Emergency Care Research Articles

A Global Review of Advanced Practice Nursing in the Emergency Department.

As demands in the way of healthcare delivery increase, nurse practitioners have become essential components in optimizing access to healthcare and improving outcomes around the globe. The authors recognize the vital role nurse practitioners play globally and that education, practice, and credentialing differ significantly across countries. Many countries have a wide variation in educational requirements, resulting in a lack of adequate advanced practice nursing training and regulation of practice. Additionally, many countries are experiencing increased demands in the form of emergency services, with long waiting times and severe crowding in emergency departments. Worldwide, many programs are being developed to educate advanced practice nurses on improving emergency medical care, but developing such programs is a complex process This article aims to discuss the scope of practice and roles of advanced practice nurses globally. We will also attempt to clarify and improve these global standards and discuss competencies in this role.

Transgender People in Emergency And Rescue Services

The treatment of transgender individuals presents a multifaceted challenge for those involved in emergency and rescue services, encompassing not only medical but also social aspects. Despite the increasing importance of healthcare for transgender individuals in Germany over recent years, there remains significant uncertainty among healthcare professionals in addressing the needs of this population. This uncertainty can result in transgender individuals delaying access to the healthcare system due to previous negative experiences, thereby increasing the risk of receiving suboptimal medical care.Ambiguities exist regarding gender-specific health issues and the appropriate use of pronouns and names. Surveyed participants have expressed a desire for more training opportunities in this area. Enhanced training of emergency services personnel is essential for fostering a better understanding of gender-specific health concerns. Additionally, there is a notable lack of specific guidelines for the treatment of transgender individuals within both emergency services and emergency rooms. Establishing specific treatment guidelines can enhance the safety of healthcare workers and consequently improve the medical care provided to transgender individuals.The objective of this CME article is to outline the key aspects of emergency medical care for transgender individuals, aiming to reduce uncertainties among emergency service personnel and enhance the quality of medical care for this group.

FI-lab in the emergency department and adverse outcomes among acutely hospitalized older adults

BackgroundThe emergency department is treating a growing number of older patients with frailty, which has been linked to poorer outcomes. Urgency is generally emphasized in the emergency department based on indicators such as triage scores and early warning scores for decision-making. However, this approach may not be sufficient for frail older people. The Frailty Index-laboratory (FI-lab) has been used as a simple assessment tool for frailty, but it may also reflect disease severity and predict adverse outcomes in the emergency care setting. Therefore, we aimed to evaluate the association between FI-lab in the emergency room and adverse outcomes during hospitalization through comparison with assessments using triage and early warning scores. MethodsThis was a retrospective cohort study conducted in a tertiary hospital. The study included patients aged 65 years or older who were admitted to the general internal medicine ward after being initially evaluated in the emergency department. FI-lab was calculated using 24 laboratory parameters from blood tests. The National Early Warning Score (NEWS), the Japan Triage and Acuity Scale (JTAS), and the modified JTAS were also used as prognostic indicators, and their association with adverse outcomes was compared with that of FI-lab. ResultsIn total, 872 patients (mean age, 80.9 years; male, 52.6 %) were analyzed. Patients who died during hospitalization had a higher FI-lab than those who survived. In multiple regression analysis, FI-lab, NEWS, and the modified JTAS were significantly associated with in-hospital death and prolonged length of hospital stay. In contrast, none of these indices were associated with in-hospital falls. The FI-lab was independently associated with the likelihood of discharge to home. ConclusionsFI-lab evaluated in the emergency department reflected the severity of illness in acutely hospitalized older adults, similarly to NEWS and JTAS, and was a useful indicator for predicting adverse outcomes. These results may indicate the value of FI-lab for older adults in the acute care setting.

370 Emergency Care Capacity Assessment of District Hospitals in Rwanda Using the WHO’s Hospital Emergency Assessment Tool

370 Emergency Care Capacity Assessment of District Hospitals in Rwanda Using the WHO’s Hospital Emergency Assessment Tool

Emergency care of injured wild deer: advice for companion animal practices

Emergency care of injured wild deer: advice for companion animal practices

Extending emergency care beyond discharge: Piloting a virtual after care clinic.

