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                  <text>VOLUME 24 2024</text>
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                <text>Prolonged length of stay and associated factors among emergency department patients in Ethiopia: systematic review and meta-analysis</text>
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                <text>The duration between a patient’s arrival at the Emergency Department (ED) and their actual departure, known as the Emergency Department Length of Stay (EDLOS), can have significant implications for a patient’s health. In Ethiopia, various studies have investigated EDLOS, but a comprehensive nationwide pooled prevalence of prolonged EDLOS, which varies across different locations, is currently lacking. Therefore, the objective of this systematic review and meta-analysis is to provide nationally representative pooled prevalence of prolonged EDLOS and identify associated factors.</text>
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                <text>We have identified eight articles that met our inclusion criteria with a total sample size of 8,612 participants. The findings of this systematic review and meta-analysis indicate that the pooled estimate for the prevalence of prolonged EDLOS is 63.67% (95% CI = 45.18, 82.16, I2 = 99.56%, P = 0.0001). The study identified several significant factors associated with prolonged EDLOS, including patients admitted to overcrowded emergency departments (OR = 5.25, 95% CI = 1.77, 15.58), delays in receiving laboratory findings (OR = 3.12, 95% CI = 2.16, 4.49), and delays in receiving radiological results (OR = 3.00, 95% CI = 2.16, 4.16).</text>
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                <text>Temesgen Ayenew, Mihretie Gedfew, Mamaru Getie Fetene, Animut Takele Telayneh, Fentahun Adane, Baye Tsegaye Amlak, Belayneh Shetie Workneh &amp; Mengistu Abebe Messelu </text>
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                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01131-6</text>
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                <text>BMC Emergency Medicine</text>
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                <text>13 november 2024</text>
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                <text>Fajar bagus W</text>
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                  <text>VOLUME 24 2024</text>
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                <text>Adaption of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care of children</text>
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                <text>The emergency medical service (EMS) addresses all chief complaints across all ages in various contexts. Children in EMS present a particular challenge due to their unique anatomical and physical properties, which require specific training that EMS clinicians often report lacking. This combination exposes children to incidents threatening patient safety. The most common method to highlight incidents is the incident reporting system. Studies have shown underreporting of such incidents, highlighting the need for multiple methods to measure and enhance patient safety in EMS for children. Thus, the aim of this study was to modify and adapt the current Ambulance TT for road-based EMS (ATT) to a pediatric version (pATT) with a guide containing definitions of triggers.</text>
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                <text>The literature search revealed 422 respective 561 articles in Cinahl and Medline where headlines and abstracts were read to identify areas posing risks to patient safety in EMS for children. During the structured discussions, one trigger was added to the existing 19 derived from the ATT, and the trigger definitions were modified to suit children. The three most common triggers identified in the 900 randomly selected records were deviation from treatment guidelines (63.9%), incomplete documentation (48.3%), and the patient is non conveyed after EMS assessment (41.1%). The positive triggers were categorized into near miss (54.6%), no harm incident (5.8%), and harmful incident (0.4%). Inter-rater reliability testing showed excellent agreement.</text>
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                <text>Niclas Packendorff, Carl Magnusson, Christer Axelsson &amp; Magnus Andersson Hagiwara </text>
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                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01125-4</text>
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                <text>BMC Emergency Medicine</text>
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                <text>Fajar bagus W</text>
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                  <text>VOLUME 24 2024</text>
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            <description>A name given to the resource</description>
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                <text>What do community paramedics in Germany do regarding the care of older people? A retrospective, descriptive analysis of low-acuity cases</text>
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                <text>Non-life-threatening cases treated by emergency services have been increasing in recent years, especially in older people. In a region in Germany with approximately 600,000 inhabitants, the role of a specially trained community paramedic (Gemeindenotfallsanitäter, G-NFS) was introduced in 2019. The G-NFS is dispatched to low-acuity requests, attends the assignment alone and is allowed to treat patients at home.</text>
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            <description>An account of the resource</description>
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                <text>Of the 1,643 included anonymous assignment report forms, 52.9% (n = 869) related to patients aged ≥ 65 years. In this population, the mean age was 80.7 years (SD 8.2), 49.6% were female and most were in long-term care, whether as home care recipients (34.8%) or as nursing home residents (26.9%). The most frequent diagnoses were categorised as urological (24.9%), general and unspecified (13.7%), circulatory (13.6%), digestive (12.8%), musculoskeletal (11.5%) and respiratory (10.3%). In 52.7% of the cases no transport was necessary, while 73.7% of urological cases did not need to be transported.</text>
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                <text>Anna Lena Obst, Insa Seeger &amp; Falk Hoffmann </text>
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            <description>A related resource from which the described resource is derived</description>
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              <elementText elementTextId="100864">
