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Hexom BJ, Quao NSA, Bandolin NS, Bonney J, Collier A, Dyal J, Lee JA, Nicholson BD, Rybarczyk MM, Rees CA, Roy CM, Bhaskar N, Kivlehan SM. Global Emergency Medicine: A Scoping Review of the Literature from 2022. Acad Emerg Med 2024; 31:71-85. [PMID: 37813813 DOI: 10.1111/acem.14816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE The objective was to identify the highest quality global emergency medicine (GEM) research published in 2022. The top articles are compiled in a comprehensive list of all the year's GEM articles and narrative summaries are performed on those included. METHODS A systematic PubMed search was conducted to identify all GEM articles published in 2022 and included a manual supplemental screen of 11 organizational websites for gray literature (GRAY). A team of trained reviewers and editors screened all identified titles and abstracts, based on three case definition categories: disaster and humanitarian response (DHR), emergency care in resource-limited settings (ECRLS), and emergency medicine development (EMD). Articles meeting these definitions were independently scored by two reviewers using rubrics for original research (OR), review (RE) articles, and GRAY. Articles that scored in the top 5% from each category as well as the overall top 5% of articles were included for narrative summary. RESULTS The 2022 search identified 58,510 articles in the main review, of which 524 articles screened in for scoring, respectively, 30% and 18% increases from last year. After duplicates were removed, 36 articles were included for narrative summary. The GRAY search identified 7755 articles, of which 33 were scored and one was included for narrative summary. ECRLS remained the largest category (27; 73%), followed by DHR (7; 19%) and EMD (3; 8%). OR articles remained more common than RE articles (64% vs. 36%). CONCLUSIONS The waning of the COVID-19 pandemic has not affected the continued growth in GEM literature. Articles related to prehospital care, mental health and resilience among patients and health care workers, streamlining pediatric infectious disease care, and disaster preparedness were featured in this year's review. The continued lack of EMD studies despite the global growth of GEM highlights a need for more scholarly dissemination of best practices.
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Affiliation(s)
- Braden J Hexom
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Nana Serwaa A Quao
- Department of Emergency Medicine, Accident and Emergency Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - N Shakira Bandolin
- Department of Emergency Medicine, University of California, Davis, California, USA
| | - Joseph Bonney
- Department of Emergency Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Global Health and Infectious Disease Research Group, Kumasi Center for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Amanda Collier
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jonathan Dyal
- Department of Emergency Medicine, University of Texas, Houston, Texas, USA
| | - J Austin Lee
- Department of Emergency Medicine, Brown University, Providence, Rhode Island, USA
| | - Benjamin D Nicholson
- Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Megan M Rybarczyk
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Charlotte M Roy
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California, USA
| | | | - Sean M Kivlehan
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
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Kivlehan SM, Hexom BJ, Bonney J, Collier A, Nicholson BD, Quao NSA, Rybarczyk MM, Selvam A, Rees CA, Roy CM, Bhaskar N, Becker TK. Global emergency medicine: A scoping review of the literature from 2021. Acad Emerg Med 2022; 29:1264-1274. [PMID: 35913419 DOI: 10.1111/acem.14575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/17/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The objective was to identify the most important and impactful peer-reviewed global emergency medicine (GEM) articles published in 2021. The top articles are summarized in brief narratives and accompanied by a comprehensive list of all identified articles that address the topic during the year to serve as a reference for clinicians, researchers, and policy makers. METHODS A systematic PubMed search was carried out to identify all GEM articles published in 2021. Title and abstract screening was performed by trained reviewers and editors to identify articles in one of three categories based on predefined criteria: disaster and humanitarian response (DHR), emergency care in resource-limited settings (ECRLS), and emergency medicine development (EMD). Included articles were each scored by two reviewers using established rubrics for original (OR) and review (RE) articles. The top 5% of articles overall and the top 5% of articles from each category (DHR, ECRLS, EMD, OR, and RE) were included for narrative summary. RESULTS The 2021 search identified 44,839 articles, of which 444 articles screened in for scoring, 25% and 22% increases from 2020, respectively. After removal of duplicates, 23 articles were included for narrative summary. ECRLS constituted the largest category (n = 16, 70%), followed by EMD (n = 4, 17%) and DHR (n = 3, 13%). The majority of top articles were OR (n = 14, 61%) compared to RE (n = 9, 39%). CONCLUSIONS The GEM peer-reviewed literature continued to grow at a fast rate in 2021, reflecting the continued expansion and maturation of this subspecialty of emergency medicine. Few high-quality articles focused on DHR and EMD, suggesting a need for further efforts in those fields. Future efforts should focus on improving the diversity of GEM research and equitable representation.