Many unscheduled return visits to the emergency department (ED) stem from insufficient access to outpatient follow-up. We piloted an emergency medicine-staffed, on-demand, virtual after care clinic (VACC) as an alternative for discharged ED patients. Prospective cohort study of discharged ED patients who scheduled VACC appointments within 72hoursof index ED visit. We performed descriptive analyses and compared risks of ED return at 72hours and 30 days between patients who did/did not attend their appointment. From March to December 2022, 309 patients scheduled VACC appointments and 210 (68%) attended them. Patients who scheduled appointments were young (median 37 years), non-Hispanic white (80%), females (75%) with a primary care physicians (PCP) (90%), and commercial insurance (72%). Most VACC visits reinforced ED testing and/or treatment (64%) or adjusted medications (26%). VACC attendees were less likely to return to the ED within 72h (3.3%vs. 13.1%; risk difference 9.3% [95% confidence interval, CI 2.7%‒19.8%]) and 30 days (16.2%vs. 30.3%; risk difference 14.1% [95% CI 3.8%‒24.4%]) compared to those who scheduled but did not attend a VACC appointment.VACC attendance was associated with lower odds of 72-h (adjusted odds ratio [aOR] 0.0; 95% CI 0.0‒0.4) and 30-day (aOR 0.4; 95% CI 0.2‒0.7) return ED visits. In this pilot study, younger, white, female, commercially insured patients with a PCP preferentially scheduled VACC appointments. Among patients who scheduled VACC appointments, those who attended their appointments were less likely to return to the ED within 72hours and 30 days than those who did not.

Exploring the burden of paediatric acute otitis media with discharge in the UK: a qualitative study

BackgroundAcute otitis media with discharge (AOMd) results from a tympanic membrane perforation secondary to a middle ear infection. Currently, the impact of AOMd on children and young people (CYP) and...

The Controversy over Price Transparency: Patients and Plastic Surgeons Disagree.

The No Surprises Act (NSA) went into effect on January 1, 2022. This federal law is designed to minimize surprise bills for emergency care, out of network (OON) care, and care for uninsured or self-pay individuals. To achieve these goals, the NSA relies heavily on physicians providing cost estimates to patients prior to administering care. Because healthcare is often price-opaque, this study was conducted to assess physician and patient attitudes toward price transparency in plastic surgery and aesthetic/self-pay medicine. Two cohorts of providers received a survey asking whether and how their practice offers pricing information prior to a consultation and their views regarding the NSA. Patients who had previously used an online price estimator tool also received a survey regarding their experience and accuracy of estimates received online. Most surveyed providers do not share the costs of their services online, whereas patients had a positive experience when receiving estimates of medical services before consultation. Although many providers cited the inaccuracy of price estimator tools as a reason not to incorporate them into their website, most patients reported that their final cost of service was close to (or even less than) the estimate received online prior to the consultation. This study suggests that price transparency is a patient satisfier. Therefore, plastic surgeons should exercise price transparency to be compliant with federal law and to gain a competitive advantage in the market, as the decision to implement price transparency can be mutually beneficial to patients and providers.

Beyond the pain: Decoding opioid use in advanced cancer ED visits.

