EMS providers (adjusted odds ratio, 1.17; 95% confidence interval, 0.42–3.29; P=0.76).
Conclusion
EMS TTI was negatively associated with the neurologic outcome of OHCA without ROSC on scene. When advanced airway was performed on scene, TTI was insignificantly associated with the outcome.

Citations

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  • Impact of establishing a new emergency and critical care center on regional out-of-hospital cardiac arrest transport patterns and outcomes
    Ichiro Hirayama, Minaho Nonaka, Hiromu Naraba, Tetsuhiro Yano, Mitsuru Ishii, Yoshiteru Tominaga
    Resuscitation Plus.2026; 29: 101336.     CrossRef
  • 佐賀県における院外心停止症例の特徴と全国データとの比較解析(Characteristics of out–of–hospital cardiac arrest in Saga Prefecture, Japan: A nationwide comparative analysis)
    品田 公太, 阪本 雄一郎, 松岡 綾華, 小網 博之
    Nihon Kyukyu Igakukai Zasshi: Journal of Japanese Association for Acute Medicine.2026; 37(7): 386.     CrossRef
  • Advanced age and neurological recovery in elderly patients with out-of-hospital cardiac arrest treated with targeted temperature management: a nationwide population‑based registry study 2016–2020
    Hyojeong Kwon, Sang-Min Kim, June-Sung Kim, Youn-Jung Kim, Won Young Kim
    Internal and Emergency Medicine.2025; 20(1): 281.     CrossRef
  • Validation of the Termination of Resuscitation Rules in Detroit
    Arqam Husain, Adam Chalek, Kaab Husain, Ryan J Reece, Robert B Dunne
    Cureus.2025;[Epub]     CrossRef
  • Factors associated with shock-refractory prehospital cardiac arrest
    Kyung Hun Yoo, Byuk Sung Ko, Won Young Kim, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Juncheol Lee, Sang Kuk Han, Phil Cho Choi, Young Hwan Lee, Sang O. Park, Jong Seok Lee, Ki Young Jeong, Sung Hyuk Choi, Young Hoon Yoon, Su Jin Kim, Kap Su Han, Min Seob Si
    Scientific Reports.2025;[Epub]     CrossRef
  • Out-of-hospital cardiac arrest outcomes’ determinants: an Italian retrospective cohort study based on Lombardia CARe
    Alice Clara Sgueglia, Leandro Gentile, Paola Bertuccio, Maddalena Gaeta, Margherita Zeduri, Daniela Girardi, Roberto Primi, Alessia Currao, Sara Bendotti, Gianluca Marconi, Giuseppe Maria Sechi, Simone Savastano, Anna Odone
    Internal and Emergency Medicine.2024; 19(7): 2035.     CrossRef
  • Current trends in emergency airway management: a clinical review
    Sangun Nah, Yonghee Lee, Sol Ji Choi, Jeongwoo Lee, Soyun Hwang, Seongmi Lim, Inhye Lee, Young Soon Cho, Hyun Soo Chung
    Clinical and Experimental Emergency Medicine.2024; 11(3): 243.     CrossRef
  • Comparison of prehospital resuscitation quality during scene evacuation and early ambulance transport in out-of-hospital cardiac arrest between residential location and non-residential location
    Seulki Choi, Tae Han Kim, Ki Jeong Hong, Stephen Gyung Won Lee, Jeong Ho Park, Young Sun Ro, Kyoung Jun Song, Sang Do Shin
    Resuscitation.2023; 182: 109680.     CrossRef
  • Copy-CAV: V2X-enabled wireless towing for emergency transport
    Constantine Ayimba, Valerio Cislaghi, Christian Quadri, Paolo Casari, Vincenzo Mancuso
    Computer Communications.2023; 205: 87.     CrossRef
  • Machine learning pre-hospital real-time cardiac arrest outcome prediction (PReCAP) using time-adaptive cohort model based on the Pan-Asian Resuscitation Outcome Study
    Hansol Chang, Ji Woong Kim, Weon Jung, Sejin Heo, Se Uk Lee, Taerim Kim, Sung Yeon Hwang, Sang Do Shin, Won Chul Cha, Marcus Ong
    Scientific Reports.2023;[Epub]     CrossRef
  • 9,048 View
  • 222 Download
  • 9 Web of Science
  • 10 Crossref

Injury & Prevention

Analysis of road traffic accidents involving standing electric scooters reported in newspapers in Italy
Tommaso Scquizzato, Lorenzo Gamberini, Federica Stella, Andrea Paoli, Arianna Gazzato, Alessandro Forti, Federico Semeraro
Clin Exp Emerg Med 2022;9(1):36-40.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.078

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Analysis of road traffic accidents involving standing electric scooters reported in newspapers in Italy
Clin Exp Emerg Med. 2022;9(1):36-40.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.078
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Analysis of road traffic accidents involving standing electric scooters reported in newspapers in Italy
Clin Exp Emerg Med. 2022;9(1):36-40.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.078
Close
Objective
As the use of electric scooters increased in Italy in the last years, we aimed to estimate the burden of accidents caused by this micro-mobility vehicle and identify characteristics, severity, and type of injuries.
Methods
We conducted a case series analysis of news reports about electric scooter crashes occurring in Italy from January 1, 2019 to September 30, 2020. Events were included when a road traffic accident involved an electric scooter and caused damages or injuries to the driver or others.
Results
We identified 96 road accidents involving electric scooters in Italy. The mean age of patients was 30 ± 16 years, and 79% (n = 71/90) were male. Of the 96 patients, only two (2%) were driving an electric scooter with a helmet, and three (3%) were driving while intoxicated. In 68% (n = 62/94) of cases, the incident was caused by a collision with another vehicle or a pedestrian, and 30% (n = 18/96) were transported with life-threatening injuries to the emergency department. In 15% (n = 14/96), the emergency medical service physician was dispatched to the scene. Head trauma was the most common injury (60%, n = 32/53). Patients who had life-threatening conditions were more likely to have head trauma than those who did not (82% [n = 9/11] vs. 55% [n = 23/42], P = 0.10). Polytrauma was significantly more common in patients with life-threatening conditions than in patients with no life-threatening conditions (36% [n = 4/11] vs. 5% [n = 2/42], P < 0.01). Fifteen percent of patients (n = 12/81) were admitted to the intensive care unit; only one death was reported.
Conclusion
Road traffic accidents involving electric scooters often result in serious injuries, including head trauma and polytrauma, necessitating the involvement of an emergency medical service physician and intensive care unit admission in a non-negligible percentage of instances.