                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01134-3</text>
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                <text>BMC Emergency Medicine</text>
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                <text>16 november 2024</text>
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                <text>Fajar bagus W</text>
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                  <text>VOLUME 24 2024</text>
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            <description>A name given to the resource</description>
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                <text>Predictive value of qSOFA and hypothermia combined with PT for prognosis in patients with severe trauma: a single-center retrospective cohort study</text>
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                <text>Trauma represents a significant global health challenge.The development of an effective scoring tool capable of predicting mortality risk in trauma cases is essential. This study aimed to investigate the combined effects of quick sequential organ failure assessment (qSOFA) and hypothermia (H) along with prothrombin time (PT) in predicting the prognosis of patients with severe trauma.</text>
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                <text>A total of 509 severe trauma patients (377 males and 132 females) were included, with a median age of 53 years (range: 42–65 years). The mortality rate was found to be 23.4%. Logistic regression analysis revealed that age, ISS, and qSOFA + H + PT were significant predictors of death in severe trauma patients, with odds ratios of 1.035 (95%CI:1.014–1.057), 1.052 (95%CI:1.017–1.090), and 6.124 (95%CI:3.107–12.072), respectively (P &lt; 0.05). The predictive efficacy of ISS and qSOFA + H + PT for mortality prediction was 0.742 and 0.816, respectively.The predictive efficacy of qSOFA + H + PT for emergency blood transfusion and operation was 0.743 and 0.702.</text>
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                <text>Limei Ma, Chen Yang, Cen Chen, Yan Wu, Rong Tang, Xiaolong Cheng, Haifei Wu, Jianjun Zhu &amp; Bing Ji </text>
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                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01132-5</text>
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                <text>BMC Emergency Medicine</text>
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                <text>17 november 2024</text>
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                <text>Fajar bagus W</text>
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                <text>Persons who become life-threateningly ill or injured (due to for example trauma or cardiac arrest) are cared for in hospitals’ designated emergency rooms at the emergency department (ED). In these rooms, the life-threatening condition and biomedical focus may reinforce a culture that value the medical-technical care. Meeting patients fundamental care needs (integrating physical, psychosocial and relational care needs) in a person-centred way might hence be challenging in emergency rooms. Little is known about how person-centred fundamental care is experienced and valued by vulnerable and exposed patients in emergency rooms. This study aims to describe fundamental care needs experienced by patients with a life-threating condition in the emergency room.</text>
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                <text>Despite being life-threateningly ill or injured, patients were still able to describe their unique needs—which were not only related to biomedical care. A relationship was established between healthcare professionals and the patient in the initial stage, but not maintained during their stay at the emergency room. Patients felt their physical needs were met to a greater extent than psychosocial and relational needs, despite their prioritizing the latter. Patients preferred personalized care but described care as task oriented. The physical environment limited patients from having their fundamental care needs met, and they adopted to a “patient role” to avoid adding to staff stress. The emergency room situation evoked existential thoughts.</text>
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                <text>Veronica Pavedahl, Åsa Muntlin, Ulrica Von Thiele Schwarz, Martina Summer Meranius &amp; Inger K. Holmström </text>
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                <text>Fajar bagus W</text>
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            <description>The file format, physical medium, or dimensions of the resource</description>
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            <description>A language of the resource</description>
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                <text>English</text>
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            <name>Type</name>
            <description>The nature or genre of the resource</description>
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              <description>A name given to the resource</description>
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            <description>A name given to the resource</description>
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                <text>Vesta Brauckmann, Dominica Hudasch, Pascal Gräff, Torben Riecke, Gökmen Aktas, Jorge Mayor &amp; Christian Macke </text>
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                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01138-z</text>
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            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
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              <elementText elementTextId="100832">
                <text>BMC Emergency Medicine</text>
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            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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                <text>Fajar bagus W</text>
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            <name>Format</name>
            <description>The file format, physical medium, or dimensions of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="100835">
                <text>PDF</text>
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            <name>Language</name>
            <description>A language of the resource</description>
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              <elementText elementTextId="100836">
                <text>English</text>
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          <element elementId="51">
            <name>Type</name>
