Int Emerg Nurs
· 2026 Jun · PMID 41962353
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AIMS AND OBJECTIVES: To systematically synthesizes current biomechanical and available clinical evidence regarding the log-roll manoeuvre in adult patients with suspected or confirmed traumatic spinal cord injury (TSCI),...AIMS AND OBJECTIVES: To systematically synthesizes current biomechanical and available clinical evidence regarding the log-roll manoeuvre in adult patients with suspected or confirmed traumatic spinal cord injury (TSCI), and to compare it with alternative patient transfer techniques. BACKGROUND: The log-roll manoeuvre has long been incorporated into trauma care to facilitate posterior examination, hygiene, and patient transfer. However, emerging biomechanical research has raised concerns about the magnitude of spinal motion generated during this manoeuvre, particularly in simulated unstable injury models. DESIGN: Systematic review conducted in accordance with PRISMA 2020 guidelines. METHODS: Electronic searches were performed in PubMed, Embase, CINAHL, and the Cochrane Library (January 2010-March 2024). Studies evaluating the log-roll manoeuvre and reporting quantitative biomechanical or clinical safety outcomes were included. Methodological quality was appraised according to study design, and levels of evidence were assigned using the Oxford Centre for Evidence-Based Medicine framework. Due to heterogeneity in study designs and outcome measures, findings were synthesised narratively. RESULTS: Ten studies met inclusion criteria, comprising predominantly cadaveric biomechanical investigations and a limited number of observational studies. Across unstable spine models, the log-roll manoeuvre consistently generated greater angular and translational displacement compared with several alternative transfer techniques, including lift-and-slide methods and mechanical transfer devices. However, no included primary studies directly demonstrated neurological deterioration attributable to the log-roll manoeuvre. Direct prospective clinical outcome data were limited. CONCLUSIONS: Current biomechanical evidence suggests that the log-roll manoeuvre may not represent the lowest-motion transfer technique in simulated unstable spinal conditions. Nevertheless, direct clinical evidence linking log-roll manoeuvres to neurological worsening remains insufficient. A context-sensitive and evidence-informed approach to patient transfer is therefore recommended. RELEVANCE TO CLINICAL PRACTICE: Clinical decision-making should balance biomechanical considerations, diagnostic needs, resource availability, and operational feasibility. Where feasible, alternative transfer methods associated with reduced motion in experimental models may be considered. Ongoing education, interprofessional training, and periodic review of institutional protocols may support safer patient handling in trauma care.
Noiré Y, Guechi Y, Pelaccia T
… +2 more, Mazar E, Ribordy V
Int Emerg Nurs
· 2026 Jun · PMID 41962352
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BACKGROUND: The ability of triage nurses to quickly identify an urgent situation is crucial and requires good clinical reasoning, which is strongly influenced by the context and professional environment. AIM: To explore...BACKGROUND: The ability of triage nurses to quickly identify an urgent situation is crucial and requires good clinical reasoning, which is strongly influenced by the context and professional environment. AIM: To explore how triage nurses generate initial hypotheses at the very start of the triage encounter and which immediately available cues contribute to this early sense-making. METHODS: This qualitative study was conducted in three regional hospitals and included 10 triage nurses. Nurses wore a forehead-mounted GoPro camera to record triage from their point of view. Semi-structured, video-cued recall interviews were conducted immediately after triage. Deductive and inductive coding was then carried out and analysed using thematic analysis methods. RESULTS: The average age of triage nurses was 36 years, with an average of 6.5 years of professional experience in the emergency department. Triage nurses generated hypotheses as soon as they encountered the patient, largely through pattern recognition (a core mechanism associated with intuition). These hypotheses were sometimes made as soon as the patient was registered at the emergency desk reception and even before talking to them. These hypotheses were based on the patient's main presenting complaint, their facial expression, and the time reported for the onset of symptoms. CONCLUSION: Triage nurses operate in a complex environment and use rapid clinical reasoning processes that draw on readily available cues and prior experience. These findings may inform triage education by highlighting the early, experience-based processes involved in hypothesis generation and the potential value of explicitly addressing intuitive reasoning in triage training.