Citations

Citations to this article as recorded by  Crossref logo
  • Work-related road traffic accidents: emergence of new modes of personal journey – analysis based on data from a register of road traffic accidents in France
    Emmanuel Fort, Nicolas Connesson, Julien Brière, Amina Ndiaye, Blandine Gadegbeku, Barbara Charbotel
    Injury Prevention.2025; 31(3): 242.     CrossRef
  • Electronic Scooter Versus Non-electronic Scooter Injuries: A Study Comparing Distal Radius Fracture Open Reduction and Internal Fixations in an Urban Trauma Centre
    Liang Zhi Wong, Anthony Kinnair, Chirag Rao, Ademola Adejuwon, Alistair R Hunter
    Cureus.2025;[Epub]     CrossRef
  • Analysis of dental traumatic patterns in standing electric scooter-related accidents
    Youngmin Kwon, Jihye Lim, Chunui Lee
    Injury.2024; 55(2): 111148.     CrossRef
  • Impact of COVID-19 pandemic on interhospital transfer of patients with major trauma in Korea: a retrospective cohort study
    Sung Hoon Cho, Woo Young Nho, Dong Eun Lee, Jae Yun Ahn, Joon-Woo Kim, Kyoung Hoon Lim, Hyun Wook Ryoo, Jong Kun Kim
    BMC Emergency Medicine.2024;[Epub]     CrossRef
  • The characteristics of e-scooter accidents reported by police in Türkiye
    Ebru Arikan Öztürk, Fatih Karaçor, Hikmet Bayirtepe
    Traffic Injury Prevention.2024; 25(8): 1089.     CrossRef
  • The Impact of Standing Electric Scooters on Maxillofacial Fractures: An Italian Multi-Centric Epidemiological Study
    Giovanni Salzano, Francesco Maffia, Luigi Angelo Vaira, Roberta Fusco, Massimo Albanese, Salvatore Crimi, Marco Cucurullo, Fabio Maglitto, Claudia Maugeri, Marzia Petrocelli, Francesca Pitino, Paolo Priore, Fabio Roccia, Alessandro Tel, Anna Maria Baietti
    Journal of Clinical Medicine.2024; 13(17): 5195.     CrossRef
  • The Investigation of Electric Scooter Accident Cases Admitted to the Emergency Department: A Multicenter Study
    Serbülent Kılıç, Melih Yüksel, Musa Şahin, Arzu Oto, Suna Eraybar, Vahide Aslıhan Durak, Sümeyye Tuğba Sarkı Cander
    Medical Science and Discovery.2023; 10(8): 640.     CrossRef
  • 10,369 View
  • 203 Download
  • 7 Web of Science
  • 7 Crossref

Emergency Medical Services | Resuscitation

Association between the number of prehospital defibrillation attempts and neurologic outcomes in out-of-hospital cardiac arrest patients without on-scene return of spontaneous circulation
Seulki Choi, Tae Han Kim, Ki Jeong Hong, Joo Jeong, Young Sun Ro, Kyoung Jun Song, Sang Do Shin
Clin Exp Emerg Med 2021;8(1):21-29.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.069

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Association between the number of prehospital defibrillation attempts and neurologic outcomes in out-of-hospital cardiac arrest patients without on-scene return of spontaneous circulation
Clin Exp Emerg Med. 2021;8(1):21-29.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.069
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Association between the number of prehospital defibrillation attempts and neurologic outcomes in out-of-hospital cardiac arrest patients without on-scene return of spontaneous circulation
Clin Exp Emerg Med. 2021;8(1):21-29.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.069
Close
Objective
Delivery of prehospital defibrillation for shockable rhythms by emergency medical service providers is crucial for successful resuscitation in out-of-hospital cardiac arrest (OHCA) patients. The optimal range of prehospital defibrillation attempts for refractory shockable rhythms is unknown. This study evaluated the association between the number of prehospital defibrillation attempts and neurologic outcomes in OHCA patients.
Methods
A retrospective observational study was conducted using the nationwide OHCA registry. Adult OHCA patients who were treated by emergency medical service providers due to presumed cardiac origin with initial shockable rhythm were enrolled from 2013 to 2016. The final analysis was performed on patients without on-scene return of spontaneous circulation. The number of prehospital defibrillation attempts was categorized as follows: 2–3, 4–5, and ≥6 attempts. The primary outcome was a good neurologic recovery at hospital discharge. Multivariate logistic regression analysis was performed to evaluate the association between neurologic outcomes and the number of prehospital defibrillation attempts.
Results
A total of 4,513 patients were included in the final analysis. The numbers of patients for whom 2–3, 4–5, and ≥6 defibrillation attempts were made were 2,720 (60.3%), 1,090 (24.2%), and 703 (15.5%), respectively. Poorer outcomes were associated with ≥6 defibrillation attempts: survival to hospital discharge (adjusted odds ratio, 0.38; 95% confidence interval, 0.21–0.65) and good neurologic recovery (adjusted odds ratio, 0.42; 95% confidence interval, 0.21–0.84).
Conclusion
Six or more prehospital defibrillation attempts were associated with poorer neurologic outcomes in OHCA patients with an initial shockable rhythm who were unresponsive to on-scene defibrillation and resuscitation.

Citations

Citations to this article as recorded by  Crossref logo
  • Predicting defibrillation outcomes by combining ventricular fibrillation and defibrillation waveforms: a retrospective clinical study
    Liang Wei, Yushun Gong, Jianjie Wang, Bihua Chen, Changlin Yin, Yongqin Li
    Resuscitation.2026; 218: 110906.     CrossRef
  • Factors associated with shock-refractory prehospital cardiac arrest
    Kyung Hun Yoo, Byuk Sung Ko, Won Young Kim, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Juncheol Lee, Sang Kuk Han, Phil Cho Choi, Young Hwan Lee, Sang O. Park, Jong Seok Lee, Ki Young Jeong, Sung Hyuk Choi, Young Hoon Yoon, Su Jin Kim, Kap Su Han, Min Seob Si
    Scientific Reports.2025;[Epub]     CrossRef
  • Temporal trends in the incidence and outcomes of shock-refractory ventricular fibrillation out-of-hospital cardiac arrest
    Abdulrahman Alhenaki, Zainab Alqudah, Brett Williams, Emily Nehme, Ziad Nehme
    Resuscitation Plus.2024; 18: 100597.     CrossRef
  • Impact of sex and role of coronary artery disease in out-of-hospital cardiac arrest presenting with refractory ventricular arrhythmias
    Maria Luce Caputo, Enrico Baldi, Joel Daniel Krüll, Damiano Pongan, Ruggero Cresta, Claudio Benvenuti, Roberto Cianella, Roberto Primi, Alessia Currao, Sara Bendotti, Sara Compagnoni, Francesca Romana Gentile, Luciano Anselmi, Simone Savastano, Catherine
    Frontiers in Cardiovascular Medicine.2023;[Epub]     CrossRef
  • 7,821 View
  • 113 Download
  • 5 Web of Science
  • 4 Crossref
The individual and neighborhood factors associated with the use of emergency medical services in patients with ST-elevation myocardial infarction
Hanzo Choi, Won Chul Cha, Ik Joon Jo, Jin-Ho Choi, Min Seob Sim, Taegun Shin
Clin Exp Emerg Med 2020;7(4):302-309.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.083

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The individual and neighborhood factors associated with the use of emergency medical services in patients with ST-elevation myocardial infarction
Clin Exp Emerg Med. 2020;7(4):302-309.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.083
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The individual and neighborhood factors associated with the use of emergency medical services in patients with ST-elevation myocardial infarction
Clin Exp Emerg Med. 2020;7(4):302-309.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.083
Close
Objective
The utilization of emergency medical services (EMS) varies widely among communities. In this study, we aimed to evaluate the relationship between the use of EMS by patients with ST-elevation myocardial infarction (STEMI) and the individual and neighborhood characteristics of these patients.
Methods
We performed a secondary analysis of data from the Cardiovascular Disease Surveillance project, which included patients diagnosed with STEMI at 29 emergency centers in South Korea. Our analysis included only patients living in Seoul, and the primary outcome measured was the use of EMS. While the clinical variables of the patients were collected from the Cardiovascular Disease Surveillance registry, the 2010 National Census data was used to identify neighborhood variables such as population density, income, age, and residence type. We used a 3-level hierarchical logistic regression to estimate the effects of neighborhood-level factors on EMS use by individual patients.
Results
We evaluated 1,634 patients with STEMI from 2007 to 2012. The neighborhoods were grouped into 25 counties. The regional rates of EMS use varied from 18.3% to 46.5%. The final adjusted logistic model revealed that the use of EMS was significantly associated with the average number of households (neighborhood level factor) and symptoms of syncope, cardiac arrest, and history of cardiovascular disease (individual level factors).
Conclusion
The individual levels factors had a greater influence on the use of EMS compared to the neighborhood-level factors.

