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Effect of bag valve ventilation versus mechanical ventilation after endotracheal intubation during cardiopulmonary resuscitation on outcomes following out-of-hospital cardiac arrest: a propensity score analysis Open Access Young Min Kim, Hyun Seok Chai, Gwan Jin Park, Sang Chul Kim, Hoon Kim, Seok Woo Lee, Hyeon Jeong Park, Han Bit Kim, Hyo Been Lee, Ji Han Lee World Journal of Emergency Medicine    2025, 16 (4): 313-320.   DOI: 10.5847/wjem.j.1920-8642.2025.062 Abstract （761）   HTML （768）    PDF（pc） （518KB）（762）       Knowledge map    Save BACKGROUND: In this study, we aimed to evaluate the impact of mechanical ventilator (MV) utilizaton during cardiopulmonary resuscitation (CPR) on out-of-hospital cardiac arrest (OHCA) patient clinical outcomes in the emergency department. METHODS: This single-centered, retrospective, case-control study analyzed electronic medical records. Patients aged >18 years with non-traumatic OHCA who were treated at an emergency medical center between January 2019 and December 2023 were included. These patients were accessed according to the ventilatory method used: MV ventilation (volume control, tidal volume 6-8 mL/kg, frequency 10 beat per minute, inspiratory time 1 s) and manual resuscitator bag valve (BV) ventilation. The primary outcome was the return of spontaneous circulation (ROSC). After 1:1 propensity score matching, the clinical outcomes were analyzed. RESULTS: A total of 649 patients were enrolled in this study. Before matching, the clinical outcomes and pneumothorax incidence did not differ between the MV and BV groups. After 1:1 matching between the two groups using propensity scores, 522 patients (261 MV and 261 BV) were analyzed. Propensity score matching yielded an adequate balance (standardized mean difference <0.10) for all covariates. The estimated odds ratio (OR) for ROSC was 1.23 (95% confidence interval [CI]: 0.85-1.77; P=0.267), for survival at hospital admission was 1.02 (95%CI: 0.68-1.53; P=0.918), for survival at hospital discharge was 2.31 (95%CI: 1.10-5.20; P=0.033), and for good neurologic outcome was 2.56 (95%CI: 0.84-9.43; P= 0.116). CONCLUSION: In patients with OHCA admitted to the emergency department, MV ventilation during CPR showed clinical outcomes similar to those of BV ventilation in most measures. However, survival at hospital discharge was significantly higher in the MV group, suggesting potential benefits of MV use in selected patients. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Modern management of maxillofacial trauma in the emergency department Gaia Bavestrello Piccini, Domenico Sfondrini, Silviu-Andrei Tomulescu, Ciro Esposito, Andrea Piccioni, Giorgia Caputo, Antonio Voza, Christian Zanza, Yaroslava Longhitano, Gabriele Savioli World Journal of Emergency Medicine    2026, 17 (1): 15-27.   DOI: 10.5847/wjem.j.1920-8642.2026.003 Abstract （689）   HTML （1154）    PDF（pc） （237KB）（944）       Knowledge map    Save BACKGROUND: Maxillofacial trauma represents a significant challenge in emergency medicine, requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation of function and aesthetics. The complex anatomy of this region, with its proximity to critical structures, demands a thorough understanding of assessment and management principles. This narrative review aims to provide evidence-based guidelines for emergency physicians managing maxillofacial trauma, with particular emphasis on early recognition of critical injuries, airway management strategies, and special population considerations. METHODS: A narrative review was conducted via a comprehensive literature search of the PubMed and Scopus databases, which focused on maxillofacial trauma management in emergency settings. Articles were selected based on relevance to clinical practice, methodological quality, and current management guidelines. The review synthesized evidence from multiple study types, including original research, systematic reviews, and clinical practice guidelines, to provide practical guidance for emergency physicians. RESULTS: Initial assessment following Advanced Trauma Life Support (ATLS) principles is crucial, with airway management being a primary concern due to the risk of dynamic obstruction. Critical time-sensitive emergencies include