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                <text>History of emergency medicine in Bhutan</text>
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                <text>Emergency medicine in Bhutan has made significant progress in the past few decades and continues to evolve. In&#13;
this article, we provide valuable insights into the history of emergency medicine at Jigme Dorji Wangchuck National&#13;
Referral Hospital (JDWNRH) and in Bhutan and highlight some of the future challenges we face as we move forward&#13;
to meet the demands of increased patient volume and complexity.&#13;
Keywords Emergency medicine, Bhutan</text>
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                <text>Ugyen Tshering1*, Erol Kohli2&#13;
&#13;
, Tashi Tenzin3 and Oriana Chen4</text>
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              <elementText elementTextId="131122">
                <text>https://doi.org/10.1186/s12245-024-00590-9</text>
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              <elementText elementTextId="131124">
                <text>Peri Irawan</text>
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                  <text>Volume 17 Issue 1 2024</text>
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          <element elementId="50">
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                <text>Evaluating the effectiveness of the pre‐hospital trauma life support (PHTLS) program for the management of trauma patients in the pre‐hospital emergency based on Kirkpatrick’s evaluation model</text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
            <elementTextContainer>
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                <text>Pre-hospital trauma life support (PHTLS)</text>
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                <text>Background Pre-hospital trauma life support (PHTLS) training courses have been developed and widely adopted&#13;
to enhance the proficiency of pre-hospital personnel in handling trauma patients. The objective of this study&#13;
&#13;
was to assess the effectiveness of the educational program for managing trauma patients in the pre-hospital emer-&#13;
gency setting, utilizing Kirkpatrick’s educational evaluation model.&#13;
&#13;
Methods This is an observational approach, consisting of four sub-studies. The PHTLS course was conducted&#13;
&#13;
over a 2-day period, encompassing both theoretical and practical components. For this study, we selected pre-hospi-&#13;
tal personnel from three emergency aid stations using a convenient sampling method. These personnel underwent&#13;
&#13;
their first-ever PHTLS course training, and we subsequently analyzed the effectiveness of the training program using&#13;
Kirkpatrick’s four levels of evaluation: satisfaction, learning, behavior, and results.&#13;
Results The study conducted on Kirkpatrick’s first-level analysis revealed that participants expressed a high level&#13;
&#13;
of satisfaction with the quality of all aspects of the course. Moving on to the second and third levels, namely learn-&#13;
ing and behavior, significant improvements were observed in the average scores of various skills that were exam-&#13;
ined both immediately after the course and 2 months later (P&lt;0.05). However, when it comes to the fourth level&#13;
&#13;
and the impact of the course on indicators such as mortality rate and permanent disability, no significant changes&#13;
were observed even after an average of 3 months since the course was introduced.&#13;
&#13;
Conclusion The implementation of PHTLS has been linked to the enhancement of participants’ skills in treat-&#13;
ing trauma patients, leading to the application of acquired knowledge in real-life scenarios and a positive change&#13;
&#13;
in participants’ behavior. The evaluation of PHTLS courses in Iran, as in other countries, highlights the need for special-&#13;
ized training in pre-hospital trauma care. To ensure the continued effectiveness of the PHTLS course, it is advisable&#13;
&#13;
for managers and policymakers to encourage regular participation of PHTLS employees in the program.</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131111">
                <text>Mohammad Hadi Kamgar Amaleh1,2, Sara Heydari3* , Peyman Nazari4 and Fatemeh Bakhshi5*</text>
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          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="131112">
                <text>https://doi.org/10.1186/s12245-024-00589-2</text>
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            <elementTextContainer>
              <elementText elementTextId="131114">
                <text>Peri Irawan</text>
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              <description>A name given to the resource</description>
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                  <text>Volume 17 Issue 1 2024</text>
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              <name>Contributor</name>
              <description>An entity responsible for making contributions to the resource</description>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
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                <text>Intentional intoxication with monkshood plant leading to atrioventricular dissociation and ventricular ectopy in a 17‐year‐old female: a case report</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
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            <description>The topic of the resource</description>
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                <text>Monkshood plant, Aconitine, Poisoning, Arrythmia, AV dissociation, Emergency medicine</text>