Citations

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  • Characteristics of consecutive versus non-consecutive frequent emergency medical services transport to a single emergency department
    Sun Hyu Kim, Hyeji Lee, Fadwa Alhalaiqa
    PLOS ONE.2024; 19(5): e0301337.     CrossRef
  • Association of Symptoms and Mode of Transportation to Emergency Department in Patients With Acute Coronary Syndrome
    Leslie L. Davis, Thomas P. McCoy, Barbara Riegel, Sharon McKinley, Lynn V. Doering, Debra K. Moser
    Dimensions of Critical Care Nursing.2023; 42(2): 95.     CrossRef
  • 7,333 View
  • 82 Download
  • 2 Web of Science
  • 2 Crossref

Resuscitation | Epidemiology

Characteristics and outcomes of public bath-related out-of-hospital cardiac arrests in South Korea
Yung Jae Yoo, Gi Woon Kim, Choung Ah Lee, Yong Jin Park, Kyoung Mi Lee, Jin Seong Cho, Won Jung Jeong, Hyuk Joong Choi, Han Joo Choi, Nam Hun Heo, Hyung Jun Moon
Clin Exp Emerg Med 2020;7(3):225-233.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.071

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Characteristics and outcomes of public bath-related out-of-hospital cardiac arrests in South Korea
Clin Exp Emerg Med. 2020;7(3):225-233.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.071
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Characteristics and outcomes of public bath-related out-of-hospital cardiac arrests in South Korea
Clin Exp Emerg Med. 2020;7(3):225-233.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.071
Close
Objective
To analyze the differences in characteristics and outcomes between public bath (PB)- related and non-PB-related out-of-hospital cardiac arrest (OHCA) patients in South Korea.
Methods
We performed a retrospective observational analysis of collected data from the Smart Advanced Cardiac Life Support (SALS) registry between September 2015 and December 2018. We included adult OHCA patients (aged >18 years) with presumed OHCA of non-traumatic etiology who were attended by dispatched emergency medical services. SALS is a field advanced life support with smartphone-based direct medical direction. The primary outcome was the survival to discharge rate measured at the time of discharge.
Results
Of 38,995 cardiac arrest patients enrolled in the SALS registry, 11,889 were included in the final analysis. In total, 263 OHCAs occurred in PBs. Male sex and bystander cardiopulmonary resuscitation proportions appeared to be higher among PB patients than among non-PB patients. Percentages for shockable rhythm, witnessed rate, and number of underlying disease were lower in the PB group than in the non-PB group. Prehospital return of spontaneous circulation (11.4% vs. 19.5%, P=0.001), survival to discharge (2.3% vs. 9.9%, P<0.001), and favorable neurologic outcome (1.9% vs. 5.8%, P=0.007) in PB patients were significantly poorer than those in non-PB patients.
Conclusion
Patient characteristics and emergency medical services factors differed between PB and non-PB patients. All outcomes of PB-related OHCA were poorer than those of non-PB-related OHCA. Further treatment strategies should be developed to improve the outcomes of PBrelated cardiac arrest.

Citations

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  • Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest
    Juncheol Lee, Yongil Cho, Jaehoon Oh, Hyunggoo Kang, Tae Ho Lim, Byuk Sung Ko, Kyung Hun Yoo, Sang Hwan Lee
    JAMA Network Open.2023; 6(4): e237809.     CrossRef
  • Impact of crowding in local ambulance demand on call-to-ambulance scene arrival in out-of-hospital cardiac arrest
    Dae Kon Kim, Tae Han Kim, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Ki Jeong Hong, Joo Jeong
    The American Journal of Emergency Medicine.2022; 52: 105.     CrossRef
  • Developing a Time-Adaptive Prediction Model for Out-of-Hospital Cardiac Arrest: Nationwide Cohort Study in Korea
    Ji Woong Kim, Juhyung Ha, Taerim Kim, Hee Yoon, Sung Yeon Hwang, Ik Joon Jo, Tae Gun Shin, Min Seob Sim, Kyunga Kim, Won Chul Cha
    Journal of Medical Internet Research.2021; 23(7): e28361.     CrossRef
  • 8,686 View
  • 129 Download
  • 3 Web of Science
  • 3 Crossref
Variability in the effects of prehospital advanced airway management on outcomes of patients with out-of-hospital cardiac arrest
Young Seok Oh, Ki Ok Ahn, Sang Do Shin, Kentaro Kagino, Tatsuya Nishiuchi, Matthew Ma, Patrick Ko, Marcus Eng Hock Ong, Ng Yih Yng, Benjamin Leong
Clin Exp Emerg Med 2020;7(2):95-106.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.022

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Variability in the effects of prehospital advanced airway management on outcomes of patients with out-of-hospital cardiac arrest
Clin Exp Emerg Med. 2020;7(2):95-106.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.022
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Variability in the effects of prehospital advanced airway management on outcomes of patients with out-of-hospital cardiac arrest
Clin Exp Emerg Med. 2020;7(2):95-106.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.022
Close
Objective
To investigate variations in the effects of prehospital advanced airway management (AAM) on outcomes of out-of-hospital cardiac arrest (OHCA) patients according to regional emergency medical service (EMS) systems in four Asian cities.
Methods
We enrolled adult patients with EMS-treated OHCA of presumed cardiac origin between 2012 and 2014 from Osaka (Japan), Seoul (Republic of Korea), Singapore (Singapore), and Taipei (Taiwan). The main exposure variable was prehospital AAM. The primary endpoint was neurological recovery. We compared outcomes between the prehospital AAM and non-AAM groups using multivariable logistic regression with an interaction term between prehospital AAM and the four Asian cities.
Results
A total of 16,510 patients were included in the final analyses. The rates of prehospital AAM varied among Osaka, Seoul, Singapore, and Taipei (65.0%, 19.2%, 84.9%, and 34.1%, respectively). The non-AAM group showed better outcomes than the AAM group (adjusted odds ratio [aOR] for neurological recovery 0.30; 95% confidence interval [CI], 0.24–0.38]). In the interaction model for neurological recovery, the aORs for AAM in Osaka and Singapore were 0.12 (95% CI, 0.06–0.26) and 0.21 (95% CI, 0.16–0.28), respectively. In Seoul and Taipei, the association between prehospital AAM and neurological recovery was not significant (aOR 0.58 [95% CI, 0.31–1.10] and 0.79 [95% CI, 0.52–1.20], respectively). The interaction between prehospital AAM and region was significant (P=0.01).
Conclusion
The effects of prehospital AAM on outcomes of OHCA patients differed according to regional variability in the EMS systems.