Int Emerg Nurs
· 2026 Jun · PMID 41955938
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INTRODUCTION: Artificial intelligence (AI) has advanced rapidly in healthcare; however, its application in emergency nursing remains underexplored. This study aimed to map and synthesise existing evidence to clarify curr...INTRODUCTION: Artificial intelligence (AI) has advanced rapidly in healthcare; however, its application in emergency nursing remains underexplored. This study aimed to map and synthesise existing evidence to clarify current applications, gaps, and practical implications. METHODS: A scoping review was conducted using seven databases from inception to 22 November 2024. From 1,885 initial records, 27 studies were included in the final analysis. The review followed the PRISMA-ScR guidelines, with data extracted in standardised formats and analysed using Arksey and O'Malley's framework. RESULTS: The study was conducted across North America, Asia, Europe, the Middle East, and Oceania. A total of 16 studies focused on triage and decision support, while others addressed direct nursing practices or emergency department operations. Evaluation of AI performance was reported in 20 studies, revealing considerable variability across algorithms, models, and metrics, with machine learning being the predominant approach; however, operational ethical aspects were explicitly discussed in just 11 studies. CONCLUSION: AI demonstrates strong potential for triage, workflow efficiency, and patient safety in emergency nursing but remains poorly integrated into clinical practice. Sustainable progress requires high-quality data, rigorous validation, auditability, and ethical safeguards. Institutional and governmental support, multidisciplinary collaboration, and nurse capacity building are critical for safe, equitable, and scalable implementation.
Mei T, Cui M, Xia Y
… +4 more, Zhou T, Liu Y, Wang Q, Huang P
Int Emerg Nurs
· 2026 Jun · PMID 41955937
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INTRODUCTION: Assessing the predictive value of nutritional indices in trauma patients could provide a scientific basis for clinical nutritional interventions. METHODS: Eight databases, including PubMed and Embase, were...INTRODUCTION: Assessing the predictive value of nutritional indices in trauma patients could provide a scientific basis for clinical nutritional interventions. METHODS: Eight databases, including PubMed and Embase, were searched up to January 19, 2025. Case-control and cohort studies involving adult trauma patients were included, with low nutritional risk as the experimental group and high risk as the control group. Primary outcomes were mortality, hospital length of stay (LOS), and complications. Study quality was assessed using the NIH tool, and statistical analysis was performed using STATA 15.0. Effect models were selected based on the I statistic, with results expressed as relative risk (RR) or weighted mean difference (WMD) with 95% confidence intervals (CI). Sensitivity analysis and publication bias assessment were conducted. RESULTS: Eighteen studies (11,275 patients) were included. Low nutritional indices were significantly associated with higher mortality (RR = 0.51; 95% CI: 0.36-0.72; P < 0.001), complications (RR = 0.68; 95% CI: 0.51-0.90; P = 0.008), and prolonged LOS (WMD = - 1.49; 95% CI: -2.20 to - 0.78; P < 0.001). Subgroup analysis showed the Mini Nutritional Assessment-Short Form (MNA-SF) had the strongest association with mortality, while the Prognostic Nutritional Index (PNI) was weakest. The Geriatric Nutritional Risk Index (GNRI) showed a non-significant trend for complications. Meta-regression indicated heterogeneity was not influenced by exposure type, sample size, or other factors. Sensitivity analysis confirmed robustness, with minimal publication bias. CONCLUSIONS: Nutritional indices effectively predict mortality, complications, and LOS in trauma patients, with higher scores linked to better outcomes, suggesting their utility as prognostic tools in trauma care.
