Emerg. Care Med., Volume 2, Issue 1 (March 2025) – 6 articles

Post-COVID-19, significant triage modifications were made in emergency hospital medical care. Previous scoping reviews investigated triage changes during COVID-19. This scoping review uniquely considers post-pandemic effects. It searches the parameters “COVID-19, triage, hospital, emergency medical care” in four primary databases, one register, and a supplementary database to determine the range of emergency hospital triage changes. Following PRISMA guidelines, studies included are post-2023 publications, those in English, and research studies. Excluded were duplicates, reviews, books, and reports lacking research studies or including irrelevant information on COVID-19, triage, hospital, or emergency medical care. Identified are 1071 records: OVID (n = 20), PubMed (n = 2), Scopus (n = 46), Web of Science (n = 20), Cochrane COVID-19 Register (n = 18), and Google Scholar (n = 965). Six studies are included from the Web of Science (n = 1) and Google Scholar (n = 5). One study includes reports from six different countries; thus, there are 11 reports. The modification of triage was concerning four ways, with each country focusing on a specific triage change. Adaptive changes were proactive rather than reactive. Triage-related future research suggestions include the four triage aspects, international comparisons, and longitudinal change. The recommendation is for research assessing Google Scholar. Full article

Background: Abnormalities in the canal of the Nuck are rare clinical entities with presentation in the early adulthood of females. Given their rarity, they can be misdiagnosed with a strangulated inguinal hernia. Methods: Herein, we report a young female with painful swelling of the right inguinal hernia and its surgical approach. Results: A 37-year-old female presented to the emergency department with pain in the right lower abdominal quadrant and an edematous inguinal mass. Physical examination showed a palpable inguinal mass, setting the suspicion for possible incarcerated inguinal hernia. Laboratory exams were within normal ranges. The patient was subsequently treated surgically. During the operation, a cystic well-rounded mass was identified and completely excised. The mesh and plug technique was the chosen technique for the restoration of the inguinal canal. The hospitalization length was one day, and the post-operative course was uneventful. Conclusions: Although a Nuck cyst is a rare entity, it should be taken into consideration in female adults who present with an inguinal mass. Full article

Intensive Care Unit-Acquired Weakness (ICU-AW) is a common and severe complication in critically ill patients, characterized by profound and often prolonged muscle weakness. The complexity of its diagnosis and management requires a multidimensional approach that integrates clinical, electrophysiological, and imaging tools. This review focuses on the challenges in diagnosing ICU-AW, emphasizing the limitations of traditional methods such as manual muscle testing and electrophysiological studies, and highlights the emerging role of neuromuscular ultrasound (NMUS) as a promising, non-invasive diagnostic aid. Despite its utility, no gold standard exists for NMUS, making it an evolving area of research. The pathophysiological basis of ICU-AW involves multiple mechanisms, including critical illness polyneuropathy (CIP), critical illness myopathy (CIM), and muscle atrophy due to disuse. Understanding these underlying mechanisms is crucial for advancing diagnostic strategies and informing therapeutic interventions. Recent insights into the molecular and cellular pathways involved, such as the role of oxidative stress, mitochondrial dysfunction, and the ubiquitin-proteasome system, have opened new avenues for targeted therapies. Management of ICU-AW remains challenging as no specific treatment has been proven fully effective. Current strategies focus on early mobilization, minimizing sedation, and optimizing nutritional support. Emerging therapies targeting molecular pathways involved in muscle degradation are under investigation, highlighting the potential to translate pathophysiological understanding into therapeutic innovations. This review underscores the need for ongoing research to establish standardized diagnostic protocols and develop targeted treatments for ICU-AW. Full article

Background: Geriatric trauma patients often present with multiple comorbidities, which can complicate their treatment and impact outcomes. This study examines the effect of common pre-existing comorbidities on mortality and recovery in polytrauma patients, comparing them to polytrauma patients without these conditions. Methods: We conducted a retrospective cohort study of patients with an Injury Severity Score (ISS) ≥ 16, admitted to a Level I trauma center between 2006 and 2019. A total of 315 patients were analyzed, including 235 with at least one comorbidity (COPD, type II diabetes, or anticoagulation due to atrial fibrillation) and 80 patients without any comorbidities, who served as the control group. Results: While comorbid patients had similar ISS scores compared to controls, they experienced significantly longer hospital and ICU stays. No significant difference in overall survival was found between the groups. However, patients with comorbidities were more prone to secondary complications, such as sepsis and thrombosis. Conclusions: The presence of common comorbidities, while associated with longer recovery times and increased complication rates, did not significantly impact mortality in polytrauma patients. Full article

In recent years, the integration of informatics in emergency medicine has led to significant improvements in clinical decision-making, patient management, and overall healthcare delivery. This literature review explores the most recent trends and applications of informatics in the field of emergency medicine, including electronic health records, telemedicine, artificial intelligence, and mobile health technologies. The goal is to provide a comprehensive overview of the state-of-the-art technologies, their current implementations, and the challenges that remain to be addressed. Full article

Introduction: Non-compressible torso hemorrhage (NCTH) is a major cause of preventable mortality in trauma, particularly when immediate surgical intervention is not available. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has emerged as a promising technique to control severe hemorrhaging and stabilize patients until definitive surgical care can be performed. Case Presentation: We report the case of a 45-year-old woman who sustained multiple traumatic injuries—including thoracic, pelvic, and aortic damage—after a fall from approximately 5 m in an apparent suicide attempt. She arrived at a secondary-level trauma center in profound hemorrhagic shock, unresponsive to standard resuscitation. Interventions: As the patient’s condition deteriorated to cardiac arrest, an emergent REBOA procedure was performed by emergency physicians. This intervention rapidly restored hemodynamic stability, enabling damage control resuscitation and safe transfer to a Level 1 Trauma Center for definitive surgical management, including thoracic endovascular aortic repair and splenectomy. Outcomes: After prolonged intensive care, the patient recovered sufficiently to be discharged for rehabilitation. This case illustrates the life-saving potential of early REBOA deployment in a non-surgical, resource-limited setting to bridge patients to definitive care. Conclusions: This case supports integrating REBOA into emergency trauma protocols, particularly in centers without immediate surgical capabilities. Further research is warranted to refine REBOA deployment strategies, balloon positioning, patient selection, and the role of imaging guidance. Full article