Emergency Care Journal

Emergency Room (ER) can be considered as a High Reliability Organization expected to guarantee reliability despite facing hectic and unpredictable events. To achieve this status, ER should invest on the management style of Organizational Mindfulness, focused on anticipation and containment of errors. The aim of this exploratory research was to investigate how Organizational Mindfulness occurs in Italian ERs and what is the role of Safety Culture and Work Engagement in predicting Organizational Mindfulness measured with an ad hoc questionnaire. Results show how the communal sphere of Safety Culture seems a better predictor of Organizational Mindfulness than the individual sphere of Work Engagement.

Michele Presutti

Rocco Paolillo

Ivo Casagranda

Emerg Care J

An explorative study of antecedents of organizational mindfulness in emergency room

急诊室组织觉察前因的探索性研究

In Italy, over 86% of patients with mental disorders have one emergency department visit per year, with 6–9% having two visits and approximately 2% having three visits. It is not significant to include those with four or more visits in this data set. In the context of the COVID-19 pandemic, there has been a notable increase in the utilisation of emergency services for psychiatric concerns. In our emergency department (ED), we observed a 10% increase in admissions for psychiatric problems, psychomotor agitation, behavioural disorders, and drug intoxication between 2022 and 2023. We present an organisational management model that has been found to be effective for patients with minor psychiatric problems, those who repeatedly present to the emergency department, and/or those with discontinuous referrals to the relevant mental health centre or acute episodes. One possible strategy could be to consider directing psychiatric emergencies that can be deferred to territorial crisis management from the Trento emergency department to the mental health centre.

Mjriam Sano'

Michela Marchiori

Wilma Angela Renata Di Napoli

A modern management model for patients with acute and subacute psychiatric problems in the emergency department of Trento (Northern Italy)

意大利北部特伦托急诊科急性及亚急性精神问题患者的现代管理模式

This case report from England describes an 8-year-old girl who suffered severe health complications culminating in cardiac arrest due to profound neglect and malnutrition. The patient presented with cardiac arrest, which was attributed to her severe wasting. Upon admission, her body mass index measured 12.8 kg/m2 (z-score ranging between -2 and -3), indicative of severe malnutrition. The patient presented with respiratory, renal, and hepatic failure, in addition to disseminated intravascular coagulation. Resuscitative measures were administered, and she underwent 162 hours of ventilation in the paediatric intensive care unit. Despite the gravity of her initial presentation, the patient exhibited a notable recovery. Paediatric cardiac arrest stemming from extreme nutritional neglect is a rare occurrence in England. This case underscores the paramount importance of prompt intervention and comprehensive medical oversight. The patient's relatively favourable recovery underscores the potential for positive outcomes when timely and appropriate medical interventions are employed.

Ashley Reed

Mohamed Bar

Extreme nutritional neglect leading to cardiac arrest in a child: a rare presentation of severe acute malnutrition in England

儿童因极度营养忽视导致心脏骤停：英格兰严重急性营养不良的罕见表现

An 83-year-old woman presented to our emergency department for a fever with nausea and an itching skin rash on her abdomen for two days. She suffered from obesity, Parkinson disease, and depression in treatment with Levodopa/Benserazide and Pramipexole, respectively. She underwent mastectomy for left breast cancer ten years earlier. She denied any allergies or use of antibiotics. Her vital signs were blood pressure 120/65 mmHg, heart rate 72 bpm, peripheral oxygen saturation 94% in room air, respiratory rate 18/min, and body temperature 36.2 °C. Examination of her abdomen revealed an extensive red warm rash without blisters or blebs, with a slight skin oedema confirmed by point-of-care ultrasound, that excluded a subcutaneous abscess, pneumoniae, liver and kidney damage, and cholecystitis. Laboratory findings showed WBC 12,400/mm3 (N 59.5%) and CRP 131 mg/L (n.v. &lt; 5). Procalcitonin was 0.3 ng/mL (n.v. &lt; 0.5). SARS-CoV-2 infection was excluded.

Erika Poggiali

Valeria Giosia

Daniele Coen

A red and warm abdomen. What’s the matter?