de Assunção LM, de Jesus Mota Z, Bomfim KF
… +3 more, Fernandes LJ, de Castro Brandão P, da Silva JC
Int Emerg Nurs
· 2026 Jun · PMID 41950795
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This study evaluated the effectiveness of simulation-based cardiopulmonary resuscitation (CPR) training for Community Health Workers (CHWs) in Brazil, hypothesizing that it would improve both theoretical knowledge and pr...This study evaluated the effectiveness of simulation-based cardiopulmonary resuscitation (CPR) training for Community Health Workers (CHWs) in Brazil, hypothesizing that it would improve both theoretical knowledge and practical skills in emergency response. A single-group pre-post intervention study was conducted with 36 CHWs from Barrocas Municipality, Bahia. Participants underwent a 10-hour training program combining theoretical instruction aligned with AHA 2020 guidelines and hands-on mannequin simulations. Pre- and post-tests assessed knowledge using a 12-item multiple-choice questionnaire, while practical performance was evaluated through objective CPR metrics (compression depth, rate, and recoil). Data were analyzed using paired-sample t-tests. Twelve participants (33.3%) reported prior structured emergency care training. Post-test scores increased by 20% (mean correct answers: 7.5 ± 1.5 vs. 9.0 ± 1.2; p < 0.001), and most participants achieved recommended benchmarks for chest compression depth and rate during post-training assessment. Simulation-based training was associated with significant short-term improvements in CPR knowledge and performance among CHWs. These findings indicate that structured simulation may enhance emergency preparedness within primary care settings.
Int Emerg Nurs
· 2026 Jun · PMID 41946272
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AIM: To explore and describe human trafficking survivors' insights and lived experiences as victims in an ED to inform recognition and response to their needs. BACKGROUND: Numerous survivors reportedly visited the emerge...AIM: To explore and describe human trafficking survivors' insights and lived experiences as victims in an ED to inform recognition and response to their needs. BACKGROUND: Numerous survivors reportedly visited the emergency department while being trafficked. The voice of the survivors needs to be heard to understand the perspectives of care, specific needs, and prevent re-traumatization. DESIGN: Descriptive qualitative design. METHODS: 12 semi-structured interviews were conducted with human trafficking survivors. The data were analyzed using thematic analysis. RESULTS: Four themes emerged from the data: distress, apprehension, intimidation, and oblivious healthcare professionals. DISCUSSION: Survivors experienced significant distress and apprehension, largely driven by intimidation related to the ongoing presence and control of traffickers. These experiences were exacerbated by healthcare professionals' limited awareness, which hindered identification and disclosure. CONCLUSION: Implementing trauma-informed care and ongoing training is essential to foster trust, improve identification, and support victims in the emergency department.
Greenwood E, Miller C, Barbaro J
… +3 more, Date P, Dyson A, Cooklin A
Int Emerg Nurs
· 2026 Jun · PMID 41932277
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BACKGROUND: Autistic children present frequently to emergency departments (ED) but often encounter distressing and exclusionary environments. Parents play a pivotal role during these encounters, yet their voices remain u...BACKGROUND: Autistic children present frequently to emergency departments (ED) but often encounter distressing and exclusionary environments. Parents play a pivotal role during these encounters, yet their voices remain underrepresented in research. AIM: To explore the lived experiences of parents with Autistic children attending the emergency departments in Australia. METHODS: A hermeneutic phenomenological approach guided the study. Fourteen parents of Autistic children (under 18 years) participated in semi-structured interviews, analysed thematically using Bronfenbrenner's Bioecological Model. FINDINGS: Five key themes were identified across ecological systems: (1) parents as experts and navigators of care; (2) parental and child interactions with health staff; (3) systems that undermine safety; (4) stigma and disclosure about perceptions of autism; and (5) time, trauma, and long-term effects. Parents reported anticipatory anxiety, institutional barriers, and repeated traumatic encounters, often compounded by stigma and inadequate support structures. CONCLUSION: Autistic children and families face substantial challenges in ED, highlighting the urgent need for trauma informed, autism specific, and family centered practices, guided by a holistic ecological framework to drive system wide change.