298 Background: Patients with advanced cancer often turn to the emergency department (ED) for pain treatment, impacting their quality of life and escalating healthcare costs. A crucial step in reducing avoidable ED visits and maintaining patient safety is to identify the characteristics of this patient group and explore potential intervention points. This study aims to characterize the use of narcotics in the ED among patients with advanced cancer. Methods: This retrospective cross-sectional study at Kaiser Permanente Northern California involved adults aged 18 and older diagnosed with Stage IV solid cancers between 2018 to 2020, who had at least one ED visit and passed away within one year (excluding those who died within 30 days). Demographics, clinical variables, frequencies, and trends in ED visits were collected and compared based on opioid utilization. Results: The study encompassed 2,554 patients with 6,406 ED visits in their final year of life. Sixty-one percent of these patients received opioids during their ED visits, with a median of three visits per patient. Pain scores taken at triage of these visits showed 23% reported severe pain, 23% moderate pain, and 7% mild pain. In 56% of visits, patients had filled an opioid prescription within the last 30 days. Morphine (39%) and hydromorphone (29%) were the most commonly administered opioids, primarily intravenously (66%). The prevalent cancer subtypes receiving opioids during ED visits were breast, head and neck, and upper GI. Among patients who received chemo or radiation, 65% received opioids during ED visits, compared to the 55% of patients not in treatment. For treated patients, chemotherapy was associated with increased ED visits requiring opioid pain management. Median survival did not differ significantly between those who received opioids during ED visits (130 days) and those who did not (123 days). Conclusions: This study emphasizes the dynamic pain needs of patients with cancer at the end of life driving utilization of emergency care. Factors influencing these needs include cancer subtype and current treatment status, particularly chemotherapy. Further studies are essential to enable providers to better recognize cancer pain and to improve patient safety by addressing changes in patients' pain requirements outside the emergency setting.

Which factors influence the decision of hospitals to provide procedures on an outpatient basis? –Mixed-methods evidence from Germany

Shifting care from the resource-intensive inpatient setting to the more economically efficient outpatient sector is being promoted internationally by policymakers. Financial incentives are a major focus of such efforts because low levels of hospital outpatient care are attributed to differences in payment for inpatient and outpatient services. In Germany, however, there is significant variation in the extent to which hospitals provide outpatient care despite a uniform payment system. Therefore, other factors must be influencing German hospitals’ strategic decisions whether to offer outpatient care. While most research has focused on specific procedures or lacks empirical support, our study provides a comprehensive analysis of the factors beyond financial incentives that influence the provision of hospital outpatient services in Germany. We employed a mixed-methods approach, first contacting health care experts with in-depth knowledge of the hospital outpatient landscape to identify possible influencing factors and then conducting a comprehensive quantitative analysis of all German hospitals. Our findings suggest that policymakers seeking to promote hospital outpatient care should consider a broad range of factors. We found that a hospital's service mix, size, procedure volume, and emergency care infrastructure significantly affected the proportion of outpatient services it offered. Strategic hospital planning emphasizing specialization and adherence to minimum volume standards might therefore be a valuable policy tool. Our analysis also highlights the importance of demographic and socioeconomic factors, such as the regional share of single-person households, suggesting that a comprehensive policy framework should account for broader population characteristics and not just elements directly related to hospital care.

A Retrospective Analysis of Patients Presenting with Acute Hyperkalemia in an Emergency Care Setting.

We aimed to analyze the clinical characteristics and prognostic factors of patients with severe hyperkalemia in the emergency department. This retrospective cohort study included adult patients diagnosed with severe hyperkalemia who sought medical care at the emergency department of Aerospace Center Hospital between January 2018 and May 2022. Clinical data, including demographics, comorbidities, laboratory findings, and outcomes, were systematically collected. Patients were categorized into survival and deceased groups based on in-hospital mortality. Comparative analysis between these groups identified significant differences, highlighting key clinically covariates. Binary logistic regression was employed to determine the primary factors influencing patient outcomes. Of 90 patients diagnosed with severe hyperkalemia, 64 were in the survival group, and 26 in the deceased group. Binary logistic regression identified several significant predictors of mortality, including higher APACHE II scores (odds ratio [OR] 1.41, P = 0.02), widened QRS wave on electrocardiogram (ECG) (OR 79.39, P = 0.04), and elevated serum potassium levels (OR 1.3, P = 0.04). In contrast, emergency blood purification was associated with a reduced mortality rate (OR 0.29, P = 0.03). Key risk factors for mortality in patients with severe hyperkalemia include widened QRS wave on ECG, elevated APACHE II score, and high serum potassium level. Timely correction of hyperkalemia through emergency blood purification significantly improves patient outcomes.