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            </elementTextContainer>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131067">
                <text>Background Monkshood, a toxic plant containing a potent cardio- and neurotoxin called aconitine, can lead&#13;
to a range of symptoms, including nausea, vomiting, dizziness, seizures, and cardiac arrhythmias. Mortality associated&#13;
with this intoxication are due to ventricular tachyarrhythmias which are difficult to treat and often refractory in nature.&#13;
Case presentation We present a case of a 17-year-old female patient who presented to the emergency department&#13;
after intentionally ingesting a monkshood plant and developed atrioventricular dissociation and frequent ventricular&#13;
ectopy. The patient was successfully treated with activated charcoal, supportive care, and cardiac monitoring.&#13;
Conclusion This case highlights the importance of early recognition of aconitine poisoning and the need for prompt&#13;
supportive care, cardiac rhythm monitoring, and preemptive antiarrhythmic treatment planning.&#13;
Keywords Monkshood plant, Aconitine, Poisoning, Arrythmia, AV dissociation, Emergency medicine</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131068">
                <text>V. W. Klokman1,2*, S. Tempelaar3&#13;
&#13;
, B. C. W. Kuipers3&#13;
&#13;
, I. A. G. van Dijk3 and M. A. M. Moviat4</text>
              </elementText>
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            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="131069">
                <text>https://doi.org/10.1186/s12245-024-00588-3</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="40">
            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131070">
                <text>2024</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131071">
                <text>Peri Irawan</text>
              </elementText>
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            <elementTextContainer>
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    <tagContainer>
      <tag tagId="15134">
        <name>Monkshood plant, Aconitine, Poisoning, Arrythmia, AV dissociation, Emergency medicine</name>
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              <name>Title</name>
              <description>A name given to the resource</description>
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                <elementText elementTextId="130912">
                  <text>Volume 17 Issue 1 2024</text>
                </elementText>
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            <element elementId="37">
              <name>Contributor</name>
              <description>An entity responsible for making contributions to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="130913">
                  <text>peri irawan</text>
                </elementText>
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        <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>
        <elementContainer>
          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131055">
                <text>Successfully conservative management of the uterus in acute pulmonary embolism during cesarean section for placenta previa: a case report from Tu Du Hospital, Vietnam and literature review</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131056">
                <text>Acute pulmonary embolism, Cardiopulmonary collapse, Cesarean section, Obstetrical anesthesia,&#13;
Emergency, Placenta previa, Postpartum hemorrhage, Mortality</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131057">
                <text>Background Cardiopulmonary collapse is a catastrophic event in cesarean section, which leads to adverse outcomes&#13;
for both the mother and the fetus. Pulmonary embolism is one of the rare etiologies of this entity. We herein reported&#13;
the successful management of acute embolism pulmonary associated with cesarean delivery on a healthy pregnant&#13;
woman at our tertiary referral hospital.&#13;
Case presentation A full-term pregnant woman hospitalized for planned cesarean delivery due to placenta previa&#13;
without cardiorespiratory diseases. She was scheduled uneventfully for a planned cesarean section. After placental&#13;
delivery, the patient spontaneously fell into cardiopulmonary collapse and her vital signs deteriorated rapidly. The&#13;
&#13;
obstetricians promptly completed the cesarean section and performed all procedures to prevent the PPH and pre-&#13;
serve the uterus. At the same time, the anesthesiologists continued to carry out advanced heart-lung resuscitation&#13;
&#13;
in order to control her vital signs. After surgery, the multidisciplinary team assessed the patient and found a throm-&#13;
bus in her pulmonary circulation. Therefore, the patient was managed with therapeutic anticoagulation. The patient&#13;
&#13;
recovered in good clinical condition and was discharged after 2 weeks without any complications.&#13;
Conclusions The diagnosis of acute pulmonary embolism is extremely difficult due to uncommon occurrence,&#13;
&#13;
sudden onset, and non-specific presentation. Awareness of this life-threatening pathology during cesarean deliv-&#13;
ery should be raised. Interdisciplinary assessment must be essentially established in this life-threatening condition.&#13;
&#13;
After the whole conventional management, uterine conservation may be acceptable where applicable. Further data&#13;
is required to encourage this finding.&#13;
Keywords Acute pulmonary embolism, Cardiopulmonary collapse, Cesarean section, Obstetrical anesthesia,&#13;
Emergency, Placenta previa, Postpartum hemorrhage, Mortality</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131058">