Int Emerg Nurs
· 2026 Jun · PMID 41932275
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AIMS: To explore advanced-level paramedics' experiences of measuring, interpreting and documenting pediatric vital signs in prehospital care, and to identify contextual factors that influence these practices. METHODS: We...AIMS: To explore advanced-level paramedics' experiences of measuring, interpreting and documenting pediatric vital signs in prehospital care, and to identify contextual factors that influence these practices. METHODS: We conducted a qualitative cross-sectional descriptive study. Fifty-six advanced-level paramedics were recruited through a national emergency medical services social media forum. Data were collected in February-March 2025 using an online semi-structured questionnaire and analyzed using inductive-deductive content analysis. FINDINGS: Measurement practices varied in systematicity and incorporated modified assessment approaches. These were shaped by the child's appearance, symptoms, urgency, paramedic- and child-related factors, caregiver involvement, and equipment-related aspects. Paramedics interpreted pediatric vital signs using assessment tools, physician consultation, and visual impressions of the child's condition, and the process was perceived as time-consuming. Interpretation was influenced by children's emotional and behavioral responses, physiological characteristics, and paramedics' interpretive competence. Electronic documentation was valued for efficiency but reported as posing safety risks, limited pediatric suitability, and insufficient flexibility. CONCLUSIONS: Advanced-level paramedics use a variety of approaches when assessing pediatric patients and adapt their practices according to personal and contextual factors. However, variability in practice and limitations in documentation systems may compromise patient safety and quality of care.
Mummery V, Jarman H, Crouch R
… +5 more, Baker E, Jones C, Wilson O, Brown A, Brennan E
Int Emerg Nurs
· 2026 Jun · PMID 41932274
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UNLABELLED: Consultant Nurse (CN) roles were introduced in the United Kingdom (UK) in 1999 to enhance clinical leadership and patient care by keeping senior nurses focused on clinical practice. Defined by the Royal Colle...UNLABELLED: Consultant Nurse (CN) roles were introduced in the United Kingdom (UK) in 1999 to enhance clinical leadership and patient care by keeping senior nurses focused on clinical practice. Defined by the Royal College of Emergency Medicine (RCEM) and Royal College of Nursing (RCN) [1], CNs are clinical experts in emergency nursing who lead on policy, research, education, and advancing practice. UK workforce standards mandate that every Emergency Department (ED) employs at least one CN at a senior pay, with additional roles in sub-specialties like paediatric emergency care. In practice these roles are undertaken by both nurses and allied health professionals. While the roles share the core functions of clinical practice, leadership, education, and research, their implementation varies. Policy initiatives such as workforce plans and a consultant-level practice capability framework have aimed to standardise and expand these roles. However, role configuration, pay, and qualifications continue to vary. Despite some evidence of positive impacts on clinical outcomes, the evidence base is limited, and inconsistent role definitions and integration into workforce planning have hindered implementation. AIM/METHODS: This study aimed to identify consultant nurse/practitioners in United Kingdom emergency care and describe their roles in EDs. A cross-sectional survey was developed, peer-reviewed, and distributed via professional networks, snowball sampling, and social media. Survey was administered via REDCap and was open June-August 2024. RESULTS: Thirty-seven survey responses were analysed, gathering data on demographics, confidence levels, and time spent in each domain. Consultant nurses/practitioners spent most time in expert clinical practice and least in research and innovation, reflecting lower confidence in research and fewer grant applications or publications. Respondents collectively had 299 years of experience, indicating a highly skilled workforce. CONCLUSION: This study offers the first updated demographic review of consultant nurse and practitioner roles in UK emergency care since 2005, revealing workforce shortfalls and role variation. Despite a skilled workforce, reasons for under-recruitment remain unclear. The findings highlight the need for further research to guide workforce planning and optimise consultant-level practice in emergency care.