orbital compartment syndrome, trapdoor fractures (in pediatric patients), and facial nerve injuries. Computed tomography (CT) imaging remains the gold standard for diagnosis. Special considerations are required for pediatric patients, who present unique anatomical challenges and injury patterns, and for elderly patients, who often have complex medical comorbidities and increased complication risks. Management strategies range from conservative treatment to urgent surgical intervention, with decisions based on the injury pattern and associated complications. CONCLUSION: Emergency physicians must maintain a structured yet flexible approach to maxillofacial trauma, focusing on early recognition of critical injuries, appropriate airway management, and timely specialist consultation. Understanding injury patterns and their potential complications allows for effective risk stratification and treatment planning, ultimately improving patient outcomes. Table and Figures | Reference | Related Articles | Metrics

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Acute lung injury induced by traumatic hemorrhagic shock: pathogenesis, biomarkers and therapeutic perspectives Open Access Jie Gao, Taiwen Rao, Yulin Li, Wenjie Gu, Qin Lu World Journal of Emergency Medicine    2025, 16 (6): 532-542.   DOI: 10.5847/wjem.j.1920-8642.2025.119 Abstract （672）   HTML （607）    PDF（pc） （636KB）（897）       Knowledge map    Save BACKGROUND: Patients suffering from hemorrhagic shock (HS) complicated by severe trauma are at high risk of developing acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The underlying pathophysiology is complex, and the lack of targeted therapeutic strategies remains a major clinical challenge. METHODS: In this narrative review, a literature search was conducted in the PubMed to identify articles published from 2006 to August 2025 concerning trauma, HS, traumatic HS (THS), biomarkers related to ALI, ARDS and HS, as well as their treatment. Through its multifactorial pathogenesis, we discuss the diagnostic and prognostic values of biomarkers, their potential role in treatment, and therapeutic advancements and perspectives. RESULTS: ALI and ARDS are serious complications in severe trauma patients with HS. Hypoperfusion, hypoxia, endothelial cell activation, inflammation, ischemia/reperfusion injury and the intestinal response, as well as chest trauma and transfusion-related events are potential causes of lung injury. The pulmonary epithelial biomarkers soluble receptor for advanced glycation end products (sRAGE) and surfactant protein-D provide indicators for evaluating the severity of lung contusion and injury, whereas Clara cell protein 16 may have clinical value for trauma patients with ALI complicated by pneumonia. Elevated endothelial biomarkers angiopoietin-2 and syndecan-1 are correlated with injury severity, transfusion, coagulopathy, the onset of ARDS, and patient outcomes. The role of biomarkers in therapeutic benefit is reviewed. CONCLUSIONS: Preventive and therapeutic strategies for THS-induced ALI/ARDS rely on the implementation of multi-target, multi-mechanism interventions that address the complex pathophysiology. Targeted phenotypic therapy guided by biomarkers would be of interest for future research aimed at improving clinical outcomes. Table and Figures | Reference | Related Articles | Metrics

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Endothelial cell injury: a crucial link in microcirculatory dysfunction associated with sepsis Open Access Yuhui Pan, Yanyan Ma, Ke Wan, Yizhou Xu, Guoxing Wang, Miaorong Xie World Journal of Emergency Medicine    2026, 17 (1): 28-35.   DOI: 10.5847/wjem.j.1920-8642.2025.093 Abstract （544）   HTML （1762）    PDF（pc） （276KB）（602）       Knowledge map    Save BACKGROUND Sepsis is a prevalent and severe condition, with microcirculation disruptions playing a crucial role in its progression. Endothelial cell (EC) injury is the primary factor behind microcirculatory issues. This review is to outline the pathomechanism, organ heterogeneity, biomarkers, and therapeutic implications of endothelial dysfunction in sepsis, offering references and insights for the clinical management of sepsis. METHODS: A systematic search of Web of Science and PubMed from inception to June 10, 2025, limited to