Current status of active cooling, deep body temperature measurement, and face mask wearing in heat stroke and heat exhaustion patients in Japan: a nationwide observational study based on the Heatstroke STUDY 2020 and 2021.

Aim: The study aimed to determine the current status of face mask use, deep body temperature measurement, and active cooling in patients suffering from heat stroke and heat exhaustion in Japan.

Methods: This was a prospective, observational, multicenter study using data from the Heatstroke STUDY 2020-2021, a nationwide periodical registry of heat stroke and heat exhaustion patients. Based on the Bouchama heatstroke criteria, we classified the patients into two groups: severe and mild-to-moderate.

Novel score for predicting early emergency endovascular therapy in trauma care using logistic LASSO regression.

Aim: To support decision-making for early interventional radiology, this study aimed to derive and validate a novel and simple scoring system for predicting the necessity of interventional radiology therapies in trauma patients.

Methods: This retrospective study used data derived from the medical records of patients with severe traumatic injuries treated at a tertiary-level emergency institution. The score was derived from 168 patients treated between April 2015 and October 2016 and validated using data from 68 patients treated between November 2016 and July 2017.

Serum D-dimer level as a predictor of neurological functional prognosis in cases of head injuries caused by road traffic accidents.

Background: The number of traffic fatalities is declining in Japan; however, a large proportion of head injuries are still attributable to traffic accidents. Severe head trauma may cause progressive and devastating coagulopathy owing to exacerbated coagulation and fibrinolysis, which results in massive bleeding and poor patient outcomes. D-dimer is a fibrinolytic marker, which remarkably increases in severe coagulopathy due to the exacerbated fibrinolytic system.

Influence of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of heat stroke and heat exhaustion in Japan: a nationwide observational study based on the Heatstroke STUDY 2019 (without COVID-19) and 2020 (with COVID-19).

Aim: To assess heat stroke and heat exhaustion occurrence and response during the coronavirus disease 2019 pandemic in Japan.

Methods: This retrospective, multicenter, registry-based study describes and compares the characteristics of patients between the months of July and September in 2019 and 2020. Factors affecting heat stroke and heat exhaustion were statistically analyzed.

Phenytoin versus other antiepileptic drugs as treatments for status epilepticus in adults: a systematic review and meta-analysis.

Aim: Status epilepticus (SE) is a life-threatening neurological emergency. There is insufficient evidence regarding which antiepileptic therapy is most effective in patients with benzodiazepine-refractory convulsive SE. Therefore, this study aimed to evaluate intravenous phenytoin (PHT) and other intravenous antiepileptic medications for SE.

Association between active cooling and lower mortality among patients with heat stroke and heat exhaustion.

Body cooling is recommended for patients with heat stroke and heat exhaustion. However, differences in the outcomes of patients who do or do not receive active cooling therapy have not been determined. The best available evidence supporting active cooling is based on a case series without comparison groups; thus, the effectiveness of this method in improving patient prognoses cannot be appropriately quantified.

Evaluation of factors related to overdose in patients with impaired consciousness who are transported by emergency medical services: an age-specific research.

Background: Drug overdose accounts for most of the admissions to the emergency department. Prescription drugs, most of which are psychotropic medications, are often misused for drug overdose. The purpose of this study was to investigate the association between overdose in patients transported with disorders of consciousness and psychotropic medications administered prior to transport, so as to enable quick differentiation of drug overdose patients from patients with disorders of consciousness.

Impact of the COVID-19 pandemic on a trauma center of a university hospital in Japan.

Background: The Coronavirus disease 2019 pandemic caused the Japanese government to declare a State of Emergency on April 7, 2020. The aim of this study is to provide an overview of the effects of the pandemic on surgical cases at a university hospital trauma center.

Methods: An observational study was performed at a trauma center in a tertiary hospital in Tokyo, Japan.

[FOURNIER GANGRENE: AN ANALYSIS OF 15 CASES].

(Objectives) This study aimed to evaluate the clinical characteristics and the mortality risk factors of 15 patients with Fournier gangrene in the past decade at Teikyo University Hospital. (Materials and methods) We retrospectively assessed 15 patients with Fournier gangrene between May 2009 and April 2019. We compared the demographic characteristics along with several clinical variables including Fournier Gangrene Severity Index of the survivors and nonsurvivors.