Int Emerg Nurs
· 2026 Jun · PMID 41930553
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BACKGROUND: Workplace violence (WPV) is a major occupational hazard for emergency nurses, with verbal, psychological, and physical threats undermining safety. Multiple safety strategies have been proposed, yet little res...BACKGROUND: Workplace violence (WPV) is a major occupational hazard for emergency nurses, with verbal, psychological, and physical threats undermining safety. Multiple safety strategies have been proposed, yet little research has examined their prevalence or link to perceived safety. METHODS: A cross-sectional design was employed using an anonymous electronic survey of emergency nurses across 17 U.S. states. The survey, validated by nursing experts, assessed demographics, workplace characteristics, exposure to WPV, and 14 safety precautions. Perceived safety was rated on a 10-point scale. Descriptive statistics, bivariate tests, and multivariate regression with bootstrapping were conducted. RESULTS: Among 134 participants (M age = 42.8 years, 84.3% female), 48.1% reported experiencing WPV in the past month. Mean safety rating was 6.84 (SD = 2). De-escalation and security presence were most prevalent (90.3%), followed by controlled access (80.6%) and security cameras (77.6%). Regression analysis showed urban nurses reported lower safety than suburban nurses (b = - 1.62, 95% CI [-2.438, -0.913], p < 0.001). Security presence, controlled access, and lighting were associated with higher safety perceptions (b = 1.31, 95% CI [0.487, 2.322], p = 0.018; b = 1.12, 95% CI [0.396, 1.881], p = 0.008; b = 1.09, 95% CI [0.478, 1.784], p = 0.004, respectively). CONCLUSION: Findings highlight the prevalence of WPV in EDs and identify key safety interventions linked to nurses' perceptions of safety. Results can inform policy and guide workplace improvements.
Int Emerg Nurs
· 2026 Jun · PMID 41921234
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BACKGROUND: Emergency nursing is a multifaceted practice shaped by rapid patient turnover, clinical uncertainty, and increasing care complexity. Despite their central role in ensuring patient safety, the specific tasks a...BACKGROUND: Emergency nursing is a multifaceted practice shaped by rapid patient turnover, clinical uncertainty, and increasing care complexity. Despite their central role in ensuring patient safety, the specific tasks and roles of emergency nurses remain underexplored. METHODS: A qualitative descriptive design was applied using four focus group interviews with nineteen nurses from four Danish emergency departments. Participants were purposively selected to represent a range of roles and functions. Data were analysed using Braun and Clarke's reflexive thematic analysis. RESULTS: Three overarching themes captured the scope of emergency nursing: (1) Clinical Assessment, (2) Communication and relational care, and (3) Coordination and system navigation. Emergency nurses described themselves as adaptive experts balancing technical, relational, and organizational demands in high-pressure contexts. CONCLUSIONS: The findings demonstrate that emergency nursing extends beyond clinical procedures to encompass relational and system-level responsibilities. Recognizing this multidimensional scope may strengthen role clarity and inform workforce planning, education, and quality improvement.
Chen Y, Li Y, Lv MH
… +5 more, Wei G, Ma F, Hu Q, Ding L, Bai Y
Int Emerg Nurs
· 2026 Jun · PMID 41916031
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OBJECTIVE: This study aimed to investigate the association between compassion fatigue and the nursing work environment among emergency department nurses in tertiary hospitals in Yunnan Province, and to explore the factor...OBJECTIVE: This study aimed to investigate the association between compassion fatigue and the nursing work environment among emergency department nurses in tertiary hospitals in Yunnan Province, and to explore the factors influencing compassion fatigue. METHODS: A cross-sectional design was employed, with a convenience sample of 265 emergency department nurses recruited from three tertiary hospitals in Yunnan Province during the peak wild mushroom poisoning season (May-July 2023). Data were collected using the Professional Quality of Life Scale (ProQoL) and the Practice Environment Scale of the Nursing Work Index (PES-NWI). Statistical analyses included descriptive statistics, univariate analysis, independent samples t-tests, Pearson correlation, and multiple linear regression. RESULTS: The prevalence of moderate to severe compassion fatigue among participants was 81.5%. Mean scores for compassion satisfaction, burnout, and secondary traumatic stress were 27.38 ± 12.97, 27.58 ± 7.91, and 23.32 ± 6.42, respectively. The mean nursing work environment score was 2.75 ± 0.49. Pearson correlation analysis showed that compassion fatigue was significantly negatively correlated with the nursing work environment (r = -0.280, p < 0.01). The results of multiple linear regression analysis showed that collegial nurse-physician relations were an influencing factor of compassion satisfaction (p < 0.05), while nurse manager ability, leadership, and support of nurses were common influencing factors of both compassion satisfaction and secondary traumatic stress (p < 0.05). CONCLUSION: Emergency nurses in Yunnan Province generally suffer from high compassion fatigue, affected by multiple factors such as local cultural diversity and seasonal wild mushroom poisoning. A supportive work environment is significantly associated with lower compassion fatigue, highlighting the urgency to optimize the workplace. Future research should use longitudinal and mixed-method designs to explore seasonal dynamic changes and develop targeted interventions adapted to Yunnan's regional features, so as to alleviate compassion fatigue, improve nurses' mental health, and enhance patient care quality.