                <text>Anh Dinh Bao Vuong1†, Thanh Hai Pham2&#13;
&#13;
, Van Hoang Bui3&#13;
&#13;
, Xuan Trang Nguyen1&#13;
&#13;
, Ngoc Bich Trinh1&#13;
,&#13;
&#13;
Yen Oanh Ngoc Nguyen1&#13;
&#13;
, Dang Khoa Tran Le1 and Phuc Nhon Nguyen1,2*†</text>
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              <elementText elementTextId="131059">
                <text>https://doi.org/10.1186/s12245-024-00587-4</text>
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                <text>2024</text>
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                <text>Peri Irawan</text>
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        <name>Acute pulmonary embolism, Cardiopulmonary collapse, Cesarean section, Obstetrical anesthesia, Emergency, Placenta previa, Postpartum hemorrhage, Mortality</name>
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                  <text>Volume 17 Issue 1 2024</text>
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              <elementText elementTextId="131044">
                <text>Using design research and human‐centered design to address growing pains in a busy, urban emergency department: a faculty, clinician, and student collaboration between nursing, design, and medicine</text>
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          <element elementId="49">
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                <text>Design thinking, Human-centered design, Emergency medicine, Materials management, Design, Emergency department operations</text>
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          <element elementId="41">
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            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131046">
                <text>In 2021, a large urban university-based hospital transitioned to a new two-floor emergency department. Despite&#13;
the new environment, there were usability and workflow challenges with the space. The authors of this paper created&#13;
a multidisciplinary, human-centered design collaborative of clinicians, university faculty, and students in an effort&#13;
to increase emergency department efficiency. After thorough design-research and clinician-focused collaboration,&#13;
the authors and design team identified the need to improve medical supply retrieval time, which directly impacts&#13;
patient care and clinician satisfaction. The primary interventions consisted of a redesign that is as follows: (a) created&#13;
standardized icons related to organ system, (b) increased visibility of supply labels, and (c) reorganized supplies based&#13;
&#13;
on usage data. Although a successful project, it was not without several barriers discussed in this article, includ-&#13;
ing design researcher and clinician-level setting and engagement, academic/institutional policies, and conflicting&#13;
&#13;
schedules. In addition, the lessons learned from implementing human-centered design concepts into clinical work-&#13;
flow sets forth future research opportunities and inspiration for other institutions to collaborate.&#13;
&#13;
Keywords Design thinking, Human-centered design, Emergency medicine, Materials management, Design,&#13;
Emergency department operations</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131047">
                <text>Mikael L. Avery1*, Jacquelyn L. Arena2&#13;
&#13;
, Nicholas D. Benson2&#13;
&#13;
, Neil A. Ray2 and Marion Leary1</text>
              </elementText>
            </elementTextContainer>
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            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="131048">
                <text>https://doi.org/10.1186/s12245-024-00586-5</text>
              </elementText>
            </elementTextContainer>
          </element>
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            <name>Date</name>
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              <elementText elementTextId="131049">
                <text>2024</text>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131050">
                <text>Peri Irawan</text>
              </elementText>
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          </element>
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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="131051">
                <text>pdf</text>
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          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131052">
                <text>english</text>
              </elementText>
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            <description>The nature or genre of the resource</description>
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    <tagContainer>
      <tag tagId="15132">
        <name>Design thinking, Human-centered design, Emergency medicine, Materials management, Design, Emergency department operations</name>
      </tag>
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                <elementText elementTextId="130912">
                  <text>Volume 17 Issue 1 2024</text>
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                  <text>peri irawan</text>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131034">
                <text>The diagnostic accuracy of point‐of‐care ultrasound parameters for airway assessment in patients undergoing intubation in emergency department—an observational study</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131035">
                <text>Difficult intubation, Airway ultrasound, Emergency department</text>
              </elementText>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131036">