红色且温暖的腹部。怎么回事？

This study aims to enhance the performance of ambulance nurses in Southern Tuscany through a Delphi method analysis. Conducted from January to December 2022, the research engaged 16 expert participants from a Tuscan health agency. Data on 89 interventions performed by "India" ambulances, which are nurse-led emergency vehicles, were collected. The Delphi method facilitated structured communication among the experts over three rounds, resulting in consensus on nine key intervention proposals. These proposals span areas including staff training, measurement and data collection methods, technologies and materials, and work environments. Key recommendations include prioritizing high-fidelity simulation training, improving data collection for clinical risk, and standardizing equipment across all emergency units. The study highlights the importance of continuous professional development, technological integration, and supportive work environments to optimize the effectiveness of pre-hospital emergency care. These findings provide a practical roadmap for enhancing the competencies and performance of ambulance nurses, ultimately improving patient outcomes in emergency situations.

Christian Ramacciani Isemann

Francesco Radi

Elena Sofia Romei

Lorenzo Righi

Optimizing ambulance nurse performance in southern Tuscany: insights from a Delphi study

优化南托斯卡纳地区救护车护士表现：一项德尔菲研究的启示

This study addresses the challenge of determining appropriate nurse staffing levels for triage in Emergency Departments (EDs). It evaluates whether existing nurse staffing models, typically designed for other hospital settings, can be effectively applied to triage. The research was conducted at Merano Hospital’s ED from January 1, 2021, to November 30, 2022, and involved an analysis of data from patient triage assessments. The findings indicate that standard ward staffing models are not easily adaptable to the triage environment, underscoring the need for a more systematic approach to calculating triage nurse staffing. The current Italian ministerial guidelines do not account for the unique demands and complexities of the triage setting.

Arian Zaboli

Francesco Brigo

Serena Sibilio

Gloria Brigiari

Magdalena Massar

Gabriele Magnarelli

Gianni Turcato

Triage nurse staffing: a study on the need for model improvements

分诊护士人员配置：一项关于模型改进需求的调查

An advisory committee of Italian experts conducted a national, cross-sectional, web-based survey in June 2024 to describe the current management of fever and associated symptoms in different settings, including primary care, emergency departments, and hospital wards in pediatric and adult patients. The survey covered two domains: participants’ features and questions about the main drugs prescribed to treat fever and associated symptoms. A total of 832 questionnaires were analyzed. Paracetamol was the most prescribed drug to treat fever. Most participants were influenced by related symptoms when choosing the most appropriate drug. Almost all participants selected the oral route as their preferred one. This survey provides a current state of fever management among physicians in different settings throughout Italy. It highlights a trend in treating fever with antipyretics at appropriate doses and evaluating pain through validated scales.

Antonio Chiaretti

Ignazio Grattagliano

Francesco Carlomagno

Massimo Magi

Luigi Carbone

Silvia Zecca

Claudia Bondone

Antonio Gatto

Lorenzo Di Sarno

Francesco Franceschi

Management of fever and associated symptoms in children and adults: an Italian national survey

儿童和成人发热及伴随症状的管理：一项意大利全国性调查

短名	Emerg. Care J.
Journal Impact	0.29
国际分区	EMERGENCY MEDICINE(Q4)

涉及主题	医学心理学内科学精神科生物外科护理部急诊科病理医疗急救放射科急诊医学重症监护医学物理麻醉心脏病学
出版信息	出版商: Page Press Publications，出版周期: ，期刊类型: journal，开源期刊: 是
基本数据	创刊年份: 2023，原创研究文献占比: 84.38%，自引率:50.00%， Gold OA占比: 99.07%
平均审稿周期	网友分享经验：10 Weeks

Emergency Care Journal

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An explorative study of antecedents of organizational mindfulness in emergency room

A modern management model for patients with acute and subacute psychiatric problems in the emergency department of Trento (Northern Italy)

Extreme nutritional neglect leading to cardiac arrest in a child: a rare presentation of severe acute malnutrition in England

A red and warm abdomen. What’s the matter?

Optimizing ambulance nurse performance in southern Tuscany: insights from a Delphi study

Extreme nutritional neglect leading to cardiac arrest in a child: a rare presentation of severe acute malnutrition in England

A modern management model for patients with acute and subacute psychiatric problems in the emergency department of Trento (Northern Italy)

A red and warm abdomen. What’s the matter?

Triage nurse staffing: a study on the need for model improvements

Management of fever and associated symptoms in children and adults: an Italian national survey

ISSN	1826-9826, 2282-2054
h-index	2