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Affiliation(s)
- Sean M Kivlehan
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
| | - Braden J Hexom
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Joseph Bonney
- Department of Emergency Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.,Global Health and Infectious Disease Research Group, Kumasi Center for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Amanda Collier
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - Benjamin D Nicholson
- Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nana Serwaa A Quao
- Department of Emergency Medicine, Accident and Emergency Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Megan M Rybarczyk
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anand Selvam
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Charlotte M Roy
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California, USA
| | | | - Torben K Becker
- Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA
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Trehan I, Kivlehan SM, Balhara KS, Bonney J, Hexom BJ, Pousson AY, Quao NSA, Rybarczyk MM, Selvam A, Nicholson BD, Bhaskar N, Becker TK, Balhara KS, Bandolin NS, Bannon‐Murphy H, Becker TK, Bhaskar N, Bonney J, Boone A, Broccoli MC, Charlton ADI, Cho DK, Ciano JD, Collier A, Dawson‐Amoah NA, Dyal JW, Flaherty KE, Hartford EA, Hayward AS, Hexom BJ, Hunter C, Jacobson AA, Joiner AP, Jones JE, Kampalath VN, Kivlehan SM, Laurence CE, Leanza J, Ledger E, Lee JA, Levine AC, Lowsby R, McCuskee S, Moretti KR, Nicholson BD, Pigoga JL, Pousson AY, Quao NSA, Rees CA, Roy CM, Rybarczyk MM, Selvam A, Skarpiak BJ, Strong JM, Trehan I, Vogel LD, Wang AH, Wegman KM, Winders WT. Global emergency medicine: A scoping review of the literature from 2020. Acad Emerg Med 2021; 28:1328-1340. [PMID: 34310782 DOI: 10.1111/acem.14356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The objective was to identify, screen, highlight, review, and summarize some of the most rigorously conducted and impactful original research (OR) and review articles (RE) in global emergency medicine (EM) published in 2020 in the peer-reviewed and gray literature. METHODS A broad systematic search of peer-reviewed publications related to global EM indexed on PubMed and in the gray literature was conducted. The titles and abstracts of the articles on this list were screened by members of the Global Emergency Medicine Literature Review (GEMLR) Group to identify those that met our criteria of OR or RE in the domains of disaster and humanitarian response (DHR), emergency care in resource-limited settings (ECRLS), and EM development. Those articles that met these screening criteria were then scored using one of three scoring templates appropriate to the article type. Those articles that scored in the top 5% then underwent in-depth narrative summarization. RESULTS The 2020 GEMLR search initially identified 35,970 articles, more than 50% more than last year's search. From these, 364 were scored based on their full text. Nearly three-fourths of the scored articles constituted OR, of which nearly three-fourths employed quantitative research methods. Nearly 10% of the articles identified this year were directly related to COVID-19. Research involving ECRLS again constituted most of the articles in this year's review, accounting for more than 60% of the literature scored. A total of 20 articles underwent in-depth narrative critiques. CONCLUSIONS The number of studies relevant to global EM identified by our search was very similar to that of last year. Revisions to our methodology to identify a broader range of research were successful in identifying more qualitative research and studies related to DHR. The number of COVID-19-related articles is likely to continue to increase in subsequent years.
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Affiliation(s)
- Indi Trehan
- Departments of Pediatrics, Global Health, and Epidemiology University of Washington Seattle Washington USA
| | - Sean M. Kivlehan
- Department of Emergency Medicine Brigham and Women’s Hospital Boston Massachusetts USA
- Harvard Humanitarian Initiative Cambridge Massachusetts USA
| | - Kamna S. Balhara
- Department of Emergency Medicine Johns Hopkins University Baltimore Maryland USA
| | - Joseph Bonney
- Department of Emergency Medicine Komfo Anokye Teaching Hospital Kumasi Ghana
- Global Health and Infectious Disease Research Group Kumasi Center for Collaborative Research in Tropical Medicine Kumasi Ghana
| | - Braden J. Hexom
- Department of Emergency Medicine Rush University Medical Center Chicago Illinois USA
| | - Amelia Y. Pousson
- Department of Emergency Medicine Johns Hopkins University Baltimore Maryland USA
| | - Nana S. A. Quao
- Department of Emergency Medicine, Accident and Emergency Centre Korle Bu Teaching Hospital Accra Ghana
| | - Megan M. Rybarczyk
- Department of Emergency Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Anand Selvam
- Department of Emergency Medicine Yale University New Haven Connecticut USA
| | - Benjamin D. Nicholson
- Department of Emergency Medicine Virginia Commonwealth University Richmond Virginia USA
| | | | - Torben K. Becker
- Department of Emergency Medicine University of Florida Gainesville Florida USA