Procedural Sedation and Analgesia in an Australian Emergency Department: Results of the First 3 Months of a Procedural Sedation Registry

Background: Procedural sedation and analgesia (PSA) is commonly performed in emergency departments (EDs) to reduce anxiety, discomfort, or pain during a procedure. The primary goal of PSA is to produce a state of relaxation and drowsiness without eliminating the patient’s protective reflexes. Despite the discovery of new techniques and medications to deliver PSA, there is a paucity of research evaluating PSA in EDs over the last decade. We aim to describe the current practice of PSA in an Australian tertiary mixed ED with 75,000 presentations per year. Methods: A retrospective study of the initial 3 months of a PSA registry, which was part of the Tasmanian Emergency Care Outcomes Registry, was analyzed; Results: All told, 80 consecutive cases were entered over a 3-month period, with pediatric patients (<14 years old) making up 35% of all cases. Joint reductions (17, 39%) and fracture reductions (13, 29%) were the most common indications for the adult population, whilst fracture reductions (9, 36%), laceration repairs (7, 28%), and other distressing procedures (7, 28%) were the most common indications in the pediatric cohort. Pharmacological approaches also differed between groups, with ketamine (25, 92%) preferred in the pediatric cohort whilst the combination of propofol and fentanyl (22, 42%) was preferred in the adult cohort. No adverse events were recorded in the pediatric cohort whilst 6 (8%) minor events occurred in the adult population, with no severe events occurring for either cohort. PSA also occurred more frequently at 0900–1000 and the incidence was reduced between 0000 and 0800. Conclusions: PSA is commonly performed in our tertiary mixed ED and is both safe and effective, with non-severe complication rates similar to those in the reported literature. Severe complications are rare and therefore a larger cohort will be required to assess this aspect. The approach to ED PSA is also different between pediatric and adult populations and therefore research needs to differentiate both populations.

Clinical practice guidelines for person-centred handover practices in emergency departments: a scoping review.

To review the available information on clinical practice guidelines for person-centred and current handover practices between emergency care practitioners (ECPs) and healthcare professionals in emergency departments (EDs). Collating existing clinical practice guidelines may improve handover practices. Clinical practice guidelines for person-centred handover practices between ECPs and healthcare professionals in EDs. ECPs transporting and handing patients over to healthcare professionals in EDs. Healthcare professionals including doctors and nurses working in EDs, who are involved in handovers with ECPs. Studies conducted in EDs, emergency rooms or emergency centres in any geographical area. No language or time restrictions were applied. The search included published and unpublished studies, opinion papers as well as primary sources, and evidence synthesis. All qualitative and quantitative research designs were included. The literature on clinical practice guidelines for person-centred handover practices was reviewed. Three electronic databases were searched: MEDLINE (PubMed), CINAHL (EBSCO) and Scopus from inception to May 2023 with no time limits set for the inclusion of published literature in the review. Six guideline organisations were also searched. A data extraction tool was developed, pilot-tested and used to extract data from the included studies. 19 studies met the inclusion criteria. Various mnemonics exist for handover practices. Where mnemonics are not used, participants have identified important information that should be included during handover practices. We did not find any clinical practice guidelines or information on person-centred handover practices in any of the reviewed articles. Currently, there is no gold standard for person-centred handover practices, which has led to various practices being implemented. Currently, there is a paucity of literature on person-centred handover practices. Most articles expressed a need for standardised handover practices; however, not all aspects of handover practices can be standardised and should be kept patient and context-specific. This scoping review protocol was registered on Figshare (10.6084/m9 /m9.figshare.21731528).

Take-home naloxone in multicentre emergency settings: the TIME feasibility cluster RCT.