Citations

Citations to this article as recorded by  Crossref logo
  • The association of prehospital advanced airway management time and outcome in out-of hospital cardiac arrest patients
    Thongpitak Huabbangyang, Pramote Papukdee, Rossakorn Klaiangthong, Fahsai Jaibergban, Pannika Paharat, Patcharaporn Doungkaew, Fatiha Chanthep, Menatthinee Suntimetaneedol, Sitthichai Chuanart
    Scientific Reports.2026;[Epub]     CrossRef
  • Factors influencing the prognosis of out-of-hospital cardiac arrest during the coronavirus disease 2019 pandemic: an analysis of the Utstein Registry in Aichi, Japan
    Masaki Ito, Toshie Manabe, Tomonori Hattori
    BMC Emergency Medicine.2026;[Epub]     CrossRef
  • Association between endotracheal intubation and outcomes of nonshockable out-of-hospital cardiac arrest in Japan
    Mai Nakai-Uchida, Masato Uchida, Shinobu Tamura, Atsushi Kubo, Kosei Kunitatsu, Tsuyoshi Nakashima, Ryosuke Horitani, Yoshinori Kajimoto, Shigeaki Inoue, Masaya Hironishi
    BMC Emergency Medicine.2025;[Epub]     CrossRef
  • Association Between Advanced Airway Management With Adrenaline Injection and Prognosis in Adult Patients With Asystole Asphyxia Out-of-hospital Cardiac Arrest
    Kenichi Katabami, Takashi Kimura, Takumi Hirata, Akiko Tamakoshi
    Journal of Epidemiology.2024; 34(1): 31.     CrossRef
  • Association of prehospital advanced airway and epinephrine with survival in patients with out-of-hospital cardiac arrest
    Sejoong Ahn, Bo-Yeong Jin, Hanjin Cho, Sungwoo Moon, Young-Duck Cho, Jong-Hak Park
    Scientific Reports.2023;[Epub]     CrossRef
  • Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study
    Jae Yun Ahn, Hyun Wook Ryoo, Sungbae Moon, Haewon Jung, Jungbae Park, Won Kee Lee, Jong-yeon Kim, Dong Eun Lee, Jung Ho Kim, Sang-Hun Lee
    BMC Emergency Medicine.2023;[Epub]     CrossRef
  • Impact of different medical direction policies on prehospital advanced airway management for out-of hospital cardiac arrest patients: A retrospective cohort study
    Takashi Hongo, Tetsuya Yumoto, Hiromichi Naito, Takeshi Mikane, Atsunori Nakao
    Resuscitation Plus.2022; 9: 100210.     CrossRef
  • Effects of prehospital management in out-of-hospital cardiac arrest: advanced airway and adrenaline administration
    Yu Wang, Qun Zhang, Guang Bo Qu, Fang Fang, Xiao Kang Dai, Liang Xi Yu, Hong Zhang
    BMC Health Services Research.2022;[Epub]     CrossRef
  • Nationwide population-based study of poisoning-induced out-of-hospital cardiac arrest in South Korea
    Gihun Park, Chiwon Ahn, Jae Hwan Kim
    BMJ Open.2022; 12(4): e060378.     CrossRef
  • The association of delayed advanced airway management and neurological outcome after out-of-hospital cardiac arrest in Japan
    Koshi Nakagawa, Ryo Sagisaka, Daigo Morioka, Shota Tanaka, Hiroshi Takyu, Hideharu Tanaka
    The American Journal of Emergency Medicine.2022; 62: 89.     CrossRef
  • Effect of Advanced Airway Management by Paramedics During Out-of-Hospital Cardiac Arrest on Chest Compression Fraction and Return of Spontaneous Circulation
    Koji Shimizu, Masahiro Wakasugi, Toshiomi Kawagishi, Tomoya Hatano, Takamasa Fuchigami, Hiroshi Okudera
    Open Access Emergency Medicine.2021; Volume 13: 305.     CrossRef
  • 8,690 View
  • 120 Download
  • 12 Web of Science
  • 11 Crossref

Airway | Resuscitation

Comparing the neurologic outcomes of patients with out-of-hospital cardiac arrest according to prehospital advanced airway management method and transport time interval
Sol Kim, Dong Eun Lee, Sungbae Moon, Jae Yun Ahn, Won Kee Lee, Jong Kun Kim, Jungbae Park, Hyun Wook Ryoo
Clin Exp Emerg Med 2020;7(1):21-29.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.002

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Comparing the neurologic outcomes of patients with out-of-hospital cardiac arrest according to prehospital advanced airway management method and transport time interval
Clin Exp Emerg Med. 2020;7(1):21-29.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.002
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Comparing the neurologic outcomes of patients with out-of-hospital cardiac arrest according to prehospital advanced airway management method and transport time interval
Clin Exp Emerg Med. 2020;7(1):21-29.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.002
Close
Objective
The incidences of prehospital advanced airway management by emergency medical technicians in South Korea are increasing; however, whether this procedure improves the survival outcomes of patients experiencing out-of-hospital cardiac arrest remains unclear. The present study aimed to investigate the association between prehospital advanced airway management and neurologic outcomes according to a transport time interval (TTI) using the Korean Cardiac Arrest Research Consortium database.

Methods
We retrospectively analyzed the favorable database entries that were prospectively collected between October 2015 and December 2016. Patients aged 18 years or older who experienced cardiac arrest that was presumed to be of a medical etiology and that occurred prior to the arrival of emergency medical service personnel were included. The exposure variable was the type of prehospital airway management provided by emergency medical technicians. The primary endpoint was a favorable neurologic outcome.

Results
Of 1,871 patients who experienced out-of-hospital cardiac arrest, 785 (42.0%), 121 (6.5%), and 965 (51.6%) were managed with bag-valve-mask ventilation, endotracheal intubation (ETI), and supraglottic airway (SGA) devices, respectively. SGAs and ETI provided no advantage in terms of favorable neurologic outcome in patients with TTIs ≥12 minutes (odds ratio [OR], 1.37; confidence interval [CI], 0.65–2.87 for SGAs; OR, 1.31; CI, 0.30–5.81 for ETI) or in patients with TTI <12 minutes (OR, 0.57; CI, 0.31–1.07 for SGAs; OR, 0.63; CI, 0.12–3.26 for ETI).

Conclusion
Neither the prehospital use of SGA nor administration of ETI was associated with superior neurologic outcomes compared with bag-valve-mask ventilation.

Citations

Citations to this article as recorded by  Crossref logo
  • Airway management with a supraglottic airway device during resuscitation by basic life support providers: a systematic review
    Guillaume Debaty, Nicholas J. Johnson, Gavin Perkins, Vihara Dassanayake, Lucas Snow, Nicolas Segond, Laurie J. Morrison, Janet E. Bray, Michael Smyth, Theresa Olasveengen, Rebecca Cash, Julie Considine, Sung Phil Chung, Katie Dainty, Bridget Dicker, Fred
    Resuscitation.2026; : 111152.     CrossRef
  • Early Advanced Airway Management and Clinical Outcomes in Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study
    Jung Ho Lee, Dahae Lee, Eujene Jung, Hyun Ho Ryu, Jeong Ho Park, Young Sun Ro, Kyoung Jun Song
    Journal of Clinical Medicine.2025; 14(21): 7652.     CrossRef
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  • 4 Web of Science
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Review Article

Emergency Medical Services

Promotion of prehospital emergency care through clinical decision support systems: opportunities and challenges
Azadeh Bashiri, Behrouz Alizadeh Savareh, Marjan Ghazisaeedi
Clin Exp Emerg Med 2019;6(4):288-296.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.032

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Promotion of prehospital emergency care through clinical decision support systems: opportunities and challenges
Clin Exp Emerg Med. 2019;6(4):288-296.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.032
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Promotion of prehospital emergency care through clinical decision support systems: opportunities and challenges
Clin Exp Emerg Med. 2019;6(4):288-296.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.032
Close
Clinical decision support systems are interactive computer systems for situational decision making and can improve decision efficiency and safety of care. We investigated the role of these systems in enhancing prehospital care. This narrative review included full-text articles published since 2000 that were available in databases/e-journals including Web of Science, PubMed, Science Direct, and Google Scholar. Search keywords included “clinical decision support system,” “decision support system,” “decision support tools,” “prehospital care,” and “emergency medical services.” Non-journal articles were excluded. We revealed 14 relevant studies that used such a support system in prehospital emergency medical service. Owing to the dynamic nature of emergency situations, decision timing is critical. Four key factors demonstrated the ability of clinical decision support systems to improve decision-making, reduce errors, and improve the safety of prehospital emergency activity: computer-based, offer support as a natural part of the workflow, provide decision support in the time and place of decision making, and offer practical advice. The use of clinical decision support systems in prehospital care resulted in accurate diagnoses, improved patient triage and patient outcomes, and reduction of prehospital time. By improving emergency management and rescue operations, the quality of prehospital care will be enhanced.