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Hughes AM, Sonesh SC, Mason RE, Gregory ME, Marttos A, Schulman CI, Salas E. Trauma, Teams, and Telemedicine: Evaluating Telemedicine and Teamwork in a Mass Casualty Simulation. Mil Med 2021; 186:e811-e818. [PMID: 33216935 DOI: 10.1093/milmed/usaa434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/05/2020] [Accepted: 10/06/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Mass casualty events (MASCAL) are on the rise globally. Although natural disasters are often unavoidable, the preparation to respond to unique patient demands in MASCAL can be improved. Utilizing telemedicine can allow for a better response to such disasters by providing access to a virtual team member with necessary specialized expertise. The purpose of this study was to examine the positive and/or negative impacts of telemedicine on teamwork in teams responding to MASCAL events. METHODS We introduced a telemedical device (DiMobile Care) to Forward Surgical Teams during a MASCAL simulated training event. We assessed teamwork-related attitudes, behaviors, and cognitions during the MASCAL scenario through pre-post surveys and observations of use. Analyses compare users and nonusers of telemedicine and pre-post training differences in teamwork. RESULTS We received 50 complete responses to our surveys. Overall, clinicians have positive reactions toward the potential benefits of telemedicine; further, participants report a significant decrease in psychological safety after training, with users rating psychological safety as significantly higher than non-telemedicine users. Neither training nor telemedicine use produced significant changes in cognitive and behavioral-based teamwork. Nonetheless, participants reported perceiving that telemedicine improved leadership and adaptive care plans. CONCLUSIONS Telemedicine shows promise in connecting Forward Surgical Teams with nuanced surgical expertise without harming quality of care metrics (i.e., teamwork). However, we advise future iterations of DiMobile Care and other telemedical devices to consider contextual features of information flow to ensure favorable use by teams in time-intensive, high-stakes environments, such as MASCAL.
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Affiliation(s)
- Ashley M Hughes
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA.,Center of Innovations in Chronic, Complex Healthcare (CINCCH), Edward Hines JR VA Medical Center, Hines, IL 60540, USA
| | | | - Rachel E Mason
- Centers for Biobehavioral Health and Innovation in Pediatric Practice, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43215, USA
| | - Megan E Gregory
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, USA.,Center for the Advancement of Team Science, Analytics and Systems Thinking in Health Services and Implementation Science Research (CATALYST), The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Antonio Marttos
- DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33101, USA
| | - Carl I Schulman
- DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33101, USA
| | - Eduardo Salas
- Center of Innovations in Chronic, Complex Healthcare (CINCCH), Edward Hines JR VA Medical Center, Hines, IL 60540, USA.,Department of Psychological Sciences, Rice University, TX 77005, USA
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Trehan I, Kivlehan SM, Balhara KS, Hexom BJ, Pousson AY, Quao NSA, Rybarczyk MM, Selvam A, Bonney J, Bhaskar N, Becker TK. Global Emergency Medicine: A Review of the Literature From 2019. Acad Emerg Med 2021; 28:117-128. [PMID: 32772445 DOI: 10.1111/acem.14107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/02/2020] [Accepted: 08/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The annual systematic search of the peer-reviewed and gray literature relevant to global emergency medicine (EM) was conducted by the Global Emergency Medicine Literature Review (GEMLR) to screen, evaluate, and review the most rigorously conducted and relevant research in global EM published in 2019. METHODS After a broad search of PubMed and websites of organizations publishing relevant gray literature, all articles that were deemed relevant to the fields of disaster and humanitarian response, emergency care in resource-limited settings, and EM development by at least one reviewer, an editor, and the managing editors were then scored by two different reviewers using a 20-point scoring template relevant to either original research (OR) or review (RE) articles. This scoring system rates articles on their clarity, research design, ethics, importance to global EM, and breadth of impact. Articles that then scored in the top 5% were then critiqued in depth. RESULTS A total of 23,321 article titles and abstracts were screened by 22 reviewers with a wide swath of clinical and research experience in global EM. From these, a total of 356 articles underwent full-text review and scoring on the 20-point scale; 26% were categorized as disaster and humanitarian response, 58% as emergency care in resource-limited settings, and 15% as EM development. Of these 356 articles, 276 (77.5%) were OR articles and 80 (22.5%) were RE articles. The 16 articles that scored in the top 5% (>17.5 of 20 points) received full in-depth narrative summaries. CONCLUSIONS In 2019, the overall number of studies relevant to global EM that were identified by our search decreased from the prior year, but more high-scoring articles related to the development of EM clinical practice and as a specialty in resource-constrained settings were identified.