Opioids kill more people than any other drug. Naloxone is an opioid antagonist which can be distributed in take-home 'kits' for peer administration (take-home naloxone). To determine the feasibility of carrying out a definitive randomised controlled trial of take-home naloxone in emergency settings. We used Welsh routine data (2015-21) to test the feasibility of developing a discriminant function to identify people at high risk of fatal opioid overdose. We carried out a cluster randomised controlled trial and qualitative study to examine experiences of service users and providers. We assessed feasibility of intervention and trial methods against predetermined progression criteria related to: site sign-up, staff trained, identification of eligible patients, proportion given kits, identification of people who died of opioid poisoning, data linkage and retrieval of outcomes. This study was carried out in the emergency environment; sites comprised an emergency department and associated ambulance service catchment area. At intervention sites, we invited emergency department clinicians and paramedics to participate. We recruited adult patients who arrived at the emergency department or were attended to by ambulance paramedics for a problem related to opioid use with capacity to consent to receiving the take-home naloxone and related training. Usual care comprised basic life support plus naloxone by paramedics or emergency department staff. The take-home naloxone intervention was offered in addition to usual care, with guidance for recipients on basic life support, the importance of calling the emergency services, duration of effect, safety and legality of naloxone administration. With low numbers of opioid-related deaths (1105/3,227,396) and a high proportion having no contact with health services in the year before death, the predictive link between death and opioid-related healthcare events was weak. Logistic regression models indicated we would need to monitor one-third of the population to capture 75% of the decedents from opioid overdose in 1-year follow-up. Four sites participated in the trial and 299 of 687 (44%) eligible clinical staff were trained. Sixty take-home naloxone kits were supplied to patients during 1-year recruitment. Eligible patients were not offered take-home naloxone kits 164 times: 'forgot' (n = 136); 'too busy' (n = 15); suspected intentional overdose (n = 3). Service users had high levels of knowledge about take-home naloxone. They were supportive of the intervention but noted concerns about opioid withdrawal and resistance to attending hospital for an overdose. Service providers were positive about the intervention but reported barriers including difficulty with consenting and training high-risk opioid users. We were able to calculate costs to train staff at three sites (£40 per AS and £17 in Site 1 ED). No adverse events were reported. Progression criteria were not met - fewer than 50% of eligible staff were trained, fewer than 50% of eligible patients received the intervention and outcomes were not retrieved within reasonable timescales. The take-home naloxone intervention needs to be developed and evaluated in emergency care settings, with appropriate methods. The Take-home naloxone Intervention Multicentre Emergency setting study was interrupted by coronavirus disease. This study did not meet progression criteria for intervention or trial methods feasibility, so outcomes were not followed up and a fully powered trial is not planned. This trial is registered as ISRCTN13232859. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/91/04) and is published in full in Health Technology Assessment; Vol. 28, No. 74. See the NIHR Funding and Awards website for further award information.

Exploring the Lived Experiences of Post-basic Nursing Students: Insights into Continuous Learning

Continuous learning in clinical settings is essential for optimum quality of care. This study examines the lived experiences of post-basic nursing students specialising in critical care, emergency care, and peri-operative care in a tertiary university hospital. Using a descriptive phenomenological approach, three focus group interviews were conducted with 23 purposively sampled post-basic critical care nursing students. Four overarching themes emerged from the data analysis: (1) the programme’s benefits to students; (2) feedback on programme implementation; (3) avenues for future improvement; and (4) challenges encountered during the programme. The findings emphasise the critical role of ongoing education in clinical contexts, particularly in post-basic critical care nursing education. Students’ lived experiences underscore the programme’s positive effects on their knowledge, skills, and organisational benefits, emphasising the crucial role of continuous education in enhancing the quality of nursing care. The identified themes offer valuable insights into the advantages, obstacles, and areas needing improvement in post-basic critical care nursing education. They showed the importance of a sustained commitment to continuous learning to ensure the delivery of high-quality care in clinical practice. This study contributes to the existing body of knowledge on nursing education and offers valuable insights for educators, administrators, and policymakers to optimise the training and development of nurses to achieve quality patient outcomes.