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Case Report

Airway

Prehospital tracheotomy in a case of avulsion of the larynx with a comminuted fracture of the jawbone
Holger Rupprecht, Katharina Gaab
Clin Exp Emerg Med 2019;6(2):173-176.   Published online April 3, 2019
DOI: https://doi.org/10.15441/ceem.18.016

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Prehospital tracheotomy in a case of avulsion of the larynx with a comminuted fracture of the jawbone
Clin Exp Emerg Med. 2019;6(2):173-176.   Published online April 3, 2019
DOI: https://doi.org/10.15441/ceem.18.016
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Prehospital tracheotomy in a case of avulsion of the larynx with a comminuted fracture of the jawbone
Clin Exp Emerg Med. 2019;6(2):173-176.   Published online April 3, 2019
DOI: https://doi.org/10.15441/ceem.18.016
Close
Emergency physicians in the field are sometimes confronted with cases wherein patients cannot be intubated and ventilated. In some cases, cricothyrotomy, the method of choice for securing an emergency airway, may not have a successful outcome. We report a rare case of a 35-yearold male patient with avulsion of the larynx and a comminuted fracture of the jawbone, due to entrapment in a dung excavator. Prehospital tracheotomy was successfully performed. In cases with crush injuries to the larynx, anatomic structures, including the ligamentum conicum, are destroyed. In addition, massive subcutaneous emphysema blurs the anatomical key structures; hence, only a tracheotomy can prevent a lethal outcome.

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  • 8,486 View
  • 133 Download
  • 2 Web of Science
  • 2 Crossref
Original Articles

Emergency Medical Services | Cardiovascular

Sensitivity, specificity, and predictive value of cardiac symptoms assessed by emergency medical services providers in the diagnosis of acute myocardial infarction: a multi-center observational study
Jeong Ho Park, Sung Woo Moon, Tae Yun Kim, Young Sun Ro, Won Chul Cha, Yu Jin Kim, Sang Do Shin
Clin Exp Emerg Med 2018;5(4):264-271.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.257

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Sensitivity, specificity, and predictive value of cardiac symptoms assessed by emergency medical services providers in the diagnosis of acute myocardial infarction: a multi-center observational study
Clin Exp Emerg Med. 2018;5(4):264-271.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.257
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Sensitivity, specificity, and predictive value of cardiac symptoms assessed by emergency medical services providers in the diagnosis of acute myocardial infarction: a multi-center observational study
Clin Exp Emerg Med. 2018;5(4):264-271.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.257
Close
Objective
For patients with acute myocardial infarction (AMI), symptoms assessed by emergency medical services (EMS) providers have a critical role in prehospital treatment decisions. The purpose of this study was to evaluate the diagnostic accuracy of EMS provider-assessed cardiac symptoms of AMI.
Methods
Patients transported by EMS to 4 study hospitals from 2008 to 2012 were included. Using EMS and administrative emergency department databases, patients were stratified according to the presence of EMS-assessed cardiac symptoms and emergency department diagnosis of AMI. Cardiac symptoms were defined as chest pain, dyspnea, palpitations, and syncope. Disproportionate stratified sampling was used, and medical records of sampled patients were reviewed to identify an actual diagnosis of AMI. Using inverse probability weighting, verification bias-corrected diagnostic performance was estimated.
Results
Overall, 92,353 patients were enrolled in the study. Of these, 13,971 (15.1%) complained of cardiac symptoms to EMS providers. A total of 775 patients were sampled for hospital record review. The sensitivity, specificity, positive predictive value, and negative predictive value of EMS provider-assessed cardiac symptoms for the final diagnosis of AMI was 73.3% (95% confidence interval [CI], 70.8 to 75.7), 85.3% (95% CI, 85.3 to 85.4), 3.9% (95% CI, 3.6 to 4.2), and 99.7% (95% CI, 99.7 to 99.8), respectively.
Conclusion
We found that EMS provider-assessed cardiac symptoms had moderate sensitivity and high specificity for diagnosis of AMI. EMS policymakers can use these data to evaluate the pertinence of specific prehospital treatment of AMI.

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    Statistics in Medicine.2025;[Epub]     CrossRef
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    Chun Yiu Wong, Rex Pui Kin Lam, Kent Shek Cheung, Wing Man Kwok, Tat Chi Tsang, Matthew Sik Hon Tsui, Timothy Hudson Rainer
    Hong Kong Journal of Emergency Medicine.2025;[Epub]     CrossRef
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    Jonathan R Powell, Maria F Gallo, Payal Chakraborty, Colleen A Reynolds, Morgan Anderson, Parvati Singh
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    Ji Hoon Kim
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    Muhammad Shafiq, Diego Robles Mazzotti, Cheryl Gibson
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    Charles Richard Knoery, Janet Heaton, Rob Polson, Raymond Bond, Aleeha Iftikhar, Khaled Rjoob, Victoria McGilligan, Aaron Peace, Stephen James Leslie
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  • 147 Download
  • 5 Web of Science
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Effect of typhoons on the Korean national emergency medical service system
Soo Hyun Park, Won Chul Cha, Giwoon Kim, Tae Rim Lee, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo
Clin Exp Emerg Med 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255

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Effect of typhoons on the Korean national emergency medical service system
Clin Exp Emerg Med. 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255
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Effect of typhoons on the Korean national emergency medical service system
Clin Exp Emerg Med. 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255
Close
Objective
While the effect of typhoons on emergency medicine has been evaluated, data are scarce on their effects on the emergency medical service (EMS). This study evaluated the effect of typhoons on EMS patients and performance.
Methods
The study period was January 2010 to December 2012. Meteorological data regarding typhoons were provided by the Korean Meteorological Administration. EMS data were retrieved from the EMS database of the national emergency management agency. The database includes ambulance run sheets, which contain clinical and operational data. In this case-crossover study, the cases and controls were EMS calls on the day of typhoon warnings and calls one week prior to the typhoon warnings, respectively.
Results
During the study period, 11 typhoons affected Korea. A total of 14,521 cases were selected for analysis. Overall, there were no obvious differences between the case and control groups. However, there were statistically significant differences in age, place, and time requests. There were fewer patients between 0 and 15 years of age (P=0.01) and more unconscious patients (P=0.01) in the case group. The EMS operational performance, as measured by the times elapsed between call to start, call to field, and call to hospital did not differ significantly. There was also no significant difference in the time from hospital arrival between the cases (28.67, standard deviation 16.37) and controls (28.97, standard deviation 28.91) (P=0.39).
Conclusion
Typhoons did not significantly affect the EMS system in this study. Further study is necessary to understand the reasons for this finding.
  • 8,474 View
  • 124 Download

Emergency Medicine Practice and Administration

Factors associated with satisfaction with pediatric emergency department services in Korea: analysis of Korea Health Panel Data 2010 to 2012
Kyeong Jae Lee, Min Joung Kim, Joon Min Park, Kyung Hwan Kim, Junseok Park, Dong Wun Shin, Hoon Kim, Woochan Jeon, Hyunjong Kim
Clin Exp Emerg Med 2018;5(3):156-164.   Published online September 30, 2018
DOI: https://doi.org/10.15441/ceem.17.254

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Factors associated with satisfaction with pediatric emergency department services in Korea: analysis of Korea Health Panel Data 2010 to 2012
Clin Exp Emerg Med. 2018;5(3):156-164.   Published online September 30, 2018
DOI: https://doi.org/10.15441/ceem.17.254
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Factors associated with satisfaction with pediatric emergency department services in Korea: analysis of Korea Health Panel Data 2010 to 2012
Clin Exp Emerg Med. 2018;5(3):156-164.   Published online September 30, 2018
DOI: https://doi.org/10.15441/ceem.17.254
Close
Objective
We aimed to investigate the factors related to satisfaction with the pediatric emergency department service in Korea.
Methods
This study examined data from the Korea Health Panel Data from 2010 to 2012. Pediatric patients who visited the emergency department at least once between 2010 and 2012 in Korea were included. Data were collected on patient satisfaction with the emergency department service, and factors related to the patient characteristics, emergency department service process, and medical institution. We compared the dissatisfied and satisfied groups, and calculated the odds ratios for satisfaction according to each variable.
Results
A total of 1,505 emergency department visits from 947 pediatric patients during the 3-year period were analyzed. We estimated that about 79.5% of patients in the population were satisfied. The odds of expressing satisfaction were higher among males than in females, and among patients who were hospitalized after emergency department treatment compared to those who were transferred to another hospital. Conversely, the odds of expressing satisfaction were lower among patients who had a chronic disease, a financial source other than National Health Insurance, experienced hospitalization within 1 year.
Conclusion
Our study results might be helpful for establishing a satisfactory pediatric emergency medical service system. In the future, further prospective studies evaluating the causal relationships between the relevant factors and patient satisfaction are warranted.