English publications, was conducted. Two reviewers independently identified studies on EC injury in patients with septic microcirculatory dysfunction. Duplicate articles based on multiple search criteria were excluded. RESULTS: Fifty-nine articles, including cell, animal, and clinical studies, were included. These studies reported the effects of EC injury on the microcirculation in sepsis, including changes in vascular permeability, coagulation dysfunction, vasomotor regulation, and inflammatory responses. These pathways interact and ultimately lead to septic microcirculation disorders. CONCLUSION: Sepsis-induced endothelial dysfunction involves various interconnected mechanisms, which collectively compromise ECs and impede microcirculatory perfusion. Future research should enhance current understanding of endothelial injury mechanisms, develop synergistic multi-target strategies to disrupt this cycle, and facilitate the clinical application of endothelial markers for early intervention and dynamic assessment. Table and Figures | Reference | Related Articles | Metrics

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Initial serum electrolyte imbalances and mortality in patients with traumatic brain injury: a retrospective study Open Access Ahammed Mekkodathil, Ayman El-Menyar, Talat Chughtai, Ahmed Abdel-Aziz Bahey, Ahmed Labib Shehatta, Ali Ayyad, Abdulnasser Alyafai, Hassan Al-Thani World Journal of Emergency Medicine    2025, 16 (4): 331-339.   DOI: 10.5847/wjem.j.1920-8642.2025.064 Abstract （541）   HTML （639）    PDF（pc） （505KB）（775）       Knowledge map    Save BACKGROUND: Electrolyte imbalance is common following traumatic brain injury (TBI) and can significantly impact patient outcomes. We aimed to explore the occurrence, patterns, and consequences of electrolyte imbalance in adult patients with TBI. METHODS: A retrospective study was conducted from 2016 to 2021 at a level 1 trauma center among hospitalized TBI patients. On admission, the levels of serum electrolytes, including sodium, potassium, calcium, magnesium, and phosphate, were analyzed. Demographics, injury characteristics, and interventions were assessed. The primary outcome was the in-hospital mortality. Multivariate logistic regression analysis was performed to identify independent predictors of mortality in TBI patients. RESULTS: A total of 922 TBI patients were included in the analysis, of whom 902 (98%) had electrolyte imbalance. The mean age of patients with electrolyte imbalance was 32.0±15.0 years. Most patients were males (94%). The most common electrolyte abnormalities were hypocalcemia, hypophosphatemia, and hypokalemia. The overall in-hospital mortality rate was 22% in the entire cohort. In multivariate logistic analysis, the predictors of mortality included age (odds ratio [OR]=1.029, 95% confidence intervals [CI]: 1.013-1.046, P<0.001), low GCS (OR=0.883, 95%CI: 0.816-0.956, P=0.002), high Injury Severity Score (ISS) scale (OR=1.051, 95%CI: 1.026-1.078, P<0.001), hypernatremia (OR=2.175, 95%CI: 1.196-3.955, P=0.011), hyperkalemia (OR=4.862, 95%CI: 1.222-19.347; P=0.025), low serum bicarbonate levels (OR=0.926, 95%CI: 0.868-0.988, P=0.020), high serum lactate levels (OR=1.128, 95%CI: 1.022-1.244, P=0.017), high glucose levels (OR=1.072, 95%CI: 1.014-1.133, P=0.015), a longer activated partial thromboplastin time (OR=1.054, 95%CI: 1.024-1.084, P<0.001) and higer international normalized ratio (INR) (OR=3.825, 95%CI: 1.592-9.188, P=0.003). CONCLUSION: Electrolyte imbalance is common in TBI patients, with the significant prevalence of hypocalcemia, hypophosphatemia, and hypokalemia. However, hypernatremia and hyperkalemia were associated with the risk of mortality, emphasizing the need for further research to comprehend electrolyte dynamics in TBI patients. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Prediction model for quality of life in sepsis survivors one year after discharge Open Access Yi Yao, Wenjin Li, Dejiang Hong, Ze Chen, Kai Peng, Guangju Zhao World Journal of Emergency Medicine    2026, 17 (2): 105-112.   