Nurses’ Experiences with the Use of Electronic Nursing Record: A Qualitative Study

Background: The electronic nursing record has contributed to improving nursing practice and ensuring nursing quality, but it is still incomplete in supporting nursing workflow. The purpose of this study is to explore the experience of using the electronic nursing record by nurses working in frontline care for trauma, emergency, and infectious disease-exposed patients.Methods: The study employed a qualitative descriptive design and qualitative content analysis. In-depth interviews were conducted with 10 nurses working in emergency, trauma, and critical care units in the tertiary hospital.Results: The nurses’ experiences with the use of the electronic nursing record emerged into three subjects (improvements to electronic nursing record implementation, benefits of electronic nursing record implementation, electronic nursing record user factors), five categories (information finding and sharing function, information input function, facilitating efficient communication, ensuring record quality, need for education), and eight subcategories.Conclusions: Electronic nursing record supports the visualization of special information such as emergency and infection, and has the advantage of facilitating communication between medical staff. Both support better clinical decision-making. However, system instability and low nursing friendliness delay nursing work in the process of inputting, confirming, and sharing information. Copy-andpaste practices, poor quality of records, and insufficient electronic nursing record education were identified as factors to be changed on the user side. Improvement of nursing-friendly interfaces, optimization of nursing workflows, and participation of nurses in the improvement process are necessary. We should also focus on developing electronic nursing record education programs.

Postpartum Emergency Care Visits Among North Carolina Medicaid Beneficiaries, 2013-2019.

Objective: To describe the rate, timing, and primary diagnosis codes for emergency care visits up to 8 weeks (56 days) after live birth among Medicaid beneficiaries in North Carolina (NC). Materials and Methods: Using a linked dataset of Medicaid hospital claims and certificates of live birth, which included Medicaid beneficiaries who had a live-born infant in NC between January 1, 2013, and November 4, 2019, and met inclusion criteria (n = 321,879), we estimated week-specific visit rates for emergency care visits that did not result in hospital admission (outpatient) and those that did (inpatient). We assessed the 10 leading diagnosis code categories for emergency care visits and described the characteristics of people with 0, 1, or ≥2 outpatient emergency care visits. Results: One in eight (12.4%) Medicaid beneficiaries had an emergency care visit that did not result in inpatient hospital admission during the first 8 weeks postpartum. Visit rates peaked in postpartum week 2. Diagnosis codes for nonspecific symptoms and substance use were the two leading diagnosis code categories for outpatient emergency care visits. Respiratory concerns and gastrointestinal concerns were the two leading diagnosis code categories for inpatient emergency care visits. Compared with those with zero outpatient emergency care visits, a greater proportion of people with ≥2 visits had less than a high school education, used tobacco during pregnancy, had Medicaid insurance outside of pregnancy, had mental health as a medical comorbidity, and/or had ≥2 medical comorbidities. Conclusions: These findings support scheduling health care visits early in the postpartum period, when emergency care visits are most frequent, and point to unmet needs for substance use support.

Effect of patient gender on the decision of ceiling of care: an European study of emergency physicians' treatment decisions in simulated cases.