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    Pediatric Emergency Care.2023; 39(5): 324.     CrossRef
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    Socio-Economic Planning Sciences.2021; 78: 101036.     CrossRef
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Emergency Medical Services

Effect of emergency medical service use on time interval from symptom onset to hospital admission for definitive care among patients with intracerebral hemorrhage: a multicenter observational study
Dae Gon Kim, Yu Jin Kim, Sang Do Shin, Kyoung Jun Song, Eui Jung Lee, Yu Jin Lee, Ki Jeong Hong, Ju Ok Park, Young Sun Ro, Yoo Mi Park
Clin Exp Emerg Med 2017;4(3):168-177.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.16.147

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Effect of emergency medical service use on time interval from symptom onset to hospital admission for definitive care among patients with intracerebral hemorrhage: a multicenter observational study
Clin Exp Emerg Med. 2017;4(3):168-177.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.16.147
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Effect of emergency medical service use on time interval from symptom onset to hospital admission for definitive care among patients with intracerebral hemorrhage: a multicenter observational study
Clin Exp Emerg Med. 2017;4(3):168-177.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.16.147
Close
Objective
This study evaluated whether emergency medical service (EMS) use was associated with early arrival and admission for definitive care among intracerebral hemorrhage (ICH) patients. Methods Patients with ICH were enrolled from 29 hospitals between November 2007 and December 2012, excluding those patients with subarachnoid hemorrhage, traumatic ICH, and missing information. The patients were divided into four groups based on visit type to the definitive hospital emergency department (ED): direct visit by EMS (EMS-direct), direct visit without EMS (non-EMS-direct), transferred from a primary hospital by EMS (EMS-transfer), and transferred from a primary hospital without EMS (non-EMS-transfer). The outcomes were the proportions of participants within early (<1 hr) definitive hospital ED arrival from symptom onset (pS2ED) and those within early (<4 hr) admission from symptom onset (pS2AD). Adjusted odds ratios were calculated to determine the association between EMS use and outcomes with and without inter-hospital transfer. Results A total of 6,564 patients were enrolled. The adjusted odds ratios (95% confidence intervals) for pS2ED were 22.95 (17.73–29.72), 1.11 (0.67–1.84), and 7.95 (6.04–10.46) and those for pS2AD were 5.56 (4.70–6.56), 0.96 (0.71–1.30), and 2.35 (1.94–2.84) for the EMS-direct, EMS-transfer, and non-EMS-direct groups compared with the non-EMS-transfer group, respectively. Through the interaction model, EMS use was significantly associated with early arrival and admission among direct visiting patients but not with transferred patients. Conclusion EMS use was significantly associated with shorter time intervals from symptom onset to arrival and admission at a definitive care hospital. However, the effect disappeared when patients were transferred from a primary hospital.

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  • Emergency Medical Services Compliance With Prehospital Stroke Quality Metrics Is Associated With Faster Stroke Evaluation and Treatment
    J. Adam Oostema, Adrienne Nickles, Justin Allen, Ghada Ibrahim, Zhehui Luo, Mathew J. Reeves
    Stroke.2024; 55(1): 101.     CrossRef
  • A Narrative Review of Interhospital Transfers for Intracerebral Hemorrhage
    Neha S. Dangayach, Masha Morozov, Ian Cossentino, John Liang, Deeksha Chada, Devin Bageac, Laura Salgado, Wheatonia Malekebu, Christopher Kellner, Joshua Bederson
    World Neurosurgery.2024; 190: 1.     CrossRef
  • Epidemiology of hypertensive intracerebral hemorrhages in the Republic of Tatarstan
    M. M. Iachkurinskikh, D. R. Khasanova, V. I. Danilov
    Russian Neurosurgical Journal named after Professor A. L. Polenov.2024; 16(3): 125.     CrossRef
  • Emergency Medical Services Stroke Care Performance Variability in Michigan: Analysis of a Statewide Linked Stroke Registry
    J. Adam Oostema, Adrienne Nickles, Zhehui Luo, Mathew J. Reeves
    Journal of the American Heart Association.2023;[Epub]     CrossRef
  • ANÁLISIS DE LOS INDICADORES DE GESTIÓN DEL SERVICIO MÓVIL DE ATENCIÓN DE URGENCIAS DE CEARÁ
    Natália Pinheiro Fabricio Formiga, Lucilane Maria Sales da Silva, José Hiago Feitosa de Matos, Emiliana Bezerra Gomes, Kelly Fernanda Silva Santana, Francisco Edilson Ferreira, Maria Veraci Oliveira Queiroz
    Cogitare Enfermagem.2023;[Epub]     CrossRef
  • ANÁLISE DOS INDICADORES DE GESTÃO DO SERVIÇO DE ATENDIMENTO MÓVEL DE URGÊNCIAS DO CEARÁ
    Natália Pinheiro Fabricio Formiga, Lucilane Maria Sales da Silva, José Hiago Feitosa de Matos, Emiliana Bezerra Gomes, Kelly Fernanda Silva Santana, Francisco Edilson Ferreira, Maria Veraci Oliveira Queiroz
    Cogitare Enfermagem.2023;[Epub]     CrossRef
  • ANALYSIS OF THE MANAGEMENT INDICATORS OF THE MOBILE EMERGENCY CARE SERVICE OF CEARÁ
    Natália Pinheiro Fabricio Formiga, Lucilane Maria Sales da Silva, José Hiago Feitosa de Matos, Emiliana Bezerra Gomes, Kelly Fernanda Silva Santana, Francisco Edilson Ferreira, Maria Veraci Oliveira Queiroz
    Cogitare Enfermagem.2023;[Epub]     CrossRef
  • 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association
    Steven M. Greenberg, Wendy C. Ziai, Charlotte Cordonnier, Dar Dowlatshahi, Brandon Francis, Joshua N. Goldstein, J. Claude Hemphill, Ronda Johnson, Kiffon M. Keigher, William J. Mack, J. Mocco, Eileena J. Newton, Ilana M. Ruff, Lauren H. Sansing, Sam Schu
    Stroke.2022;[Epub]     CrossRef
  • Accuracy and Implications of Hemorrhagic Stroke Recognition by Emergency Medical Services
    J. Adam Oostema, Todd Chassee, William Baer, Allison Edberg, Mathew J. Reeves
    Prehospital Emergency Care.2021; 25(6): 796.     CrossRef
  • Influence of time to admission to a comprehensive stroke centre on the outcome of patients with intracerebral haemorrhage
    Luis Prats-Sánchez, Marina Guasch-Jiménez, Ignasi Gich, Elba Pascual-Goñi, Noelia Flores, Pol Camps-Renom, Daniel Guisado-Alonso, Alejandro Martínez-Domeño, Raquel Delgado-Mederos, Ana Rodríguez-Campello, Angel Ois, Alejandra Gómez-Gonzalez, Elisa Cuadrad
    European Stroke Journal.2020; 5(2): 115.     CrossRef
  • 10,936 View
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  • 9 Web of Science
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Infectious Disease | Emergency Medical Services