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Affiliation(s)
- Indi Trehan
- From the Departments of Pediatrics and Global Health University of Washington Seattle WAUSA
| | - Sean M. Kivlehan
- the Department of Emergency Medicine Brigham and Women’s Hospital Boston MAUSA
- the Harvard Humanitarian Initiative Cambridge MAUSA
| | - Kamna S. Balhara
- the Department of Emergency Medicine Johns Hopkins University Baltimore MDUSA
| | - Braden J. Hexom
- the Department of Emergency Medicine Rush University Medical Center Chicago ILUSA
| | - Amelia Y. Pousson
- the Department of Emergency Medicine Johns Hopkins University Baltimore MDUSA
| | | | - Megan M. Rybarczyk
- the Department of Emergency Medicine Brigham and Women’s Hospital Boston MAUSA
| | - Anand Selvam
- the Department of Emergency Medicine Yale University New Haven CTUSA
| | - Joseph Bonney
- the Department of Emergency Medicine Komfo Anokye Teaching Hospital Kumasi Ghana
| | | | - Torben K. Becker
- and the Department of Emergency Medicine University of Florida Gainesville FLUSA
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Trehan I, Osei‐Ampofo M, Balhara KS, Hexom BJ, Kivlehan SM, Modi P, Pousson AY, Selvam A, Quao NSA, Cho DK, Becker TK, Levine AC, Bannon‐Murphy H, Bartels SA, Beyene T, Bonney J, Collier AT, Cook J, Dyal JW, Enriquez KT, Gomes DJ, Hayward AS, Ibrahim WMA, Keefe DM, Lee JA, Lee S, Lowsby R, Mediratta RP, Mickman CT, Nicholson BD, O'Reilly GM, Relan P, Ragins KT, Reid EA, Roy CM, Rybarczyk MM, Schultz ML, Stanford KA, Vogel LD, Wang AH, Zewdie A. Global Emergency Medicine: A Review of the Literature from 2018. Acad Emerg Med 2019; 26:1186-1196. [PMID: 31313411 DOI: 10.1111/acem.13832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/06/2019] [Accepted: 07/12/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The Global Emergency Medicine Literature Review (GEMLR) conducts a systematic annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most rigorously conducted and widely relevant research in global EM. METHODS An electronic search of PubMed, a comprehensive retrieval of articles from specific journals, and search of the gray literature were conducted. Title and abstracts retrieved by these searches were screened by a total of 22 reviewers based on their relevance to the field of global EM, across the domains of disaster and humanitarian response (DHR), emergency care in resource-limited settings (ECRLS), and emergency medicine development (EMD). All articles that were deemed relevant by at least one reviewer, their editor, and the managing editor underwent formal scoring of overall methodologic quality and importance to global EM. Two independent reviewers scored all articles; editors provided a third score in cases of widely discrepant scores. RESULTS A total of 19,102 articles were identified by the searches and, after screening and removal of duplicates, a total of 517 articles underwent full review. Twenty-five percent were categorized as DHR, 61% as ECRLS, and 15% as EMD. Inter-rater reliability testing between the reviewers revealed a Cohen's kappa score of 0.213 when considering the complete score or 0.426 when excluding the more subjective half of the score. A total of 25 articles scored higher than 17.5 of 20; these were selected for a full summary and critique. CONCLUSIONS In 2018, the total number of articles relevant to global EM that were identified by our search continued to increase. Studies and reviews focusing on pediatric infections, several new and traditionally underrepresented topics, and landscape reviews that may help guide clinical care in new settings represented the majority of top-scoring articles. A shortage of articles related to the development of EM as a specialty was identified.
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Affiliation(s)
- Indi Trehan
- Lao Friends Hospital for Children Luang Prabang Lao PDR
- Department of Pediatrics Washington University in St. Louis St. Louis MO
| | - Maxwell Osei‐Ampofo
- Emergency Medicine Directorate Komfo Anokye Teaching Hospital, and the Department of Anaesthesia and Intensive Care Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Kamna S. Balhara
- Department of Emergency Medicine Johns Hopkins University Baltimore MD
| | - Braden J. Hexom
- Department of Emergency Medicine Rush University Medical Center Chicago IL
| | - Sean M. Kivlehan
- Department of Emergency Medicine Brigham and Women's Hospital Boston MA
- Harvard Humanitarian Initiative Cambridge MA
| | - Payal Modi
- Department of Emergency Medicine University of Massachusetts Worcester MA
| | - Amelia Y. Pousson
- Department of Emergency Medicine Johns Hopkins University Baltimore MD
| | - Anand Selvam
- Department of Emergency Medicine Yale University New Haven CT
| | - Nana Serwaa A. Quao
- Department of Emergency Medicine Korle Bu Teaching Hospital (NSAQ) Accra Ghana
| | | | - Torben K. Becker
- Department of Emergency Medicine University of Florida Gainesville FL
| | - Adam C. Levine
- and the Department of Emergency Medicine Brown University Providence RI
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Becker TK, Trehan I, Hayward AS, Hexom BJ, Kivlehan SM, Lunney KM, Modi P, Osei‐Ampofo M, Pousson A, Cho DK, Levine AC, Anderson Reid E, Balhara KS, Bartels S, Becker TK, Beyene T, Bills CB, Bonney J, Bustamante ND, Chan J, Chang J, Cho DK, Coker A, Collier AT, Cook J, Chow Garbern S, Gutierrez CE, Hansoti B, Hauswald M, Hayward AS, Hexom B, Kearney A, Koval K, Keefe DM, Kivlehan SM, Lee S, Levine AC, Lowsby R, Lunney KM, McVane B, Mediratta RP, Modi P, Nicholson B, Osei‐Ampofo M, Osterhoudt KC, Pousson A, Quao NSA, Ragins K, Rees CA, Rybarczyk M, Schultz M, Selvam A, Silvestri D, Stanford K, Trehan I, Vogel L, Winders WT, Zewdie A. Global Emergency Medicine: A Review of the Literature From 2017. Acad Emerg Med 2018; 25:1287-1298. [PMID: 29791967 DOI: 10.1111/acem.13456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. METHODS This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. Another two reviewers searched the gray literature, yielding an additional 11 articles. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. RESULTS A total of 848 articles met our inclusion criteria and underwent full review. Sixty-three percent were categorized as emergency care in resource-limited settings, 23% as disaster and humanitarian response, and 14% as EM development. Twenty-one articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed a Cohen's kappa of 0.344. CONCLUSIONS In 2017, the total number of articles identified by our search continued to increase. Studies and reviews with a focus on infectious diseases, pediatrics, and trauma represented the majority of top-scoring articles.