            <description>The nature or genre of the resource</description>
            <elementTextContainer>
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                <text>Text</text>
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    <fileContainer>
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            <element elementId="50">
              <name>Title</name>
              <description>A name given to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="100587">
                  <text>VOLUME 24 2024</text>
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      <name>Text</name>
      <description>A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.</description>
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    <elementSetContainer>
      <elementSet elementSetId="1">
        <name>Dublin Core</name>
        <description>The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.</description>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
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                <text>Improving triage performance in emergency departments using machine learning and natural language processing: a systematic review</text>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
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                <text>In Emergency Departments (EDs), triage is crucial for determining patient severity and prioritizing care, typically using the Manchester Triage Scale (MTS). Traditional triage systems, reliant on human judgment, are prone to under-triage and over-triage, resulting in variability, bias, and incorrect patient classification. Studies suggest that Machine Learning (ML) and Natural Language Processing (NLP) could enhance triage accuracy and consistency. This review analyzes studies on ML and/or NLP algorithms for ED patient triage.</text>
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            <description>An account of the resource</description>
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                <text>Sixty studies covering 57 ML algorithms were included. Logistic Regression (LR) was the most used model, while eXtreme Gradient Boosting (XGBoost), decision tree-based algorithms with Gradient Boosting (GB), and Deep Neural Networks (DNNs) showed superior performance. Frequent predictive variables included demographics and vital signs, with oxygen saturation, chief complaints, systolic blood pressure, age, and mode of arrival being the most retained. The ML algorithms showed significant bias risk due to critical bias assessment in classification models.</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="100821">
                <text>Bruno Matos Porto</text>
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            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="100822">
                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01135-2</text>
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            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="100823">
                <text>BMC Emergency Medicine</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="100824">
                <text>18 november 2024</text>
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            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
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              <elementText elementTextId="100825">
                <text>Fajar bagus W</text>
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          <element elementId="42">
            <name>Format</name>
            <description>The file format, physical medium, or dimensions of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="100826">
                <text>PDF</text>
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            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="100827">
                <text>English</text>
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          </element>
          <element elementId="51">
            <name>Type</name>
            <description>The nature or genre of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="100828">
                <text>text</text>
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    <fileContainer>
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            <element elementId="50">
              <name>Title</name>
              <description>A name given to the resource</description>
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                  <text>VOLUME 24 2024</text>
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      <name>Text</name>
      <description>A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.</description>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
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                <text>Sepsis management in pre-hospital care – the earlier, the better?</text>
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            <name>Description</name>
            <description>An account of the resource</description>
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                <text>Emergency medical services often serve as the initial point of contact for septic patients, offering crucial pre-hospital intervention opportunities. However, the efficacy of pre-hospital interventions remains uncertain. From this perspective, we’ll talk about the available evidence of pre-hospital sepsis and septic shock treatment and the barriers to its implementation.</text>
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              <elementText elementTextId="100810">
                <text>Taline Lazzarin, Raquel Simões Ballarin, Leonardo Zornoff, Suzana Erico Tanni, Sergio Alberto Rupp de Paiva, Paula Schmidt Azevedo &amp; Marcos Ferreira Minicucci </text>
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            <description>A related resource from which the described resource is derived</description>
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              <elementText elementTextId="100811">
                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01137-0</text>
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            <description>An entity responsible for making the resource available</description>
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              <elementText elementTextId="100812">
                <text>BMC Emergency Medicine</text>
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            <name>Date</name>
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                <text>19 november 2024</text>
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            <description>An entity responsible for making contributions to the resource</description>
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                <text>Fajar bagus W</text>