Prospective evaluation of the "Stop the Bleed" program in Japanese participants.

Background: The Stop the Bleed (STB) program was developed to bring military bleeding control techniques into wider use among American civilians. It was introduced in Japan in case of mass casualty events during the Tokyo Olympic/Paralympic Games in 2021, and its effectiveness was prospectively evaluated.

Methods: Japanese physicians certified as STB instructors held bleeding control basic training courses from April to July 2019.

Clinical characteristics, prognostic factors, and outcomes of heat-related illness (Heatstroke Study 2017-2018).

Aim: Heat-related illness is common, but its epidemiology and pathological mechanism remain unclear. The aim of this study was to report current clinical characteristics, prognostic factors, and outcomes of heat-related illness in Japan.

Methods: We undertook a prospective multicenter observational study in Japan.

Relationship Between Institutional Volume of Out-of-Hospital Cardiac Arrest Cases and 1-Month Neurologic Outcomes: A Post Hoc Analysis of a Prospective Observational Study.

Background: The influence of institutional volume of out-of-hospital cardiac arrest (OHCA) cases on outcomes remains unclear.

Objectives: This study evaluated the relationship between institutional volume of adult, nontraumatic OHCA cases and 1-month favorable neurologic outcomes.

Methods: This study retrospectively analyzed data between January 2012 and March 2013 from a prospective observational study in the Kanto area of Japan.

Emergency intensive care unit pharmacist's intervention may reduce time to four-factor prothrombin complex concentrate administration: a retrospective study.

Background: Four-factor prothrombin complex concentrate (4F-PCC) must be administered as soon as possible, and in our emergency intensive care unit (EICU), pharmacists are available on weekdays for consultation on expediting 4F-PCC administration. Although recent reports have described a reduction in time to 4F-PCC administration, few studies have addressed if this is because of EICU pharmacist's intervention, and there are no such studies in Japan. Therefore, we aimed to examine whether EICU pharmacist's intervention reduced time to 4F-PCC administration.

Hybrid emergency room system improves timeliness of angioembolization for pelvic fracture.

Background: Timely angioembolization (AE) is known to improve outcomes of patients with hemorrhage resulting from pelvic fracture. The hybrid emergency room system (HERS) is a novel trauma resuscitation room equipped with a computed tomography scanner, fluoroscopy equipment, and an operating room setup. We hypothesized that the HERS would improve the timeliness of AE for pelvic fracture.

Comparison between the Bouchama and Japanese Association for Acute Medicine Heatstroke Criteria with Regard to the Diagnosis and Prediction of Mortality of Heatstroke Patients: A Multicenter Observational Study.

Background: This study aims to compare the Bouchama heatstroke (B-HS) and Japanese Association for Acute Medicine heatstroke (JAAM-HS) criteria with regard to the diagnosis and prediction of mortality and neurological status of heatstroke patients.

Methods: This multicenter observational study recruited eligible patients from the emergency departments of 110 major hospitals in Japan from 1 July to 30 September, 2014.

Results: A total of 317 patients (median age, 65 years; interquartile range, 39-80 years) were included and divided into the B-HS, JAAM-HS, and non-HS groups, with each group consisting of 97, 302, and 15 patients, respectively.

Emergency trauma laparotomy and/or thoracotomy in the emergency department: risks and benefits.

Background: It is not mandatory for Japanese trauma centers to have an operating room (OR) and OR team available 24 hours a day/7 days a week. Therefore, emergency laparotomy/thoracotomy is performed in the emergency department (ED). The present study was conducted to assess the safety of this practice.

Relationship between institutional case volume and one-month survival among cases of paediatric out-of-hospital cardiac arrest.

Aim: To evaluate volume-outcome relationship in paediatric out-of-hospital cardiac arrest (OHCA).

Methods: This post hoc analysis of the SOS-KANTO 2012 study included data of paediatric OHCA patients <18 years old who were transported to the 53 emergency hospitals in the Kanto region of Japan between January 2012 and March 2013. Based on the paediatric OHCA case volume, the higher one-third of institutions (more than 10 paediatric OHCA cases during the study period) were defined as high-volume centres, the middle one-third institutions (6-10 cases) were defined as middle-volume centres and the lower one-third of institutions (less than 6 cases) were defined as low-volume centres.