DOI: 10.5847/wjem.j.1920-8642.2026.015 Abstract （537）   HTML （521）    PDF（pc） （538KB）（445）       Knowledge map    Save BACKGROUND: Sepsis survivors experience poor long-term quality of life post-discharge. The aim of this study was to analyze the factors that impact the long-term quality of life of sepsis survivors and develop a clinical prediction model. METHODS: A total of 442 sepsis patients from the Emergency Intensive Care Unit of a tertiary hospital in Wenzhou were included. These patients were assigned to the training set or the validation set at a ratio of 7:3. The European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire was used to evaluate the quality of life in sepsis survivors one year after discharge. Multivariate logistic regression analysis was used to identify predictors, which were then used to develop the prediction model and subsequently derive a scoring system. The model's effectiveness was assessed using an area under the receiver operating characteristic curve, calibration curves, and clinical decision analysis. RESULTS: Of the 442 patients included, 70 died one year after discharge, and 372 completed the questionnaire. A total of 46.6% of sepsis survivors have poor quality of life one year after discharge in the training set. Multivariate logistic regression revealed that age, platelet, serum albumin, serum urea, and C-reactive protein were independent risk factors for poor quality of life in sepsis survivors. The area under the curve of the scoring system was 0.777 (95% CI: 0.726-0.828). The calibration curves showed that it was well calibrated. Decision curve analysis indicated that the scoring system provided good clinical usefulness. The internal validation also demonstrated its effectiveness. CONCLUSION: The prediction model incorporating five risk factors may predict quality of life one year after discharge in sepsis survivors, which provides a measure to develop post-discharge rehabilitation and follow-up plans for this patient population. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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BRASH syndrome: a systematic review of clinical manifestations and associated risk factors Open Access Silviu-Andrei Tomulescu, Gaia Bavestrello Piccini, Ciprian Niță, Anca Stoian, Yaroslava Longhitano, Raymond Planinsic, Giorgia Caputo, Manfredi Tesauro, Antonio Voza, Christian Zanza World Journal of Emergency Medicine    2025, 16 (6): 521-531.   DOI: 10.5847/wjem.j.1920-8642.2025.107 Abstract （516）   HTML （736）    PDF（pc） （467KB）（672）       Knowledge map    Save BACKGROUND: BRASH syndrome (Bradycardia, Renal failure, AV nodal blockade, Shock, and Hyperkalemia) is a recently described clinical entity characterized by synergistic interaction between AV nodal blocking medications and hyperkalemia. Despite increasing recognition, its clinical characteristics, risk factors, and outcomes remain poorly defined. The rationale of this review is to provide clinicians an up-to-date overview of the most commonly encountered risk factors, triggers, clinical pictures, usual lab values, complications and outcomes, via the systemic analysis of currently published cases. METHODS: A systematic review was conducted using MEDLINE, Web of Science, and Cochrane Library databases through December 2024. Case reports, case series, and conference abstracts involving adult patients with BRASH syndrome were included. Data extraction focused on demographics, clinical presentations, laboratory findings, management strategies, and outcomes. RESULTS: Analysis included 131 patients from 111 published cases. Mean age was (71±13) years, with female predominance (58.1%). Hypertension (77.0%), chronic kidney disease (48.4%), and diabetes mellitus (46.7%) were the most common comorbidities. Beta-blockers were the predominant medication (76.5%). Most common presenting symptoms were syncope (17.9%), generalized weakness (16.2%), and altered mental status (11.9%). Mean potassium level was 6.6 mEq/L, with more than half of cases presenting with non-severe hyperkalemia (<6.5 mEq/L). Management often required multimodal therapy, with 50.8% of patients requiring vasopressors and 31.6% requiring hemodialysis. CONCLUSION: This systematic review provides the most comprehensive analysis of BRASH syndrome to date, demonstrating that while potentially serious, outcomes are generally favorable with appropriate recognition and management. The syndrome can develop even with modest hyperkalemia, particularly in elderly patients with multiple comorbidities. Early recognition and systematic management addressing all components of the syndrome appear crucial for optimal outcomes. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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An approach for the emergency diagnosis and treatment of sepsis-associated encephalopathy in elderly individuals: a literature review Open Access Wei Gu, Jie Zhong, Chuanzhu Lyu, Guoqiang Zhang, Miaorong Xie, Yuefeng Ma, Wei Guo World Journal of Emergency Medicine    2025, 16 (5): 415-422.   DOI: 10.5847/wjem.j.1920-8642.2025.0101 Abstract （497）   HTML （1475）    PDF（pc） （241KB）（864）       Knowledge map    Save BACKGROUND: Sepsis-associated encephalopathy (SAE) is a diffuse dysfunction of the nervous system resulting from sepsis originating outside the central nervous system. Elderly individuals (≥65 years of age) constitute a particularly vulnerable population comprised by a high burden of underlying diseases and complications, which frequently leads to underdiagnosis or misdiagnosis. These patients are at increased risk of long-term or permanent central nervous system impairment, making rapid and accurate diagnosis and treatment especially critical. The review is expected to promote improvements in the diagnosis and treatment of SAE in elderly patients, ultimately achieving more standardized and efficient SAE management. METHODS: We performed a literature search in four databases—PubMed, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang—from inception to April 2025 using bilinguals (Chinese and English). RESULTS: The diagnostic criteria for SAE in elderly individuals include the following: (1) sepsis; (2) new-onset neurological dysfunction; and (3) exclusion of other causes of neurological dysfunction. Physicians should develop tailored empiric anti-infective plans for elderly SAE patients, considering comorbidities, organ function, infection site, local bacterial spectrum, and resistance. The treatment protocol can be adjusted once the pathogen is identified. Stabilizing hemodynamics and ensuring cerebral perfusion are two fluid resuscitation strategies used in elderly SAE patients. An individualized approach to fluid resuscitation using restrictive fluid volumes should be employed. Supportive treatment for elderly SAE patients focuses on improving tissue perfusion/oxygenation, controlling blood glucose levels, and correcting internal imbalances. Early rehabilitation, nutritional support, cognitive training, and family-based emotional support are important components of comprehensive care. CONCLUSION: The diagnosis and management of SAE in elderly patients support early recognition and timely intervention. Table and Figures | Reference | Related Articles | Metrics

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A risk prediction model for acute kidney injury following acute heart failure in an emergency department cohort in China Open Access Lingjie Cao, Yuanyuan Pei, Xiaolu Ma, Liping Guo, Fengtao Yang, Fange Shi, Pengfei Wang, Dilu Li, Kunyu Yang, Jihong Zhu World Journal of Emergency Medicine    2025, 16 (4): 348-356.   DOI: 10.5847/wjem.j.1920-8642.2025.068 Abstract （496）   HTML （447）    PDF（pc） （534KB）（603）       Knowledge map    Save BACKGROUND: Acute kidney injury (AKI) is a severe and fatal complication of acute heart failure (AHF). Existing studies on AKI following AHF in the Chinese population have scarce insights available from the emergency department (ED). This study aimed to investigate the predictive factors of patients with AHF complicated with AKI in a Chinese ED cohort, and to establish a risk prediction model. METHODS: Hospitalized patients diagnosed with AHF in the ED from December 2016 to September 2023 were included. The overall dataset were divided into the training set and the testing set at a 7:3 ratio. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for AKI in patients with AHF in the training set, leading to the development of a risk prediction model. The performance of the model was further assessed. RESULTS: A total of 789 patients with AHF were enrolled, with an AKI incidence of 29.7%. The mortality rates of the AKI and non-AKI groups were 23.1% and 7.6%, respectively. Logistic regression analysis showed that the levels of white blood cell (OR=2.368; 95%CI: 1.502-3.733, P<0.001), albumin (OR=2.669; 95%CI: 1.601-4.451, P<0.001), serum creatinine (OR=3.221; 95%CI: 1.935-5.363, P<0.001), and hemoglobin (OR=2.009; 95%CI: 1.259-3.205, P=0.003), maximum 24-h furosemide dosage (OR=2.196; 95%CI: 1.346-3.582, P=0.002), the use of non-invasive ventilation (OR=2.419; 95%CI: 1.454-4.024, P=0.001), and diabetes mellitus (OR=3.192; 95%CI: 2.014-5.059, P<0.001) were independent risk factors for AKI after AHF. These factors were subsequently incorporated into a risk prediction model. The area under the receiver operating characteristic (AUROC) curve for the predictive model was 0.815 (95%CI: 0.776-0.854) and 0.802 (95%CI: 0.776-0.854) in the training set and the testing set, respectively. CONCLUSION: This risk prediction model might assist physician to predict AKI following AHF effectively in the emergency setting. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Prognostic scores of extracorporeal membrane oxygenation: a scoping review Open Access Jie Zhu, Sijie Lu, Yawen Wu, Qiming Zhao, Weina Pei, Yanlin Hu, Mingming Li, Yongnan Li, Xiangyang Wu World Journal of Emergency Medicine    2025, 16 (4): 303-312.   DOI: 10.5847/wjem.j.1920-8642.2025.078 Abstract （483）   HTML （895）    PDF（pc） （472KB）（506）       Knowledge map    Save BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is an effective measure for saving the lives of critically ill patients. Prompt identification of the risk factors for mortality among patients receiving ECMO and comprehensive analysis of the long-term prognosis of survivors are vital. This scoping review summarized the representative prognostic scoring systems, aiming to help clinicians in selecting an appropriate scoring system to avoid unnecessary medical resource consumption and reduce ECMO-associated mortality. METHODS: A comprehensive search of multiple databases, including PubMed, Embase, and the Cochrane Library, was conducted. After removing duplicate studies, a full-text review was performed, and all studies that reported score systems before and/or after ECMO support were included. This protocol adheres to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and has been registered with the Open Science Framework (osf.io/zp4ge). RESULTS: Among the 114 studies included, we identified three scores for patients receiving veno-venous ECMO (VV-ECMO), five scores for patients receiving veno-arterial ECMO (VA-ECMO), and three critical illness scores, which apply to both VV- and VA-ECMO conditions. All characteristics of these scoring systems, their advantages, and their limitations were summarized. CONCLUSION: The implementation of an ECMO scoring system helps to assess the condition of critically ill patients, predict outcome, and provide objective indicators to determine the optimal timing for ECMO intervention. Due to the limitations of the currently available scores, further efforts in improving and validating the ECMO scoring system are needed to achieve the goals of minimizing unnecessary consumption of medical resources and reducing mortality rates. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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The utility of the trans-splenic retrocardiac view in supine critically ill patients Open Access Issac Cheong, Pablo Martín Merlo, Francisco Marcelo Tamagnone World Journal of Emergency Medicine    2026, 17 (2): 205-206.   DOI: 10.5847/wjem.j.1920-8642.2026.018 Abstract （478）   HTML （434）    PDF（pc） （500KB）（263）       Knowledge map    Save Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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A case report of atypical type E botulism Open Access Huanling Li, Hua Xu, Weihua Hao, Huiying Zhao, Yanling Dong, Hui Meng, Hongmei Bai, Yingping Tian, Zhihong He World Journal of Emergency Medicine    2026, 17 (2): 190-192.   DOI: 10.5847/wjem.j.1920-8642.2026.013 Abstract （465）   HTML （365）    PDF（pc） （336KB）（321）       Knowledge map    Save Reference | Supplementary Material | Related Articles | Metrics

