Emergency medicine in Japan: past, present, and future

Shimizu, Kentaro; Hibino, Seikei; Biros, Michelle H.; Irisawa, Taro; Shimazu, Takeshi

doi:10.1186/s12245-020-00316-7

Cited by 25 publications

(23 citation statements)

References 25 publications

(26 reference statements)

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“…The emergency medical system in our country has three designated levels according to the perceived acuity of the patients. Our designated tertiary hospital deals with patients who need to be managed in the operating room or the ICU [ 12 ]. During the study period, only severe COVID-19 patients who required a ventilator were transferred to our hospital.…”

Section: Methodsmentioning

confidence: 99%

Ivermectin administration is associated with lower gastrointestinal complications and greater ventilator-free days in ventilated patients with COVID-19: A propensity score analysis

Shimizu

Hirata

Kabata

et al. 2022

Journal of Infection and Chemotherapy

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Introduction COVID-19 patients have been reported to have digestive symptoms with poor outcome. Ivermectin, an antiparasitic drug, has been used in COVID-19 patients. The objective of this study was to evaluate whether ivermectin has effects on gastrointestinal complications and ventilator-free days in ventilated patients with COVID-19. Methods COVID-19 patients who were mechanically ventilated in the ICU were included in this study. The ventilated patients who received ivermectin within 3 days after admission were assigned to the Ivermectin group, and the others were assigned to the Control group. Patients in the Ivermectin group received ivermectin 200 μg/kg via nasal tube. The incidence of gastrointestinal complications and ventilator-free days within 4 weeks from admission were evaluated as clinical outcomes using a propensity score with the inverse probability weighting method. Results We included 88 patients in this study, of whom 39 patients were classified into the Ivermectin group, and 49 patients were classified into the Control group. The hazard ratio for gastrointestinal complications in the Ivermectin group as compared with the Control group was 0.221 (95% confidence interval [CI], 0.057 to 0.855; p = 0.029) in a Cox proportional-hazard regression model. The odds ratio for ventilator-free days as compared with the Control group was 1.920 (95% CI, 1.076 to 3.425; p = 0.027) in a proportional odds logistic regression model. Conclusions Ivermectin improved gastrointestinal complications and the number of ventilator-free days in severe COVID-19 patients undergoing mechanical ventilation. Prevention of gastrointestinal symptoms by SARS-Cov-2 might be associated with COVID-19 outcome.

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Section: Methodsmentioning

confidence: 99%

Ivermectin administration is associated with lower gastrointestinal complications and greater ventilator-free days in ventilated patients with COVID-19: A propensity score analysis

Shimizu

Hirata

Kabata

et al. 2022

Journal of Infection and Chemotherapy

Self Cite

View full text Add to dashboard Cite

show abstract

“…As the study periods of this study was long, survival outcomes might be affected the development of emergency system and hospital care in Japan. 10 There is still limited data on effect of road safety campaigns on mortality in Japan, and it is important to evaluate the current situation to improve the National Traffic Safety Campaign. Therefore, this study aimed to examine the difference in mortality from serious road traffic injuries during the National Traffic Safety Campaign compared with other periods using a nationwide database in Japan.…”

Section: Introductionmentioning

confidence: 99%

“…Although it did not show any statistically significant difference in mortality after 1990, this study assessed only spring events of biannual campaigns and used national police data which do not include detailed hospital outcome data such as survival information after 24 hours. As the study periods of this study was long, survival outcomes might be affected the development of emergency system and hospital care in Japan 10…”

Section: Introductionmentioning

confidence: 99%

Assessing the impact of the national traffic safety campaign: a nationwide cohort study in Japan

et al. 2022

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ObjectivesThis study aimed to examine the difference in mortality from serious road traffic injuries during the National Traffic Safety Campaign compared with other periods and identify the common mechanisms of injury by age group in Japan.DesignA retrospective review of Japan Trauma Data Bank (JTDB).SettingA total of 280 participating major emergency institutions across Japan.ParticipantsPatients with road traffic injuries registered in JTDB between 2004 and 2018 were recruited in the study. We included patients injured by traffic crashes during the National Traffic Safety Campaigns and controls using a double control method. The National Traffic Safety Campaign comprises 10 consecutive days in spring and fall (20 days in each year), and controls was the same calendar days 2 weeks before and after the days in the National Traffic Safety Campaigns (40 days in each year) to control for weekday, seasonal and yearly trends.Primary and secondary outcome measuresThe primary outcome was in-hospital mortality. The secondary outcome was the incidences of severe traffic injury.ResultsAmong 126 857 patients recorded as road traffic injuries in JTDB, we identified 6181 patients (21 cases per day) with injuries occurring during the National Traffic Safety Campaigns and 12 382 controls (21 cases per day). The overall in-hospital mortality was 11.4%. We did not observe a significant difference in in-hospital mortality between the groups (11.8% vs 11.1%) with an adjusted OR of 1.05 (95% CI 0.95 to 1.16). The most common mechanism of injury in each age group was bicycle crash among children, motorcycle crash among adults and pedestrian among the elderly.ConclusionsWe found no change in the incidence of severe traffic injury or in-hospital mortality during the National Traffic Safety Campaign in Japan. Serious road trauma was high for bicycles among children, motorcycles among adults and pedestrian among the elderly.

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“…There are three levels of emergency hospital designation in Japan: “primary” for patients who can be managed as outpatients, “secondary” for patients who need to be hospitalized, and “tertiary” for patients who need to be managed in an intensive care unit (ICU) [ 29 ]. Japan has one of the most aged populations in the world [ 30 ], and the number of patients visiting the ER is on the rise because of the COVID-19 pandemic [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Emergency Nursing-Care Patient Satisfaction Scale (Enpss): Development and Validation of a Patient Satisfaction Scale with Emergency Room Nursing

et al. 2022

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This study aimed to develop and validate an emergency nursing-care patient satisfaction scale to measure patient satisfaction with emergency room (ER) nursing. Patient satisfaction scales for ER nursing have been validated without considering the perspectives of the healthcare system or cultural background of the country. Moreover, although nursing care is changing with COVID-19, no scale has been specifically designed to assess patient satisfaction with ER nursing. The study population included patients who visited five ERs in Japan (March to December 2021) (n = 135). The rating scales were provided to patients who visited the ER and gave consent, and the patients were asked to reply. In the process of validating the scale, exploratory and confirmatory factor analyses of the construct and criterion validity were conducted. The confirmatory factor analysis results showed a factorial structure consisting of four factors. The domain and summary scores demonstrated good-to-excellent internal reliability (Cronbach’s range = 0.81–0.89). This patient satisfaction scale was designed and validated from the perspective of the Japanese healthcare system and cultural backgrounds. This scale may be useful for developing assessments and interventions to improve patient satisfaction with ER nursing.

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Emergency medicine in Japan: past, present, and future

Cited by 25 publications

References 25 publications

Ivermectin administration is associated with lower gastrointestinal complications and greater ventilator-free days in ventilated patients with COVID-19: A propensity score analysis

Ivermectin administration is associated with lower gastrointestinal complications and greater ventilator-free days in ventilated patients with COVID-19: A propensity score analysis

Assessing the impact of the national traffic safety campaign: a nationwide cohort study in Japan

Emergency Nursing-Care Patient Satisfaction Scale (Enpss): Development and Validation of a Patient Satisfaction Scale with Emergency Room Nursing

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