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Affiliation(s)
- Torben K. Becker
- Department of Emergency Medicine University of Florida Gainesville FL
| | - Indi Trehan
- Lao Friends Hospital for Children Luang Prabang Lao PDR
- Department of Pediatrics and Institute for Public Health Washington University in St. Louis St. Louis MO
- Department of Paediatrics and Child Health University of Malawi BlantyreMalawi
| | | | - Braden J. Hexom
- Department of Emergency Medicine Rush University Medical Center Chicago IL
| | - Sean M. Kivlehan
- Department of Emergency Medicine Brigham and Women's Hospital Boston MA
- Harvard Humanitarian Initiative Cambridge MA
| | - Kevin M. Lunney
- Navy Trauma Training Center Los Angeles County and University of Southern California Los Angeles CA
| | - Payal Modi
- Department of Emergency Medicine University of Massachusetts Worcester MA
| | - Maxwell Osei‐Ampofo
- Emergency Medicine Directorate Komfo Anokye Teaching Hospital and the Kwame Nkrumah University of Science and Technology KumasiGhana
| | - Amelia Pousson
- Department of Emergency Medicine The Johns Hopkins University School of Medicine Baltimore MD
| | | | - Adam C. Levine
- Department of Emergency Medicine The Warren Alpert Medical School of Brown University Providence RI
- Humanitarian Innovation Initiative (HI²) Watson Institute for International and Public Affairs Providence RI
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Balhara KS, Bustamante ND, Selvam A, Winders WT, Coker A, Trehan I, Becker TK, Levine AC. Bystander Assistance for Trauma Victims in Low- and Middle-Income Countries: A Systematic Review of Prevalence and Training Interventions. PREHOSP EMERG CARE 2018; 23:389-410. [PMID: 30141702 DOI: 10.1080/10903127.2018.1513104] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Lack of organized prehospital care may contribute to the disproportionate burden of trauma-related deaths in low- and middle-income countries (LMICs). The World Health Organization (WHO) recommends bystander training in basic principles of first aid and victim transport; however, prevalence of bystander or layperson assistance to trauma victims in LMICs has not been well-described, and organized reviews of existing evidence for bystander training are lacking. This systematic review aims to 1) describe the prevalence of bystander or layperson aid or transport for trauma victims in the prehospital setting in LMICs and 2) ascertain impacts of bystander training interventions in these settings. METHODS A systematic search of OVID Medline, Cochrane Library, and relevant gray literature was conducted. We included 1) all studies detailing prevalence of bystander-administered aid or transport for trauma victims in LMICs and 2) all randomized controlled trials and observational studies evaluating bystander training interventions. We extracted study characteristics, interventions, and outcomes data. Study quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. RESULTS Sixty-two studies detailed prevalence of bystander transport and aid. Family members, police, and bus or taxi drivers commonly transported patients; a majority of patients, up to >94%, received aid from bystanders. Twenty-four studies examined impacts of training interventions. Only one study looked at transport interventions; the remainder addressed first aid training. Interventions varied in content, duration, and target learners. Evidence was generally of low quality, but all studies demonstrated improvements in layperson knowledge and skills. Five studies reported a mortality reduction. CONCLUSIONS Heterogeneity in data reporting and outcomes limited formal meta-analysis. However, this review shows high rates of bystander involvement in prehospital trauma care and transport in LMICs and highlights the need for bystander training. Bystander training in these settings is feasible and may have an important impact on meaningful outcomes such as mortality. Categories of involved bystanders varied by region and training interventions should be targeted at relevant groups. "Train the trainer" models appear promising in securing community engagement and maximizing participation. Further research is needed to examine the value of bystander transport networks in trauma.