Impact of Middle East respiratory syndrome outbreak on the use of emergency medical resources in febrile patients
Hyunho Jeong, Sikyoung Jeong, Juseok Oh, Seon Hee Woo, Byung Hak So, Jeong Hee Wee, Ji Hoon Kim, Ji Yong Im, Seung Pill Choi, Kyoungnam Park, Byul Nim Hee Cho, Sungyoup Hong
Clin Exp Emerg Med 2017;4(2):94-101.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.166

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Impact of Middle East respiratory syndrome outbreak on the use of emergency medical resources in febrile patients
Clin Exp Emerg Med. 2017;4(2):94-101.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.166
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Impact of Middle East respiratory syndrome outbreak on the use of emergency medical resources in febrile patients
Clin Exp Emerg Med. 2017;4(2):94-101.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.166
Close
Objective
Outbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources.
Methods
An ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea. All demographic and diagnostic data from patients presenting with febrile symptoms as a main complaint were collected. The data were compared to the equivalent period in the three years preceding the MERS outbreak in Korea.
Results
Following the MERS outbreak, there was an increase in overall ED visits by febrile patients and the proportion of visits by febrile patients, relative to total ED attendances. This effect was more prominent in the children under five years. The duration of the chief complaint before ED arrival and the length of ED stay were significantly increased among younger pediatric patients. Decreased body temperature on arrival was observed in younger pediatric patients.
Conclusion
MERS outbreak appears to have had a significant effects on ED use by febrile patients. The use of emergency care services by pediatric patients makes them more vulnerable to an outbreak of a transmissable disease. An effective strategy to control emergency center visits by non-urgent febrile patients and provide proper medical services is urgently needed.

Citations

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  • The Impact of the COVID-19 Pandemic on the Utilization of Outdoor Services at Secondary Care Hospitals of Punjab, Pakistan
    Atiq ur Rahman, Muhammad Imran, Zarmeena Yasmeen, Muzammil Irshad
    The International Journal of Frontier Sciences.2024; 4(2): 1.     CrossRef
  • Characteristics of pediatric emergency department visits before and during the COVID-19 pandemic: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Jin Hyuck Hong, So Hyun Paek, Taerim Kim, Seongjung Kim, Eunsil Ko, Young Sun Ro, Jungeon Kim, Jae Hyun Kwon
    Clinical and Experimental Emergency Medicine.2023; 10(S): S13.     CrossRef
  • Assessment of the Preparedness and Planning of Academic Emergency Departments in India During the COVID-19 Pandemic: A Multicentric Survey
    Vivek Gopinathan, Sanjan Asanaru Kunju, Vimal Krishnan S, Freston Marc Sirur, Jayaraj Mymbilly Balakrishnan
    Disaster Medicine and Public Health Preparedness.2022; 16(5): 1910.     CrossRef
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    Sua Kim, Hangseok Choi, Jae Kyeom Sim, Won Jai Jung, Young Seok Lee, Je Hyeong Kim
    Annals of Intensive Care.2022; 12(1): 57.     CrossRef
  • Impact of temporary closures of emergency departments during the COVID-19 outbreak on clinical outcomes for emergency patients in a metropolitan area
    Dong Eun Lee, Young Sun Ro, Hyun Wook Ryoo, Sungwoo Moon
    The American Journal of Emergency Medicine.2021; 47: 35.     CrossRef
  • Impact of the COVID-19 Outbreak on Emergency Care Utilization in Patients with Acute Myocardial Infarction: a Nationwide Population-based Study
    Ho Kyung Sung, Jin Hui Paik, Yu Jin Lee, Soo Kang
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Middle East Respiratory Syndrome (MERS) Virus—Pathophysiological Axis and the Current Treatment Strategies
    Abdullah M Alnuqaydan, Abdulmajeed G Almutary, Arulmalar Sukamaran, Brian Tay Wei Yang, Xiao Ting Lee, Wei Xuan Lim, Yee Min Ng, Rania Ibrahim, Thiviya Darmarajan, Satheeshkumar Nanjappan, Jestin Chellian, Mayuren Candasamy, Thiagarajan Madheswaran, Ankur
    AAPS PharmSciTech.2021;[Epub]     CrossRef
  • Comparison of emergency department utilization trends between the COVID-19 pandemic and control period
    Soo Kang, Tae Kyu Ahn, Young Ho Seo, Young Ju Suh, Jin Hui Paik
    Medicine.2021; 100(32): e26847.     CrossRef
  • Assessing the Impact of COVID-19 Public Health Stages on Paediatric Emergency Attendance
    Thérèse McDonnell, Emma Nicholson, Ciara Conlon, Michael Barrett, Fergal Cummins, Conor Hensey, Eilish McAuliffe
    International Journal of Environmental Research and Public Health.2020; 17(18): 6719.     CrossRef
  • Preparedness and Response to Pediatric COVID-19 in European Emergency Departments: A Survey of the REPEM and PERUKI Networks
    Silvia Bressan, Danilo Buonsenso, Ruth Farrugia, Niccolo’ Parri, Rianne Oostenbrink, Luigi Titomanlio, Damian Roland, Ruud G. Nijman, Ian Maconochie, Liviana Da Dalt, Santiago Mintegi, Said Hachimi-Idrissi, Marianne Sjølin Frederiksen, Ulle Uustalu, Gerar
    Annals of Emergency Medicine.2020; 76(6): 788.     CrossRef
  • Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea
    Sun Young Lee, Young-Ho Khang, Hwa-Kyung Lim
    Yonsei Medical Journal.2019; 60(8): 796.     CrossRef
  • A database of geopositioned Middle East Respiratory Syndrome Coronavirus occurrences
    Rebecca E. Ramshaw, Ian D. Letourneau, Amy Y. Hong, Julia Hon, Julia D. Morgan, Joshua C. P. Osborne, Shreya Shirude, Maria D. Van Kerkhove, Simon I. Hay, David M. Pigott
    Scientific Data.2019;[Epub]     CrossRef
  • The impact of the improvement in internal medicine consultation process on ED length of stay
    Sangheon Shin, Soo Hoon Lee, Dong Hoon Kim, Seong Chun Kim, Tae Yun Kim, Changwoo Kang, Jin Hee Jeong, Daesung Lim, Yong Joo Park, Sang Bong Lee
    The American Journal of Emergency Medicine.2018; 36(4): 620.     CrossRef
  • 12,681 View
  • 140 Download
  • 12 Web of Science
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Emergency Medical Services | Epidemiology

Epidemiology of prehospital emergency medical service use in Korean children
Se Uk Lee, Dongbum Suh, Hahn Bom Kim, Jin Hee Jung, Ki Jeong Hong, Jin Hee Lee, Hye Young Jang, Hyun Noh, Jae Yun Jung, Do Kyun Kim, Young Ho Kwak
Clin Exp Emerg Med 2017;4(2):102-108.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.14.024

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Epidemiology of prehospital emergency medical service use in Korean children
Clin Exp Emerg Med. 2017;4(2):102-108.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.14.024
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Epidemiology of prehospital emergency medical service use in Korean children
Clin Exp Emerg Med. 2017;4(2):102-108.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.14.024
Close
Objective
The aim of this study was to elucidate the epidemiology of pediatric patients transported by the National 119 Rescue Services in Korea.
Methods
We enrolled all pediatric patients (<16 years old) who used the National 119 Rescue Services in Korea between January 2006 and December 2008, and analyzed the 119 ambulance patient care record databases.
Results
The total number of the cases was 238,644 for 3 years. The median age was 6 years old and 59.0% were male, and the 2- to 5-year-old group was the largest (31.0%). The peak transport times were in the afternoon (from 12:00 p.m. to 17:59 p.m., 36.3%), on Saturday and Sunday (15.9% and 15.7%), and in summer (June to August, 27.3%). The ratio of disease versus injury as the cause of the transports was 42.3% vs. 57.7%. Among the 16 metropolitan cities and provinces, Gyeonggi (25.7%), Seoul (17.6%), and Incheon (7.0%) account for almost half of the all transported children. Regarding the annual transport rates per 100,000 children standardized by age, and gender to the Korean child population, Jeju was the largest (1,650.2) followed by Gangwon (1,201.3), and Jeonnam (1,178.1).
Conclusion
This report presents comprehensive epidemiologic data of pediatric patients transported by 119 rescue services in Korea.