Gender bias in healthcare can significantly influence clinical decision-making, potentially leading to disparities in treatment outcomes. This study addresses the impact of patient gender on the decision-making process for establishing a ceiling of care in emergency medicine, particularly the decision to limit tracheal intubation. To determine whether patient gender influences emergency physicians' decisions regarding the recommendation for tracheal intubation in critically ill patients. A European survey-based study was conducted using a standardized clinical scenario to assess physicians' decisions in a controlled setting. The survey targeted European emergency physicians over a 2-week period in April 2024. A total of 3423 physicians participated, with a median age of 40 years and a distribution of 46% women. Physicians were presented with a clinical vignette of a 75-year-old patient in acute respiratory distress. The vignettes were randomized to vary only by the patient's gender (woman/man) and level of functional status: (1) can grocery shop alone, (2) cannot grocery shop alone but can bathe independently, or (3) cannot perform either task independently. The primary outcome was the recommendation for intubation, with secondary analyses exploring the influence of patient functional status levels. Multivariable logistic regression was used to adjust for potential confounders, including physician gender, age, experience, and practice setting. A total of 3423 physicians responded, mostly from France, Spain, Italy, and the UK (1,532, 494, 247, and 245 respectively). Women patients were less likely to be intubated compared to male patients [67.9% vs. 71.7%; difference 3.81%; 95% confidence interval (CI), 0.7-6.9%]. The likelihood of recommending intubation decreased with lower levels of patient functional status. Women physician gender was also associated with a reduced likelihood of recommending intubation. This study suggests a significant gender-based disparity in emergency care decision-making, with women patients being less likely to receive recommendations for intubation. However, these results should be interpreted with caution due to potential limitations in the representativity of respondents and the uncertain applicability of survey responses to real-life clinical practice.

Assessment of Knowledge and Practices of Medical Emergencies in Medical and Dental Students of the University of Ha'il, Saudi Arabia: A Cross-Sectional Study.

Aim and background Medical emergencies (MEs) pose urgent threats to life and occur frequently, with primary care providers seeing at least one emergency per year. Common MEs include asthma, anaphylaxis, seizures, and cardiac arrest. However, many medical offices are ill-equipped to handle these emergencies. Practices should obtain appropriate emergency equipment and medications based on their patient population, provider expertise, and proximity to the ER. A lack of emergency preparedness and training can have fatal consequences, so all healthcare providers must be well-prepared to respond. Providing basic life support (BLS) is the crucial first step until definitive treatment is available. The study aimed to assess emergency-related knowledge, its relationship to expertise, and the need for emergency management training among medical/dental students at University of Ha'il (UOH) in Saudi Arabia. Methods The study included 214 participants. It consisted of male and female dental and medical students in their clinical years at the UOH in Saudi Arabia. This targeted sampling approach ensured the study focused on the relevant demographic factors of dental and medical students to provide insights into their level of MR-related knowledge and its relationship to their expertise, as well as their awareness and need for training in ME management. The researchers aimed to assess these factors among the medical and dental students at the UOH. Result Dental and medical students show a strong grasp of emergency care fundamentals, with 78.6% familiar with BLS protocols. Most students correctly identify crucial actions, such as assessing airway, breathing, and circulation (ABCs), and immobilizing the head and neck for spinal injuries. Responses to emergencies include starting chest compressions, calling 911, and administering appropriate treatments for cardiovascular, respiratory, and neurological issues. Despite high competency levels, continuous education is vital to maintain and enhance their preparedness for emergencies. Conclusions Dental and medical students demonstrate a solid understanding of BLS, with 78.6% familiar with protocols and many identifying critical emergency actions. However, inconsistencies in responses highlight the need for ongoing education to improve decision-making and preparedness. Continuous training will ensure these future healthcare professionals are equipped to handle real-world emergencies effectively.

The long-run effect of COVID-19 on hospital emergency department attendances:evidence from statistical analysis of hospital data from England

During the COVID-19 pandemic, hospital emergency departments worldwide experienced a pronounced fall in utilisation of emergency care, with a decrease of up to 40% in many countries. Evidence suggests the cause of these changes include both population fear of COVID-19 and the effects of lockdowns and the interaction of these two effects. We analyse a sub-sample of national data on Accident and Emergency (A&E) attendances in England over an extended period from April 2019 to March 2022 for different patient groups, including by age, mental/physical health status, acuity, and common clinical groupings. Our results showed that all patient groups experienced substantial declines in attendances during the first two waves of the pandemic, including high acuity and cardiovascular patients. Mental health patients were the only exception, with a smaller decline in attendances. Our findings suggest that policymakers should recognise the potential harmful effects of lockdowns, public messaging, and changes in health care provision on all patients during health emergencies.