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Becker TK, Hansoti B, Bartels S, Hayward AS, Hexom BJ, Lunney KM, Marsh RH, Osei-Ampofo M, Trehan I, Chang J, Levine AC. Global Emergency Medicine: A Review of the Literature From 2016. Acad Emerg Med 2017; 24:1150-1160. [PMID: 28474823 DOI: 10.1111/acem.13216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. METHODS This year 13,890 articles written in four languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. RESULTS A total of 716 articles met our inclusion criteria and underwent full review. Fifty-nine percent were categorized as emergency care in resource-limited settings, 17% as EM development, and 24% as disaster and humanitarian response. Nineteen articles received scores of 18.5 or higher out of a maximum score of 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed Cohen's kappa of 0.441. CONCLUSIONS In 2016, the total number of articles identified by our search continued to increase. The proportion of articles in each of the three categories remained stable. Studies and reviews with a focus on infectious diseases, pediatrics, and the use of ultrasound in resource-limited settings represented the majority of articles selected for final review.
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Affiliation(s)
- Torben K. Becker
- Department of Critical Care Medicine; University of Pittsburgh Medical Center; Pittsburgh PA
| | - Bhakti Hansoti
- Department of Emergency Medicine; Johns Hopkins University; Baltimore MD
| | - Susan Bartels
- Department of Emergency Medicine; Queen's University; Kingston Ontario Canada
- Harvard Humanitarian Initiative; Cambridge MA
| | | | - Braden J. Hexom
- Department of Emergency Medicine; Rush University Medical Center; Chicago IL
| | - Kevin M. Lunney
- TheMedical Corps, US Navy, and the Navy Trauma Training Center; Los Angeles County and University of Southern California; Los Angeles CA
| | - Regan H. Marsh
- Department of Emergency Medicine; Brigham and Women's Hospital; Boston MA
- Partners In Health; Boston MA
| | - Maxwell Osei-Ampofo
- Emergency Medicine Directorate; Komfo Anokye Teaching Hospital, and Kwame Nkrumah University of Science and Technology; Kumasi Ghana
| | - Indi Trehan
- Partners In Health; Harper Liberia
- Department of Pediatrics and Institute for Public Health; Washington University in St. Louis; St. Louis MO
- Department of Paediatrics and Child Health; University of Malawi; Blantyre Malawi
| | | | - Adam C. Levine
- Department of Emergency Medicine; Warren Alpert Medical School of Brown University; Providence RI
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Becker TK, Hansoti B, Bartels S, Bisanzo M, Jacquet GA, Lunney K, Marsh R, Osei‐Ampofo M, Trehan I, Lam C, Levine AC, Anderson RE, Armstrong P, Aschkenasy M, Balhara KS, Boyd M, Chan J, Dickason RM, Grover E, Hauswald M, Hayward AS, Hexom B, House E, Jenson A, Kearney A, Keefe DM, Kivlehan S, Machen HE, Mahal J, Marsh RH, Millikan DJ, Modi P, Nicholson B, Rahman N, Rybarczyk M, Schroeder ED, Selvam A, Silvestri D, Trehan I, Tyler Winders W. Global Emergency Medicine: A Review of the Literature From 2015. Acad Emerg Med 2016; 23:1183-1191. [PMID: 27146277 DOI: 10.1111/acem.12999] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 04/25/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. METHODS This year 12,435 articles written in six languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. A total of 723 articles were deemed appropriate by at least one reviewer and approved by their editor for formal scoring of overall quality and importance. Two independent reviewers scored all articles. RESULTS A total of 723 articles met our predetermined inclusion criteria and underwent full review. Sixty percent were categorized as emergency care in resource-limited settings (ECRLS), 17% as EM development (EMD), and 23% as disaster and humanitarian response (DHR). Twenty-four articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability between reviewers gave an intraclass correlation coefficient of 0.71 (95% confidence interval = 0.66 to 0.75). Studies and reviews with a focus on infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource-limited settings represented the majority of articles selected for final review. CONCLUSIONS In 2015, there were almost twice as many articles found by our search compared to the 2014 review. The number of EMD articles increased, while the number ECRLS articles decreased. The number of DHR articles remained stable. As in prior years, the majority of articles focused on infectious diseases.