                <text>Background Endotracheal intubation is an essential resuscitative procedure in the emergency setting. Airway assess-&#13;
ment parameters such as the Mallampati classification are difficult to perform in an emergency setting. As point-&#13;
of-care ultrasound (POCUS) assessment of airway parameters does not require patients to perform any mandatory&#13;
&#13;
action, ultrasound may become the potential first-line noninvasive airway assessment tool in the emergency depart-&#13;
ment (ED). The use of POCUS in the ED has not been sufficiently studied. Using POCUS in airway assessment for pre-&#13;
dicting difficult intubation may be the next step in successful airway management.&#13;
&#13;
Methodology The study was an observational study conducted at the ED of the All India Institute of Medical&#13;
Sciences (Rishikesh). The treating emergency physician recorded the patient history and systemic examination&#13;
&#13;
along with an indication for intubation. The POCUS assessment of airway parameters pre-epiglottis to epiglot-&#13;
tic vocal cord ratio (Pre-E/E-VC), tongue thickness, hyomental distance, and distance from skin to the hyoid bone&#13;
&#13;
was performed by the study investigator. During laryngoscopy, Cormack-Lehane (CL) grading was assessed. The data&#13;
was entered and analyzed.&#13;
Results Seventy patients who required intubation in the ED were enrolled in the study. Among the study population,&#13;
48.6%, 28.6%, 14.3%, 1.4%, and 7.1% were classified with the following CL grading: 1, 2a, 2b, 3a, and 3b, respectively.&#13;
At a cutoff of ≥ 1.86, Pre-E/E-VC predicts difficult laryngoscopy (AUC 0.835) with a sensitivity of 83% and a specificity&#13;
of 94%. At a cutoff of ≥ 5.98 cm, tongue thickness predicts difficult laryngoscopy (AUC 0.78) with a sensitivity of 83%&#13;
&#13;
and a specificity of 88%. At a cutoff of hyomental distance ≤ 6 cm, it predicts difficult laryngoscopy with a sensitiv-&#13;
ity of 83% and a specificity of 88%. All parameters can act as a promising tool for predicting difficult laryngoscopy,&#13;
&#13;
with the single best parameter being Pre-E/E-VC.</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131037">
                <text>Aadya Pillai1&#13;
&#13;
, Poonam Arora2*, Ankita Kabi3&#13;
&#13;
, Udit Chauhan4&#13;
&#13;
, Reshma Asokan5&#13;
, P. Akhil6&#13;
, Takshak Shankar2&#13;
,&#13;
&#13;
D. J. Lalneiruol1&#13;
&#13;
, Himanshi Baid7 and Hannah Chawang1</text>
              </elementText>
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          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="131038">
                <text>https://doi.org/10.1186/s12245-024-00585-6</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="131039">
                <text>2024</text>
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            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131040">
                <text>Peri Irawan</text>
              </elementText>
            </elementTextContainer>
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            <elementTextContainer>
              <elementText elementTextId="131042">
                <text>english</text>
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        <name>Difficult intubation, Airway ultrasound, Emergency department</name>
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                <elementText elementTextId="130912">
                  <text>Volume 17 Issue 1 2024</text>
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                  <text>peri irawan</text>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131024">
                <text>Strategies for improving ED‐related outcomes of older adults who seek care&#13;
in emergency departments: a systematic review</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131025">
                <text>Emergency department, Frequent use, Older adults, Systematic review</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131026">
                <text>Background Despite constituting 14% of the general population, older adults make up almost a quarter of all emer-&#13;
gency department (ED) visits. These visits often do not adequately address patient needs, with nearly 80% of older&#13;
&#13;
patients discharged from the ED carrying at least one unattended health concern. Many interventions have been&#13;
implemented and tested in the ED to care for older adults, which have not been recently synthesized.&#13;
Methods A systematic review was conducted to identify interventions initiated in the ED to address the needs&#13;
of older adults. Embase, MEDLINE, CINAHL, Cochrane CENTRAL, the Cochrane Database of Systematic Reviews,&#13;
and grey literature were searched from January 2013 to January 18, 2023. Comparative studies assessing interventions&#13;
for older adults in the ED were included. The quality of controlled trials was assessed with the Cochrane risk-of-bias&#13;
&#13;
tool for randomized trials, and the quality of observational studies was assessed with the risk of bias in non-rand-&#13;
omized studies of interventions tool. Due to heterogeneity, meta-analysis was not possible.&#13;
&#13;
Results Sixteen studies were included, assessing 12 different types of interventions. Overall study quality was low&#13;
&#13;
to moderate: 10 studies had a high risk of bias, 5 had a moderate risk of bias, and only 1 had a low risk of bias. Follow-&#13;
up telephone calls, referrals, geriatric assessment, pharmacist-led interventions, physical therapy services, care plans,&#13;
&#13;
education, case management, home visits, care transition interventions, a geriatric ED, and care coordination were&#13;
assessed, many of which were combined to create multi-faceted interventions. Care coordination with additional&#13;
