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The Journal of Emergency Management and Disaster Communications (JEMDC) has experienced significant growth in the field of international emergency management since its launch in 2020. However, there is still a lack of precision in defining the boundaries and scope of emergency management as an interdisciplinary field. In China, emergency management was integrated as a secondary discipline within public administration, but it was found to be insufficient in addressing medical emergencies during catastrophic events. Therefore, there is a need for the development of emergency medicine as a distinct discipline within emergency management. Emergency medicine extends beyond traditional hospital settings and requires standardized theoretical instruction and hands-on training for medical and nursing professionals. The three core components of modern emergency medicine are medical rescue, psychological aid, and cultural communication. Medical rescue involves adapting medical strategies to challenging environments and limited resources. Psychological aid focuses on addressing the psychological effects experienced by disaster survivors. Cultural communication is crucial in managing public sentiment and the dissemination of accurate information during emergencies. The establishment of a holistic emergency medicine system is essential for safeguarding public safety. [Extracted from the article]

Osmotic therapy has been recognized as an important treatment option for patients with traumatic brain injury (TBI). Nevertheless, the effect of hypertonic saline (HTS) remains unknown, as findings are primarily based on a large database. This study aimed to elucidate the effect of HTS on the clinical outcomes of patients with TBI admitted to the intensive care unit (ICU). We retrospectively identified patients with moderate-to-severe TBI from two public databases: Medical Information Mart for Intensive Care (MIMIC)-IV and eICU Collaborative Research Database (eICU-CRD). A marginal structural Cox model (MSCM) was used, with time-dependent variates designed to reflect exposure over time during ICU stay. Trajectory modeling based on the intracranial pressure evolution pattern allowed for the identification of subgroups. Overall, 130 (6.65%) of 1955 eligible patients underwent HTS. MSCM indicated that the HTS significantly associated with higher infection complications (e.g., urinary tract infection (HR 1.88, 95% CI 1.26–2.81, p = 0.002)) and increased ICU LOS (HR 2.02, 95% CI 1.71–2.40, p < 0.001). A protective effect of HTS on GCS was found in subgroups with medium and low intracranial pressure. Our study revealed no significant difference in mortality between patients who underwent HTS and those who did not. Increased occurrence rates of infection and electrolyte imbalance are inevitable outcomes of continuous HTS infusion. Although the study suggests slight beneficial effects, including better neurological outcomes, these results warrant further validation. [ABSTRACT FROM AUTHOR]

Objective The aim of this meta-analysis is to compare the potential effects of inhalation anesthetics with total intravenous anesthetics on alveolar cytokine expression and lung-related clinical outcomes in patients undergoing one-lung ventilation (OLV) for thoracic surgery. Methods We retrieved the PubMed, EMBASE, and the Cochrane Library respectively to identify randomized controlled trials comparing different anesthetics (volatile anesthetics vs. intravenous anesthetics) on the pulmonary inflammatory response to OLV. The primary outcomes were the levels of alveolar concentrations of inflammatory cytokines. Results Eight randomized controlled trials that included 365 patients were screened. Overall, there were significant differences in the concentration of alveolar inflammatory mediators between volatile group and intravenous group, in which volatile group had lower levels of TNF-[alpha] (SMD -1.51; 95 % CI -2.15 to -0.87; p < 0.001), IL-6 (SMD -0.70; 95 % CI -0.99 to -0.41; p < 0.001) and IL-8 (SMD -1.32; 95 % CI -2.20 to -0.45; p = 0.003). The overall number of pulmonary complications in the volatile group was smaller (RR 0.42; 95 % CI 0.23-0.77; p = 0.005) and patients in that group had significantly abridged hospitalization stay (WMD -3.59 days; 95 % CI -5.70 to -1.48 days; p = 0.001). Conclusions Inhalation anesthetics might be preferable in patients undergoing OLV for thoracic surgery and their protective effects might work via attenuating inflammatory responses., Author(s): Bin Sun[sup.1] , Jinfeng Wang[sup.2] , Lulong Bo[sup.3] , Yan Zang[sup.1] , Haihui Gu[sup.1] , Jinbao Li[sup.3] , Baohua Qian[sup.1] Author Affiliations: (1) Department of Transfusion Medicine, Changhai Hospital, [...]

Background: Postoperative delirium (POD) is associated with perioperative complications and mortality. Data on the risk factors for delirium after subthalamic nucleus deep brain stimulation (STN-DBS) surgery is not clarified in Parkinson's disease (PD) patients receiving total intravenous anesthesia. We aimed to investigate the risk factors for delirium after STN-DBS surgery in PD patients. Methods:The retrospective cohort study was conducted, including 131 PD patients who underwent STN-DBS for the first time under total intravenous anesthesia from January to December 2021. Delirium assessments were performed twice daily for 7 days after surgery or until hospital discharge using the confusion assessment method for the intensive care unit. Multivariate logistic regression analysis was used to determine the risk factor of POD. Results: In total, 22 (16.8%) of 131 patients were in the POD group, while the other 109 patients were in the Non-POD group. Multivariate logistic regression analysis showed that preoperative Mini-mental State Examination score [odds ratio = 0.855, 95% confidence interval = 0.768–0.951, p = 0.004] and unified Parkinson's disease rating scale part 3 (on state) score (odds ratio = 1.061, 95% confidence interval = 1.02–1.104, p = 0.003) were independently associated with delirium after surgery. Conclusions: In this retrospective cohort study of PD patients, a lower Mini-mental State Examination score and a higher unified Parkinson's disease rating scale part 3 (on state) score were the independent risk factors for delirium after STN-DBS surgery in PD patients under total intravenous anesthesia. [ABSTRACT FROM AUTHOR]