Malak MZ, Shuhaiber A, Alshawish E
… +3 more, Shehadeh A, Bani Hani M, Swalma A
Int Emerg Nurs
· 2026 Jun · PMID 41886860
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PURPOSE: Nurses working in emergency departments, especially in conflict-affected areas such as the West Bank, Palestine, face severe and unique challenges related to maintaining ethical climate, organizational justice,...PURPOSE: Nurses working in emergency departments, especially in conflict-affected areas such as the West Bank, Palestine, face severe and unique challenges related to maintaining ethical climate, organizational justice, and work engagement. Limited evidence is available on these variables among emergency nurses in Palestine. This study investigated the levels of these variables and examined the mediating role of organizational justice between ethical climate and work engagement. METHODS: A descriptive correlational design with a convenience sample of 387 emergency nurses was employed in this study. Data were collected using a validated survey instrument, which included the Ethical Climate Questionnaire (ECQ), Organizational Justice Scale, and Utrecht Work Engagement Scale (UWES-9), as well as sociodemographic data. Data analysis included the Structural Equation Model using the Partial Least Square to examine the overall structure of the research model. RESULTS: The results revealed average satisfaction with the ethical climate (M = 3.01 + 0.93/5), average levels of organizational justice (M = 3.46 + 0.92/5), and average level of work engagement (M = 3.58 + 1.46/6). Significant positive relationships were found between ethical climate, organizational justice, and work engagement. In addition, a significant positive relationship was found between ethical climate and organizational justice and the research model showed an acceptable fit, which supported the mediating role of organizational justice between ethical climate and work engagement. CONCLUSION: This study underscored the need to develop interventions and policies aiming to improve ethical climate and organizational justice to improve emergency nurses' work engagement. Fostering ethical workplace climate directly improves work engagement and improves organizational justice, which also improves work engagement. The interplay of these variables is evident even in high-stress, resource-limited, and challenging work environments.
Int Emerg Nurs
· 2026 Jun · PMID 41856001
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BACKGROUND: Virtual reality (VR) is a promising nonpharmacological approach for reducing procedural distress during emergency department laceration repair. This systematic review and meta-analysis evaluated the effective...BACKGROUND: Virtual reality (VR) is a promising nonpharmacological approach for reducing procedural distress during emergency department laceration repair. This systematic review and meta-analysis evaluated the effectiveness of VR in alleviating pain, anxiety, and fear and assessed the certainty of evidence. METHODS: Following PRISMA 2020 guidelines, six databases were searched from inception to August 2025 for randomized controlled trials (RCTs) comparing VR with standard care. Two reviewers independently screened studies, assessed risk of bias using the Cochrane Risk of Bias 2.0 tool, and conducted meta-analyses when at least two trials reported comparable outcomes. RESULTS: Six RCTs (n = 607) were included. VR significantly reduced pain (SMD = - 0.75, 95% CI: -1.29 to - 0.21, P = 0.007) and fear (SMD = - 0.90, 95% CI: -1.55 to - 0.26, P = 0.006). Anxiety reduction did not reach statistical significance (SMD = - 1.80, 95% CI: - 3.89 to 0.28, P = 0.090), though trends were favorable. All trials had some concerns regarding risk of bias, and certainty of evidence-especially for anxiety-was limited. CONCLUSION AND RECOMMENDATIONS: VR is a feasible, nurse-led intervention with consistent benefits for pain and fear and potential value for anxiety. Larger, high-quality RCTs are needed to guide emergency nursing practice.