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Affiliation(s)
- Torben K. Becker
- Department of Critical Care Medicine University of Pittsburgh Medical Center Pittsburgh PA
| | - Bhakti Hansoti
- Department of Emergency Medicine Johns Hopkins University Baltimore MD
| | - Susan Bartels
- Department of Emergency Medicine Queen's University Kingston Ontario Canada
- Harvard Humanitarian Initiative Cambridge MA
| | - Mark Bisanzo
- Department of Emergency Medicine University of Massachusetts Worcester MA
| | - Gabrielle A. Jacquet
- Department of Emergency Medicine Boston University School of Medicine, and Boston University Center for Global Health and Development Boston MA
| | - Kevin Lunney
- Medical Corps US Navy Department of Emergency Medicine Navy Hospital Camp Lejeune Camp Lejeune NC
| | - Regan Marsh
- Department of Emergency Medicine Brigham and Women's Hospital Boston MA
- Partners In Health Boston MA
| | - Maxwell Osei‐Ampofo
- Accident & Emergency Department Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Indi Trehan
- Department of Pediatrics and Institute for Public Health Washington University in St. Louis St. Louis MO
- Department of Pediatrics and Child Health University of Malawi Blantyre Malawi
| | - Christopher Lam
- Warren Alpert Medical School of Brown University Providence RI
| | - Adam C. Levine
- Department of Emergency Medicine Warren Alpert Medical School of Brown University Providence RI
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Becker TK, Bartels S, Hansoti B, Jacquet GA, Lunney K, Marsh R, Osei-Ampofo M, Lam C, Levine AC. Global emergency medicine: a review of the literature from 2014. Acad Emerg Med 2015. [PMID: 26223901 DOI: 10.1111/acem.12733] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners. METHODS This year 6,376 articles written in six languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. A total of 477 articles were deemed appropriate by at least one reviewer and approved by the editor for formal scoring of overall quality and importance. RESULTS Of the 477 articles that met our predetermined inclusion criteria, 63% were categorized as emergency care in resource-limited settings, 13% as EM development, and 23% as disaster and humanitarian response. Twenty-five articles received scores of 17.5 or higher and were selected for formal summary and critique. Inter-rater reliability for two reviewers using our scoring system was good, with an intraclass correlation coefficient of 0.657 (95% confidence interval = 0.589 to 0.713). Studies and reviews focusing on infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource-limited settings represented the majority of articles selected for final review. CONCLUSIONS In 2014, there were fewer total articles, but a slightly higher absolute number of articles screening in for formal scoring, when compared to the 2013 review. The number of EM development articles decreased, while the number of disaster and humanitarian response articles increased. As in prior years, the majority of articles focused on infectious diseases and trauma.
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Affiliation(s)
- Torben K. Becker
- Department of Emergency Medicine; University of Michigan; Ann Arbor MI
| | - Susan Bartels
- Department of Emergency Medicine; Queen's University; Kingston Ontario Canada
- Harvard Humanitarian Initiative; Cambridge MA
| | - Bhakti Hansoti
- Department of Emergency Medicine; Johns Hopkins University; Baltimore MD
| | - Gabrielle A. Jacquet
- Department of Emergency Medicine; Boston University School of Medicine; Boston MA
- Boston University Center for Global Health and Development; Boston MA
| | - Kevin Lunney
- Medical Corps; US Navy, Department of Emergency Medicine; Navy Hospital Camp Lejeune; Camp Lejeune NC
| | - Regan Marsh
- Department of Emergency Medicine; Brigham and Women's Hospital; Boston MA
- Partners In Health; Boston MA
| | - Maxwell Osei-Ampofo
- Accident & Emergency Department; Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology; Kumasi Ghana
| | - Christopher Lam
- Warren Alpert Medical School of Brown University; Providence RI
| | - Adam C. Levine
- Department of Emergency Medicine; Warren Alpert Medical School of Brown University; Providence RI
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Becker TK, Jacquet GA, Marsh R, Schroeder ED, Foran M, Bartels S, Duber HC, Cockrell H, Levine AC. Global emergency medicine: a review of the literature from 2013. Acad Emerg Med 2014; 21:810-7. [PMID: 25040254 DOI: 10.1111/acem.12414] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 04/14/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and grey literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners. METHODS This year 8,768 articles written in six languages were identified by our search. These articles were distributed among 22 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the grey literature. A total of 434 articles were deemed appropriate by at least one reviewer and approved by an editor for formal scoring of overall quality and importance. RESULTS Of the 434 articles that met our predetermined inclusion criteria, 65% were categorized as emergency care in resource-limited settings, 18% as EM development, and 17% as disaster and humanitarian response. A total of 24 articles received scores of 18 or higher and were selected for formal summary and critique. Interrater reliability for two reviewers using our scoring system was good, with an intraclass correlation coefficient of 0.63 (95% confidence interval = 0.55 to 0.69). Infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource-limited settings represented the majority of articles selected for final review. CONCLUSIONS In 2013, there were more emergency care in resource-limited settings articles, while the number of disaster and humanitarian response articles decreased, when compared to the 2012 review. However, the distribution of articles selected for full review did not change significantly. As in prior years, the majority of articles focused on infectious diseases, as well as trauma and injury prevention.