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  • Outcomes of nontraumatic pediatric versus adult out-of-hospital cardiac arrest: a nationwide multicenter registry study
    Jin Hee Jung, Young Ho Kwak
    Pediatric Emergency Medicine Journal.2026;[Epub]     CrossRef
  • The prehospital paediatric emergency care burden managed by a public ambulance service in the Western Cape, South Africa
    Naseef Abdullah, Naqeeb Majiet, Simpiwe Sobuwa
    BMC Emergency Medicine.2024;[Epub]     CrossRef
  • Paediatric frequent use of emergency medical services: a systematic review
    Jason Scott, Ashrafunessa Khanom, Joanne Straw, Annette Strickland, Alison Porter, Helen Snooks
    Emergency Medicine Journal.2023; 40(1): 20.     CrossRef
  • The influence of age on transfer of pediatric trauma patients after initial transport to hospitals with a higher capacity for general emergency care
    Seungmin Jeong, Ki Ok Ahn, Jungeun Kim, Sang Do Shin, Young Sun Ro
    Journal of EMS Medicine.2022; 1(1): 6.     CrossRef
  • Effect of the COVID-19 outbreak on emergency transport of children by an emergency medical service system: a population-based, ORION registry study
    Koshi Ota, Daisuke Nishioka, Yusuke Katayama, Tetsuhisa Kitamura, Jun Masui, Kanna Ota, Masahiko Nitta, Tetsuya Matsuoka, Akira Takasu
    BMC Emergency Medicine.2022;[Epub]     CrossRef
  • Why do infants need out-of-hospital emergency medical services? A retrospective, population-based study
    Jelena Oulasvirta, Heini Harve-Rytsälä, Mitja Lääperi, Markku Kuisma, Heli Salmi
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2021;[Epub]     CrossRef
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    Hang A Park, Ki Ok Ahn, Ju Ok Park, Jungeun Kim, Seungmin Jeong, Meesook Kim
    Journal of Korean Medical Science.2018;[Epub]     CrossRef
  • Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department
    Sang Bum Lee, Jae Hun Oh, Jeong Ho Park, Seung Pill Choi, Jung Hee Wee
    Clinical and Experimental Emergency Medicine.2018; 5(4): 249.     CrossRef
  • Strengthening the role of pediatric emergency centers in Korea
    Jin Hee Jung, Young Ho Kwak, Hyun Noh
    Pediatric Emergency Medicine Journal.2017; 4(2): 29.     CrossRef
  • Prehospital transport of critically ill children via 119 emergency medical service providers: problems and improvement plan
    Hyun Noh
    Pediatric Emergency Medicine Journal.2017; 4(2): 34.     CrossRef
  • 12,063 View
  • 165 Download
  • 6 Web of Science
  • 10 Crossref
Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Joongmin Park, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Hee Yoon, Tae Rim Lee, Won Chul Cha, Min Seob Sim
Clin Exp Emerg Med 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159

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Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Clin Exp Emerg Med. 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159
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Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Clin Exp Emerg Med. 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159
Close
Objective
We aimed to evaluate the knowledge and attitudes of emergency medical service (EMS) personnel pertaining to sepsis. We also compared EMS personnel’s knowledge of sepsis and their intention to engage in prehospital sepsis management.
Methods
The survey was conducted during education conferences for EMS personnel in December 2013 and January 2015 in Seoul, Korea. The questionnaire composed of 10 questions relevant to sepsis, was distributed on-scene, and was retrieved by investigators after the conference. We classified subjects into active and passive groups based on intent to participate in prehospital sepsis care.
Results
A total of 271 questionnaires were distributed; 255 EMS personnel (94%) completed the survey, 126 (49%) of whom were first-degree emergency medical technicians (EMTs). Less than 75% of subjects provided clinically relevant responses to questions about the definitions of sepsis, tachycardia, tachypnea, hypotension, hypothermia, fluid resuscitation, and vasopressor. Only 15% of participants had suspected that a patient had sepsis, and 9% reported that they could identify patients with sepsis during transportation. Overall, first-degree EMTs showed higher levels of knowledge and a positive attitude to sepsis compared with non-first-degree EMTs. Sixty percent of the participants reported that they were actively involved in prehospital sepsis care. The active group showed significantly higher levels of knowledge and more positive responses to the clinical impact of prehospital sepsis care.
Conclusion
Our study showed that is a substantial portion of EMS personnel lacks appropriate level of knowledge on sepsis care. We also found that the intention to engage in sepsis management was associated with appropriate knowledge of sepsis.

Citations

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  • Knowledge, attitudes, and practices of pre-hospital emergency medical care practitioners regarding sepsis recognition: a cross-sectional study in Qatar
    Michael Steven Paul Lewis, Paula J. W. Smith, Ian Lucas Howard, Hassan Farhat, Guillaume Alinier
    BMC Emergency Medicine.2026;[Epub]     CrossRef
  • Barriers and facilitators to optimal sepsis care – a systematized review of healthcare professionals’ perspectives
    Lea Draeger, Carolin Fleischmann-Struzek, Sabine Gehrke-Beck, Christoph Heintze, Daniel O. Thomas-Rueddel, Konrad Schmidt
    BMC Health Services Research.2025;[Epub]     CrossRef
  • Prehospital fluid therapy in patients with suspected infection: a survey of ambulance personnel’s practice
    Marie Egebjerg Jensen, Arne Sylvester Jensen, Carsten Meilandt, Kristian Winther Jørgensen, Ulla Væggemose, Allan Bach, Hans Kirkegaard, Marie Kristine Jessen
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2022;[Epub]     CrossRef
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    Martin Holmbom, Maria Andersson, Sören Berg, Dan Eklund, Pernilla Sobczynski, Daniel Wilhelms, Anna Moberg, Mats Fredrikson, Åse Östholm Balkhed, Håkan Hanberger
    BMJ Open.2021; 11(11): e052582.     CrossRef
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    Stefani Stefani, Yanny Trisyani, Anita Setyawati
    Open Access Macedonian Journal of Medical Sciences.2021; 9(T6): 116.     CrossRef
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    Stephen Woolley, Mick Allen, Renata Medeiros Mirra
    British Dental Journal.2020;[Epub]     CrossRef
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    Christopher L. Hunter, Salvatore Silvestri, Amanda Stone, Anne Shaughnessy, Stacie Miller, Alexa Rodriguez, Linda Papa
    The American Journal of Emergency Medicine.2019; 37(1): 114.     CrossRef
  • Emergency medical service providers' knowledge and perception of sepsis at Makkah Saudi Red Crescent Authority
    BassamHassan Basaffar, NasserSafar Aloitibi, RashedMohammad Alzahrani, OmarOsama Felimban, KhalidSafir Algethami, AbdullahHamdan Alshehri
    Saudi Critical Care Journal.2019; 3(2): 85.     CrossRef
  • 12,002 View
  • 157 Download
  • 8 Web of Science
  • 8 Crossref
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CEEM : Clinical and Experimental Emergency Medicine