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            <description>The file format, physical medium, or dimensions of the resource</description>
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              <elementText elementTextId="100815">
                <text>PDF</text>
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            <name>Language</name>
            <description>A language of the resource</description>
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              <elementText elementTextId="100816">
                <text>English</text>
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          <element elementId="51">
            <name>Type</name>
            <description>The nature or genre of the resource</description>
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                <text>Text</text>
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    <fileContainer>
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            <element elementId="50">
              <name>Title</name>
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                  <text>VOLUME 24 2024</text>
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      <name>Text</name>
      <description>A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.</description>
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          <element elementId="50">
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            <description>A name given to the resource</description>
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                <text>Outcome of video laryngoscopy versus direct laryngoscopy for emergency tracheal intubation in emergency department: a propensity score matching analysis</text>
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          <element elementId="49">
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                <text>The high incidence of airway management failure in the emergency department (ED) necessitates a comparative analysis of laryngoscopy methods. This study aims to compare the success and complications associated with video-assisted laryngoscopy (VL) and direct laryngoscopy (DL) in emergency tracheal intubation in ED.</text>
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                <text>The study included 3,424 patients, with 342 in the VL group and 3,082 in the DL group. The initial analysis revealed no significant differences in the intubation success rates between the two methods. However, the VL group experienced fewer peri-intubation adverse events (33% compared to 40%). After propensity score matching, a higher first-attempt success rate was observed in the DL group (88.9% vs. 81.3%, risk difference: 7.6, 95% CI: 1.9 to 13.2, p=0.009), but there was no statistically significant difference in peri-intubation adverse events. VL had a lower first-attempt success rate among low-experience intubators. Subgroup analyses of intubators with moderate and high experience, as well as patients who received both induction agents and neuromuscular blocking agents, show results consistent with the analysis of the entire cohort.</text>
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                <text>Triratana Kongsawaddee, Kumpol Kornthatchapong &amp; Winchana Srivilaithon </text>
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              <elementText elementTextId="100801">
                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01136-1</text>
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                <text>BMC Emergency Medicine</text>
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                <text>Fajar bagus W</text>
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            <name>Format</name>
            <description>The file format, physical medium, or dimensions of the resource</description>
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              <elementText elementTextId="100805">
                <text>PDF</text>
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                  <text>VOLUME 24 2024</text>
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                <text>Triage processes in primary, secondary, and tertiary health care facilities in the Kathmandu Valley, Nepal: a mixed-methods study</text>
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                <text>In healthcare facilities, an efficient triage system is critical to optimize patient care. The main objective of this study was to explore the triage processes and practices in three different tiers of healthcare facilities in the Kathmandu Valley, Nepal.</text>
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                <text>PHCs had designated space for triage with less equipped emergency services and outpatient departments (OPDs) and received severely ill patients rarely. Although prioritizing critical patients and prompt care was part of the services, there was a lack of triage protocols with more than half of the HCWs (56.3%; 36/64) from the tertiary hospital reporting the availability of triage guidelines compared to SHCs (28.1%; 9/32) and PHCs (6.3%; 3/48). The majority of HCWs from the tertiary level recognized triage's effectiveness in reducing time lag, and prioritizing patients. Tertiary level had the consistent use of triage (94%; 60/64) compared to only around two-thirds in SHCs (66%; 19/29) and PHCs (62%; 28/45). Patients often attended PHC services for routine check-ups and were motivated by health insurance, affordability, free medicines, referral cards, and proximity. In the SHC, there was a well-equipped emergency department (ED) with specific guidelines, but its use was infrequent. Patients were unaware of the triage process and its utility. In all settings, while most HCWs had a basic knowledge of triage, some were not confident due to limited exposure to the triage process and training. Many HCWs reported the need for triage-related training and its’ consistent implementation.</text>
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                <text>Lava Shrestha, Bipin Adhikari, Manjita Bajracharya, Nishika Aryal, Anuja Rajbhandari, Sweekriti Shrestha, Rakesh Pariyar, Ramesh K. Maharjan, Michael Otieno, Mikaela Watson, Jyotshna Sapkota, Sabine Dittrich, Kevin K. A. Tetteh &amp; Debashish Das</text>
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                <text>https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01139-y</text>
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                <text>BMC Emergency Medicine</text>
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                <text>25 november 2024</text>
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                <text>Fajar bagus W</text>
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