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Successful treatment of a case of paraganglioma presenting Takotsubo syndrome Open Access Ruojie Zhu, Hong Liu, Wen Han, Mao Zhang World Journal of Emergency Medicine    2026, 17 (2): 187-189.   DOI: 10.5847/wjem.j.1920-8642.2026.014 Abstract （455）   HTML （450）    PDF（pc） （941KB）（269）       Knowledge map    Save Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Gastric volvulus--a rare but potentially fatal mimicker of gastroenteritis: a case report Open Access Alston Guan Jie Ong, Jean Mui Hua Lee World Journal of Emergency Medicine    2026, 17 (2): 196-198.   DOI: 10.5847/wjem.j.1920-8642.2026.016 Abstract （445）   HTML （421）    PDF（pc） （551KB）（230）       Knowledge map    Save Reference | Related Articles | Metrics

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Prevalence and factors associated with acute pain among emergency trauma patients Elias Alemayehu Worku, Habtu Adane Aytolign, Zemenay Ayinie Mekonnen, Endale Gebreegziabher Gebremedhn World Journal of Emergency Medicine    2026, 17 (1): 36-42.   DOI: 10.5847/wjem.j.1920-8642.2026.001 Abstract （432）   HTML （133）    PDF（pc） （233KB）（404）       Knowledge map    Save BACKGROUND Acute pain is a sudden experience secondary to injuries and varies in perception among individuals. In trauma patients, it can negatively affect respiratory function, immune response, and wound healing, making it a significant public health concern. This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients. METHODS: A multicenter cross-sectional study was conducted. Data were collected via interviewer-administered questionnaires and patient chart review. The data were analyzed via the statistical package for social science version 25. Bivariable and multivariable logistic regression analyses were used. Variables with a P-value <0.05 were considered statistically significant. RESULTS: A total of 397 patients were included in the study, for a response rate of 96.8%. The prevalence of pain during admission was 91.9% (95% confidence intervals [95% CIs]: 88.8%-94.4%). Blunt trauma (adjusted odds ratio [aOR]=2.82; 95% CI: 1.23-6.45), analgesia before admission to the emergency department (aOR=2.71; 95% CI: 1.16-6.36), documentation of pain severity in the chart (aOR=2.71; 95% CI: 1.16-6.36), analgesia provided within two hours after admission (aOR=7.60; 95% CI: 2.79-20.68), use of non-pharmacological pain management methods (aOR=3.09; 95% CI: 1.35-7.08) and availability of analgesia (aOR=3.95; 95% CI: 1.36-11.43) were associated with acute pain experience. CONCLUSION: The prevalence of acute pain among emergency trauma patients was high in the study area. Analgesia should be administered prior to admission, and non-pharmacological pain management should be implemented. Moreover, training on pain assessment and management should be provided for healthcare providers in the emergency department. Table and Figures | Reference | Related Articles | Metrics

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A case report of brain abscess caused by Nocardia cyriacigeorgica identified by metagenomic next-generation sequencing Open Access Wenqing Tu, Peiting Zeng, Zhuangtian Wu, Zuyong Li, Tao Yu, Wenxian Zhang, Ran Chen, Lian Liang World Journal of Emergency Medicine    2026, 17 (2): 199-201.   DOI: 10.5847/wjem.j.1920-8642.2026.019 Abstract （424）   HTML （48）    PDF（pc） （1273KB）（401）       Knowledge map    Save Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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The association of the plasma iron and neuron-specific enolase combination and the 28-day neurological outcome after cardiopulmonary resuscitation: a prospective study of iron metabolism disturbances Open Access Yi Jiang, Jianyong Wu, Ying Liu, Xianfei Ji, Ping Gong World Journal of Emergency Medicine    2025, 16 (6): 559-566.   DOI: 10.5847/wjem.j.1920-8642.2025.106 Abstract （422）   HTML （176）    PDF（pc） （612KB）（463）       Knowledge map    Save BACKGROUND: Iron metabolism dyshomeostasis is associated with ferroptosis and ischemia-reperfusion injury. We aim to investigate post-cardiac arrest changes in plasma iron metabolism-related parameters and their prognostic value for 28-day neurological outcomes. METHODS: In this prospective observational cohort study, plasma iron metabolism-related parameters (iron, ferritin, hepcidin, soluble transferrin receptor [sTfR], total iron binding capacity [TIBC], and transferrin saturation), interleukin-6, and neuron-specific enolase (NSE) were assessed in 120 patients after restoration of spontaneous