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Treatments, Care Pathway and Organizational Issues in Emergency Medicine

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 March 2023) | Viewed by 2160

Special Issue Editor


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Guest Editor
1. Service d'Accueil des Urgences—SAMU 69, Centre Hospitalier Universitaire Edouard Herriot, 69003 Lyon, France
2. Laboratory “Research on Healthcare Performance” (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France
Interests: pain management; opioid; analgesics; health volunteers; translational research; pain model; drug misuse; Sepsis; blood management; health policy

Special Issue Information

Dear Colleagues,

The International Journal of Environmental Research and Public Health is calling for papers for a Special Issue on the “Treatments, Care pathway and Organizational issues in Emergency Medicine”. 

Emergency Medicine is a large research area, but organizational issues are not enough promoted in literature. In our modern practice, drug efficacy can’t be considered in an isolated manner. Emergency Care is a piece of a care system, a moment in a global care path. Covid-19 crisis had recently highlighted the relevance of organizational concerns in Emergency medicine. Minor trauma and geriatric pathways are known to need new diagnostic and therapeutic tools since several years, and new care-providers categories have emerged in emergency medicine  in line with this objective (advanced practice nurses). Emergency pathways are growing in order to improve care level and care efficiency, beyond the scope of “fast tracks”, and visibility of these changes must be enhanced.

Moreover, Physicians and nurses are now involved in a complex decision-making process, for a better balance between standardization of treatment and personalized patient-physician care contracts. Drug management have now to target personalized medicine whereas overcrowding phenomenon, and multiplicity of health-care providers still remain heavy constraints in Emergency care.

Adequate use of technological innovations is one of the new cornerstones, but medico-economic considerations must become systematic and evolve. Drug circuits must allow easy access but have also to deal with larger environmental concerns to fit new society priorities as ecology.

Quality of care in Emergency Medicine will be linked to these new goals in the next decade.

In this special issue we aim to highlight original perspectives regarding treatment, care pathway and organizational issues regarding this new context.

Any Emergency location will be considered. We expected to encourage submissions from contributors in a large population of health providers. All thematic will be considered, but with a particular interest for: Pain management, Blood management, Prevention of Drug Misuse, and Sepsis management. Patient-centered researches will be favored, but evaluation of professional practices and Health-professional management will be also considered, as long as they are focused on care pathway, decision-making, barriers to innovation, or on treatment compliance.

We look forward to receiving your contributions.

Dr. Virginie Ève Lvovschi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Published Papers (1 paper)

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Research

11 pages, 522 KiB  
Article
Accuracy of a Prehospital Triage Protocol in Predicting In-Hospital Mortality and Severe Trauma Cases among Older Adults
by Axel Benhamed, Marcel Emond, Eric Mercier, Matthieu Heidet, Tobias Gauss, Pierre Saint-Supery, Krishan Yadav, Jean-Stéphane David, Clement Claustre and Karim Tazarourte
Int. J. Environ. Res. Public Health 2023, 20(3), 1975; https://doi.org/10.3390/ijerph20031975 - 20 Jan 2023
Cited by 3 | Viewed by 1887
Abstract
Background: Prehospital trauma triage tools are not tailored to identify severely injured older adults. Our trauma triage protocol based on a three-tier trauma severity grading system (A, B, and C) has never been studied in this population. The objective was to assess [...] Read more.
Background: Prehospital trauma triage tools are not tailored to identify severely injured older adults. Our trauma triage protocol based on a three-tier trauma severity grading system (A, B, and C) has never been studied in this population. The objective was to assess its accuracy in predicting in-hospital mortality among older adults (≥65 years) and to compare it to younger patients. Methods: A retrospective multicenter cohort study, from 2011 to 2021. Consecutive adult trauma patients managed by a mobile medical team were prospectively graded A, B, or C according to the initial seriousness of their injuries. Accuracy was evaluated using sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios. Results: 8888 patients were included (14.1% were ≥65 years). Overall, 10.1% were labeled Grade A (15.2% vs. 9.3% among older and younger adults, respectively), 21.9% Grade B (27.9% vs. 20.9%), and 68.0% Grade C (56.9% vs. 69.8%). In-hospital mortality was 7.1% and was significantly higher among older adults regardless of severity grade. Grade A showed lower sensitivity (50.5 (43.7; 57.2) vs. 74.6 (69.8; 79.1), p < 0.0001) for predicting mortality among older adults compared to their younger counterparts. Similarly, Grade B was associated with lower sensitivity (89.5 (84.7; 93.3) vs. 97.2 (94.8; 98.60), p = 0.0003) and specificity (69.4 (66.3; 72.4) vs. 74.6 (73.6; 75.7], p = 0.001) among older adults. Conclusions: Our prehospital trauma triage protocol offers high sensitivity for predicting in-hospital mortality including older adults. Full article
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