Despite the increasing availability of clinical decision support systems (CDSSs) and rising expectation for CDSSs based on artificial intelligence (AI), little is known about acceptance AI-based CDSS by physicians its barriers facilitators in emergency care settings.We aimed to evaluate acceptance, barriers, implementing setting through opinions our newly developed, real-time CDSS, which alerts ED predicting aortic dissection numeric text information from medical charts, using Unified Theory...

The Japan Coma Scale (JCS) is the most frequently adopted method for evaluating level of consciousness in Japan. However, no validated converting JCS to Glasgow (GCS) exists. aims present study were develop and validate a convert GCS.This multicenter retrospective analysis involving three emergency departments (EDs) We included all adult patients who visited ED between 2017 2020. participating facilities divided into two cohorts-one cohort table GCS (development cohort), other conversion...

Abstract Background β‐Hydroxy‐β‐methylbutyrate (HMB), a metabolite of leucine, can strongly induce muscle protein synthesis. We evaluated the efficacy HMB complex on volume loss during critical care. Methods For this prospective, single‐center, randomized control trial, we created and groups by random assignment intensive care unit (ICU) patients for whom enteral nutrition could be performed. From 164 ICU patients, 88 severely ill were included assigned: 43 to 45 HMB. day 2 after admission,...

Belt electrode skeletal muscle electrical stimulation can induce contraction of the whole lower body. This study examined efficacy belt on reducing loss volume in critically ill patients.Intensive care unit patients were randomly assigned to control and groups. In both groups, early rehabilitation was administered from day 2 admission. group, administered. Femoral evaluated with computed tomography days 1 10.Ninety-Four severely included 47 each group. volumes 16 21 group measured. For...

Abstract Background Although the combination of rehabilitation and nutrition may be important for prevention intensive care unit (ICU)-acquired weakness, a protocolized intervention this has not yet been reported. We herein developed an original combined protocol evaluated its efficacy. Methods In single-center historical control study, we enrolled adult patients admitted to ICU. Patients in group received standard care, while those protocol-based intervention. The ICU mobility scale was...

Digital advancements can reduce the burden of recording clinical information. This intra-subject experimental study compared time and error rates for vital signs prescriptions between an optical character reader (OCR) manual typing. was conducted at three community hospitals two fire departments in Japan. Thirty-eight volunteers (15 paramedics, 10 nurses, 13 physicians) participated study. We prepared six sample pictures: ambulance monitors (normal, abnormal, shock) pharmacy notebooks that...

For patients admitted to the intensive care unit (ICU) with sepsis, mobilization therapy during ICU stay can improve their outcomes and after stay. However, little is known about optimal timing of introducing therapy.This a retrospective cohort study using data from tertiary medical center in Japan 2013-2017. We included aged ≥ 18 years who were sepsis based on Sepsis-3 criteria. defined early (EM) as rehabilitation at level sitting edge bed or more within first 3 days patients' Patients...

Emergency department information systems (EDIS) facilitate free-text data use for clinical research; however, no study has validated whether the Next Stage ER system (NSER), an EDIS used in Japan, accurately translates electronic medical records (EMRs) into structured data.This is a retrospective cohort using from emergency (ED) of tertiary care hospital 2018 to 2019. We EMRs 500 random samples 27,000 ED visits during period. Through NSER system, chief complaints were translated 231...

Persistent inflammation, immunosuppression and catabolism syndrome (PIICS) often occur after critical care. Disseminated intravascular coagulation (DIC) is expected to be associated independently with PIICS development. We retrospectively analyzed 5397 patients admitted the Hitachi General Hospital emergency care center during four years. classified as C-reactive protein > 3.0 mg/dL or albumin < g/dL lymphocyte count 800/μL on day 14. Prolonged hospital stay (>14 days) without early...

Benzodiazepines are used as first-line treatments for status epilepticus. Fosphenytoin (FPHT) is recommended second-line therapy; however, intravenous injection of levetiracetam (LEV) may also be effective against Herein, we compared the efficacy and safety LEV a treatment epilepticus with FPHT in Japanese patients. Patients were selected from database Emergency Critical Care Center Hitachi General Hospital. The subjects patients whose was successfully stopped by diazepam, whom or...

A specific antibiogram is necessary for the empiric antibiotic treatment of community-acquired urinary tract infections (UTI) because global spread antimicrobial resistance. This study aimed to develop an UTI and assess risk factors associated with caused by antimicrobial-resistant organisms. cross-sectional observational retrospective included patients Gram-negative rods (GNR) who were admitted emergency department at a tertiary care hospital in Ibaraki, Japan, 2017–2018. total 172 enrolled...

The quick sequential organ failure assessment (qSOFA) was widely used to estimate the risks of sepsis in patients with suspected infection prehospital and emergency department (ED) settings. Due insufficient sensitivity qSOFA on arrival at ED (ED qSOFA), Surviving Sepsis Campaign 2021 recommended against using as a single screening tool for sepsis. However, it remains unclear whether combined use improves its identifying higher risk ED.We retrospectively analyzed data from tertiary medical...

Patients with septic cardiomyopathy (SCM) occasionally develop refractory cardiogenic shock, which is difficult to resolve even the administration of standard dose catecholamines. Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) has recently been reported good treatment results, there have no evidence-based practices. Furthermore, severe SCM may be fatal if blood pressure cannot increased. This case series explored whether application intra-arterial balloon pumping (IABP)...

Purpose: Although self-measurement of home blood pressure (HBP) is common in Japan and HBP telemonitoring via the Internet possible, whether improves control better than conventional practice remains unclear. Furthermore, hypertension care with online communication using telemonitored feasible, whereas efficacy safety such telemedicine have not been established. We aim to compare traditional care, office visits telemonitoring, antihypertensive based on telemonitoring.Methods design: In...

Background Mechanical insufflation-exsufflation (MI-E) facilitates extubation. However, its potential to reduce the duration of ventilator use remains unclear. Therefore, present study investigated whether MI-E shortened mechanical ventilation in patients with high sputum retention. Methods A randomized open-label trial was conducted at a single intensive care unit (ICU) Japan between November 2017 and June 2019. Ventilated subjects requiring suctioning least once every hour due retention...

Background Although multiple prediction models have been developed to predict hospital admission emergency departments (EDs) address overcrowding and patient safety, only a few studies examined for prehospital use. Development of institution-specific is feasible in this age data science, provided that predictor-related information readily collectable. Objective We aimed develop model based on commonly available during ambulance transport before hospitalization. Methods Patients transported...

Rationale: Various neurological manifestations are observed in thyroid storm patients but protracted disturbance of consciousness is rare. Patient concerns: A 58-year-old male was admitted to our hospital after a traffic accident. Diagnoses: Although awake on arrival, he fell into coma admission. Based the clinical symptoms and hyperthyroidism, patient diagnosed with (TS). Interventions: Even improvement protracted. Considering possibility immune-related etiology, methylprednisolone pulse...

Background While time in targeted blood glucose range (TIR) 70–140 mg/dL is a known factor associated with mortality critically ill patients, it remains unclear whether TIR 28-day under the glycemic control less tight target of 70–180 mg/dL. We aimed to examine was mortality. Methods This retrospective cohort study using data from tertiary care center Japan collected January 2016 through October 2019. included adult patients (aged ≥20 years) admitted ICU. excluded 1) diabetic ketoacidosis 2)...