circulation (ROSC) on days 1 and 3 of intensive care unit (ICU) admission and in 40 healthy controls. The primary outcome was poor 28-day neurological prognosis. RESULTS: Compared to controls, post-ROSC patients exhibited significant plasma iron metabolism disturbances, including decreased iron, TIBC, transferrin saturation, with elevated hepcidin, ferritin, sTfR, interleukin-6, and NSE on day 1 after ICU admission (P<0.05 for all). On day 28 post-ROSC, patients with poor neurological outcomes (71/120) presented more pronounced alterations than those with good neurological outcomes. Binary logistic analysis revealed that a plasma iron concentration ≤11.2 µmol/L (odds ratio [OR] 0.607, 95% confidence interval [CI] 0.455-0.808) and an NSE concentration ≥20.5 ng/mL (OR 1.020, 95% CI 1.005-1.035) on day 1 of ICU admission were associated with 28-day poor neurological outcomes. The plasma iron-NSE combination showed better predictive performance (area under the curve=0.935, sensitivity 89.8%, specificity 84.5%). CONCLUSION: Early post-ROSC plasma iron metabolism disturbances combined with NSE elevation were associated with the 28-day neurological prognosis, suggesting the therapeutic potential of targeting the iron metabolism pathway. Table and Figures | Reference | Related Articles | Metrics

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Emergency at altitude: exploring physicians’ knowledge, preparedness, and perspectives on in-flight medical emergencies in Saudi Arabia Open Access Abdulmajeed Almadhyan, Dhai Almuteri, Sadeem Alsenidi, Mohammed Alazmi, Raghad Rajab, Sarah Alghamdi, Samah Alkuraydis World Journal of Emergency Medicine    2025, 16 (6): 552-558.   DOI: 10.5847/wjem.j.1920-8642.2025.104 Abstract （421）   HTML （545）    PDF（pc） （404KB）（326）       Knowledge map    Save BACKGROUND: In-flight medical emergencies (IMEs) present significant challenges to healthcare professionals, particularly those with limited training or experience in managing such situations. The objective of this study was to evaluate the level of knowledge, attitudes, and behaviors of licensed doctors in Saudi Arabia concerning IMEs, and to identify the demographic factors influencing their preparedness. METHODS: A cross-sectional study was conducted with a sample of 383 licensed physicians across five regions of Saudi Arabia. Participants completed a self-administered questionnaire assessing demographics, knowledge of IMEs, attitudes towards providing assistance, and previous experience with in-flight emergencies. Data were analyzed using SPSS 26, with statistical significance set at P<0.05. RESULTS: The results revealed a predominantly young (75.8% aged 25-34 years) and male (69.6%) participant pool. While 76.6% of respondents recognized the impact of cabin pressure on oxygen, only 45.4% correctly identified air travel risks for asthmatic patients. Although 66.8% felt confident assisting in IMEs, 20.9% cited medicolegal concerns. Moreover, area of working within Saudi Arabia (P=0.020), year of experience (P=0.041), prior experience with IMEs (P=0.021), and IMEs training (P<0.001) had a significant association with levels of knowledge. CONCLUSION: The study highlights a critical need for enhanced training programs with a focus on the management of IMEs among healthcare practitioners in Saudi Arabia. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Multidisciplinary collaborative management of vertebral artery dissection in a young male: a case report Open Access Huan Zhang, Lei Zhang, Linjuan Sun, Ye Huang World Journal of Emergency Medicine    2026, 17 (2): 193-195.   DOI: 10.5847/wjem.j.1920-8642.2026.017 Abstract （417）   HTML （61）    PDF（pc） （1900KB）（249）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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Refractory fever, pulmonary infiltrates, and auricular chondritis: a rare case of VEXAS syndrome following COVID-19 infection in the emergency department Open Access Shuo Zhang, Bingjie Wang, Yanan Tian, Zhiyu Lao, Jia Liu, Hang Yin, Hui Xiong World Journal of Emergency Medicine    2025, 16 (4): 398-400.   DOI: 10.5847/wjem.j.1920-8642.2025.066 Abstract （415）   HTML （9）    PDF（pc） （404KB）（473）       Knowledge map    Save Table and Figures | Reference | Supplementary Material | Related Articles | Metrics