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Affiliation(s)
- Torben K. Becker
- The Department of Emergency Medicine; University of Michigan; Ann Arbor MI
| | - Gabrielle A. Jacquet
- The Department of Emergency Medicine; Boston University School of Medicine; Boston MA
- The Boston University Center for Global Health and Development; Boston MA
| | - Regan Marsh
- The Department of Emergency Medicine; Brigham and Women's Hospital; Boston MA
- The Department of Emergency Medicine; Partners In Health; Boston MA
| | - Erika D. Schroeder
- The Department of Emergency Medicine; Providence Regional Medical Center; Everett WA
| | - Mark Foran
- The Department of Emergency Medicine; New York University; New York NY
- The Harvard Humanitarian Initiative; Cambridge MA
| | - Susan Bartels
- The Harvard Humanitarian Initiative; Cambridge MA
- The Department of Emergency Medicine; Beth Israel Deaconess Medical Center; Boston MA
- The FXB Center for Health and Human Rights; Boston MA
| | - Herbert C. Duber
- The Division of Emergency Medicine; University of Washington; Seattle WA
| | - Hannah Cockrell
- The Department of Emergency Medicine; Rhode Island Hospital; Providence RI
| | - Adam C. Levine
- The Harvard Humanitarian Initiative; Cambridge MA
- The Department of Emergency Medicine; Rhode Island Hospital; Providence RI
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Jacquet G, Levine A, Bruijns S, Wallis L. Global Emergency Medicine Literature Review, Tanzania and adopting delegates. Afr J Emerg Med 2012. [DOI: 10.1016/j.afjem.2012.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Casey ER, Muro F, Thielman NM, Maya E, Ossmann EW, Hocker MB, Gerardo CJ. Analysis of traumatic injuries presenting to a referral hospital emergency department in Moshi, Tanzania. Int J Emerg Med 2012; 5:28. [PMID: 22682499 PMCID: PMC3407759 DOI: 10.1186/1865-1380-5-28] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 06/08/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Injuries represent a significant and growing public health concern in the developing world, yet their impact on patients and the emergency health-care system in the countries of East Africa has received limited attention. This study evaluates the magnitude and scope of injury related disorders in the population presenting to a referral hospital emergency department in northern Tanzania. METHODS A retrospective chart review of patients presenting to the emergency department at Kilimanjaro Christian Medical Centre was performed. A standardized data collection form was used for data abstraction from the emergency department logbook and the complete medical record for all injured patients. Patient demographics, mechanism of injury, location, type and outcomes were recorded. RESULTS Ten thousand six hundred twenty-two patients presented to the emergency department for evaluation and treatment during the 7-month study period. One thousand two hundred twenty-four patients (11.5%) had injuries. Males and individuals aged 15 to 44 years were most frequently injured, representing 73.4% and 57.8%, respectively. Road traffic injuries were the most common mechanism of injury, representing 43.9% of injuries. Head injuries (36.5%) and extremity injuries (59.5%) were the most common location of injury. The majority of injured patients, 59.3%, were admitted from the emergency department to the hospital wards, and 5.6%, required admission to an intensive care unit. Death occurred in 5.4% of injured patients. CONCLUSIONS These data give a detailed and more robust picture of the patient demographics, mechanisms of injury, types of injury and patient outcomes from similar resource-limited settings.
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Affiliation(s)
- Erica R Casey
- Division of Emergency Medicine, Duke University School of Medicine, Durham, NC, USA.
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Aschkenasy M, Arnold K, Foran M, Lippert S, Schroeder ED, Bertsch K, Levine AC. International emergency medicine: a review of the literature from 2010. Acad Emerg Med 2011; 18:872-9. [PMID: 21790839 DOI: 10.1111/j.1553-2712.2011.01129.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The International Emergency Medicine (IEM) Literature Review aims to highlight and disseminate high-quality global EM research in the fields of EM development, disaster and humanitarian response, and emergency care in resource-limited settings. For this review, we conducted a Medline search for articles published between January 1 and December 31, 2010, using a set of international and EM search terms and a manual search of journals that have produced large numbers of IEM articles for past reviews. This search produced 6,936 articles, which were divided among 20 reviewers who screened them using established inclusion and exclusion criteria to select articles relevant to the field of IEM. Two-hundred articles were selected by at least one reviewer and approved by an editor for scoring. Two independent reviewers using a standardized and predetermined set of criteria then scored each of the 200 articles. The 27 top-scoring articles were chosen for full review. The articles this year trended toward evidence-based research for treatment and care options in resource-limited settings, with an emphasis on childhood illness and obstetric care. These articles represent examples of high-quality international emergency research that is currently ongoing in high-, middle-, and low-income countries alike. This article is not intended to serve as a systematic review or clinical guideline but is instead meant to be a selection of current high-quality IEM literature, with the hope that it will foster further growth in the field, highlight evidence-based practice, and encourage discourse.
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