support and early assessment and intervention were the only two interventions that consistently reported improved&#13;
outcomes. Most studies did not report significant improvements in ED revisits, hospitalization, time spent in the ED,&#13;
costs, or outpatient utilization. Two studies reported on patient perspectives.&#13;
&#13;
Conclusion Few interventions demonstrate promise in reducing ED revisits for older adults, and this review identi-&#13;
fied significant gaps in understanding other outcomes, patient perspectives, and the effectiveness in addressing&#13;
&#13;
underlying health needs. This could suggest, therefore, that most revisits in this population are unavoidable manifes-&#13;
tations of frailty and disease trajectory. Efforts to improve older patients’ needs should focus on interventions initiated&#13;
&#13;
outside the ED.</text>
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            <description>An entity primarily responsible for making the resource</description>
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              <elementText elementTextId="131027">
                <text>Ally Memedovich1&#13;
&#13;
, Benedicta Asante1&#13;
&#13;
, Maha Khan1&#13;
&#13;
, Nkiruka Eze1&#13;
&#13;
, Brian R. Holroyd2,4, Eddy Lang1,3,4,5,&#13;
&#13;
Sherri Kashuba4 and Fiona Clement1,5*</text>
              </elementText>
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          </element>
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            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="131028">
                <text>https://doi.org/10.1186/s12245-024-00584-7</text>
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          </element>
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            <name>Date</name>
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              <elementText elementTextId="131029">
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            <elementTextContainer>
              <elementText elementTextId="131030">
                <text>Peri Irawan</text>
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                <text>english</text>
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      <tag tagId="15130">
        <name>Emergency department, Frequent use, Older adults, Systematic review</name>
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              <name>Title</name>
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                <elementText elementTextId="130912">
                  <text>Volume 17 Issue 1 2024</text>
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              <elementTextContainer>
                <elementText elementTextId="130913">
                  <text>peri irawan</text>
                </elementText>
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        <elementContainer>
          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131014">
                <text>Triage implementation in resource‐limited emergency departments: sharing tools and experience from the Pacific region</text>
              </elementText>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131015">
                <text>According to the World Health Organization’s (WHO) Emergency Care Systems Framework, triage is an essential&#13;
function of emergency departments (EDs).</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131016">
                <text>According to the World Health Organization’s (WHO) Emergency Care Systems Framework, triage is an essential&#13;
function of emergency departments (EDs). This practice innovation article describes four strategies that have been&#13;
used to support implementation of the WHO-endorsed Interagency Integrated Triage Tool (IITT) in the Pacific region,&#13;
namely needs assessment, digital learning, public communications and electronic data management.&#13;
Using a case study from Vila Central Hospital in Vanuatu, a Pacific Small Island Developing State, we reflect on lessons&#13;
learned from IITT implementation in a resource-limited ED. In particular, we describe the value of a bespoke needs&#13;
assessment tool for documenting triage and patient flow requirements; the challenges and opportunities presented&#13;
by digital learning; the benefits of locally designed, public-facing communications materials; and the feasibility&#13;
and impact of a low-cost electronic data registry system.&#13;
&#13;
Our experience of using these tools in Vanuatu and across the Pacific region will be of interest to other resource-lim-&#13;
ited EDs seeking to improve their triage practice and performance. Although the resources and strategies presented&#13;
&#13;
in this article are focussed on the IITT, the principles are equally relevant to other triage systems.</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="131017">
                <text>Rob Mitchell1,2*, Libby White2&#13;
&#13;
, Leigh Elton3&#13;
, Cliff Luke4&#13;
, Sarah Bornstein5 and Vincent Atua4</text>
              </elementText>
            </elementTextContainer>
          </element>
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            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="131018">
                <text>https://doi.org/10.1186/s12245-024-00583-8</text>
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              <elementText elementTextId="131019">
                <text>2024</text>
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&#13;
that played a part, and the aspirations their community and government have set for this. This can guide future evolu-&#13;
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Marcus Ong Eng Hock1,2,3 and Anantharaman Venkataraman1,3</text>
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