Evolution of methodology and reporting of emergency medicine quantitative research over a 20-year period.

OBJECTIVE: We aimed to determine trends over time in article origin, and article and methodology characteristics. METHOD: We examined original research articles published every fifth year over a 20-year period (1997-2017) in six emergency medicine (EM) journals (Ann Emerg Med, Acad Emerg Med, Eur J Emerg Med, Emerg Med J, Am J Emerg Med, Emerg Med Australas). Explicit data extraction of 21 article characteristics was undertaken. These included regional contributions, specific article items and research methodology. RESULTS: 2152 articles were included. Over the study period, the proportional contributions from the USA and the UK steadily fell while those from Australasia, Europe and 'other' countries increased (p<0.001). All specific article items increased (p<0.01). Institutional Review Board/Ethics Committee approval and conflicts of interest were almost universal by 2017. There were substantial increases in the reporting of keywords and authorship contributions. The median (IQR) number of authors increased from 4 (2) in 1997 to 6 (3) in 2017 (p<0.001) and the proportion of female first authors increased from 24.3% to 34.2% (p<0.01). Multicentre and international collaborations, consecutive sampling, sample size calculations, inferential biostatistics and the reporting of CIs and p values all increased (p<0.001). There were decreases in the use of convenience sampling and blinding (p<0.001). The median (IQR) study sample size increased from 148 (470) to 349 (2225) (p<0.001). CONCLUSION: Trends over time are apparent within the EM research literature. The dominance in contributions from the US and UK is being challenged. There is more reporting of research accountability and greater rigour in both research methodology and results presentation.

Emergency medicine in China: A review of the history of progress and current and future challenges after 40 years of reform.

The year 2018 marks the 40th anniversary of China's reform, tremendous change had taken place in Chinese society. Looking back 40 years from 1978 to 2018, China's medical reform had made remarkable achievements, but still faces many challenges. These papers review the historical progress of emergency medicine, the current and the future challenges in China's medical reform process.

Enfermedades médicas, trepanación y cirugía de emergencia durante el sitio de Gibraltar (1779-1783). Las operaciones de Joaquín de Villalba (1752-1807) / Medical diseases, trepanning, and emergency surgery during the 1779-1783 Siege of Gibraltar: the surgeries of Joaquín de Villalba (1752-1807)

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Los orígenes militares del triaje / Triage origins in the military

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A Historical Perspective of Lateral Canthotomy and Its Adoption as an Emergency Medicine Procedure.

BACKGROUND: The treatment of orbital compartment syndrome has a rich history rooted in surgery and emergency medicine. It is a rare but acute and vision-threatening condition that most commonly occurs secondary to facial trauma or as a postoperative complication, and was first recognized in 1950. Surgical techniques and medical management were developed and refined soon afterwards to eventually become the modern-day treatment, lateral canthotomy, and inferior cantholysis. OBJECTIVE: This article details the history of orbital compartment syndrome and the evolution of its treatment to the present day. DISCUSSION: Given the time-sensitive nature and acuity of orbital compartment syndrome, lateral canthotomy was adopted by emergency physicians who could perform it more quickly at the bedside. CONCLUSIONS: Lateral canthotomy is a procedure adopted by emergency physicians from the surgical literature. The history of its adoption is a representative example of how emergency medicine evolves as a field.

Analysis of the citation of articles published in the European Journal of Emergency Medicine since its foundation.

OBJECTIVES: The aim of this study was to evaluate the evolution of the citation of articles from the European Journal of Emergency Medicine (EJEM) from 1994 (EJEM foundation) to 2015 and identify highly cited articles and their principal characteristics and determine a possible correlation between the citations counted in different databases. MATERIALS AND METHODS: We obtained the articles published in EJEM from 1994 to 2015 in ISI-WoS (main source) and Scopus, Google Scholar, and Medline databases (accessory sources). The citations were quantified and their annual evolution and the bibliometric indices derived (impact factor and SCImago Journal Rank) were evaluated. We identified and analyzed the highly cited EJEM articles and evaluated the possible correlation between the citations counted for these articles in the databases. RESULTS: Overall, 1705 EJEM articles were cited 9422 times in 8122 different articles. The evolution of the global citation, impact factor, and SCImago Journal Rank from 1994 to 2015 increased significantly. The h-index of EJEM was 30, and 31 articles were considered highly cited (≥30 citations), 16.1% of them being clinical trials. By subjects, 22.5% corresponded to cardiology, 19.3% to emergency department management, and 12.9% to pediatrics; by countries, 81% were from Europe, with Belgian authors publishing four (12.9%) highly cited articles, and French, Spanish, British, and Swedish authors having three (9.7%) each. Two studies in the EJEM achieved the definition of 'citation classics' (more than 100 citations). The number of citations in all the databases, except Medline, showed statistically significant correlations. CONCLUSION: Citation of EJEM articles has progressively increased and EJEM bibliometric indicators have improved; most highly cited articles are mainly by European authors.

Old Tricks for New Dogs? John Caddy and the Victorian Origins of TCCC.

The success of Tactical Combat Casualty Care (TCCC) in reducing potentially preventable combat deaths may rely on both specific interventions (such as tourniquets) and the systematized application of immediate care. Essential elements of a combat care system include clear specification of immediate care priorities, standardized methodology, and inclusion and training of all nonmedical personnel in early response. Although TCCC is fairly recent, the construct is similar to that first suggested during the mid-nineteenth century by John Turner Caddy (1822-1902), a British Royal Navy staff surgeon. Although naval warfare engagements at the time were relatively infrequent, casualties could be numerous and severe and often overwhelmed the small medical staff on board. Caddy recognized that nonmedical personnel properly trained in the fundamentals of combat injury management would result in lives saved and greatly improved morale. The novelty was in his attempt to make procedures simple enough to be performed by nonmedical personnel under stress. However, Caddy's guidelines were completely overlooked for nearly two centuries. The principles of best practice for managing combat trauma injuries learned in previous wars have often been lost between conflicts. Understanding the historical roots of combat first responder care may enable us to better understand and overcome barriers to recognition and retention of essential knowledge.

The German emergency and disaster medicine and management system-history and present.

As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Standard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach.

How can emergency physicians harness the power of new technologies in clinical practice and education?

As the Royal College of Emergency Medicine looks back on 50 years of progress towards the future it is clear that new and emerging technologies have the potential to substantially change the practice of emergency medicine. Education, diagnostics, therapeutics are all likely to change as algorithms, personalised medicine and insights into complexity become more readily available to the emergency clinician. This paper outlines areas of our practice that are already changing and speculates on how we might need to prepare our workforce for a technologically enhanced future.