Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 0 0 2026 05 06 1743 1743 Reza Ghasemi Department of Emergency Medicine, Imam-Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Science, Tehran, Iran. Mohammad Eftekhari Department of Emergency Medicine, Imam-Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Science, Tehran, Iran. 2026 04 25 2026 05 01 In this editorial, we provide an overview of the performance of Frontiers in Emergency Medicine (FEM) in 2025 compared with the preceding year and summarize the 37 articles published during this period. The included manuscripts are described with respect to the authors’ countries of origin, article type, and major domains of emergency medicine (EM). FEM appears to have successfully fostered international collaboration among EM specialists. In addition, through strengthened oversight of the submission‑to‑publication process, the journal has sought to publish high‑quality, clinically relevant research while maintaining a high level of author satisfaction. https://fem.tums.ac.ir/index.php/fem/article/view/1743 https://fem.tums.ac.ir/index.php/fem/article/download/1743/546

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 0 0 2026 05 06 1570 1570 Mohammad Reza Kardan Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran. Mehdi Torabi Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran. Amin Saberinia Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran. Moghaddameh Mirzaee Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 2025 03 12 2025 11 24 Objective: In traditional triage, there is often a challenge in accurately assessing the severity of a patient's condition, which can result in under-triage or over-triage. The purpose of this study is to compare traditional and innovative vital signs in predicting possible mortality in critically ill patients. Methods: This is a cross-sectional study conducted over a three-month period. Patients presenting emergency severity index (ESI) level 1 and 2 triage were divided into two groups: those with and without mortality. Subsequently, the role of traditional triage vital signs [blood pressure, heart rate, oxygen saturation (SpO2), mean arterial pressure (MAP), pulse pressure (PP)] was compared with that of innovative vital signs [shock index (SI), reverse shock index (RSI), modified shock index (MSI), age-shock index (ASI)] in predicting mortality in two groups. Results: A total of 360 patients were included in the study. A statistically significant association was observed between all innovative and traditional vital signs (with the exception of heart rate) and mortality. In logistic regression, the univariate model revealed a significant association between age, triage level, innovative and traditional vital signs with the occurrence of mortality. In the multivariate model, only MAP, PP, SI, RSI×SpO2, and ASI were found to have a significant association with mortality. Conclusion: The combination of innovative and traditional vital signs, including MAP, PP, SI, MSI, RSI×SpO2, and ASI in triage may be capable of predicting critically ill patients with a higher probability of mortality. https://fem.tums.ac.ir/index.php/fem/article/view/1570 https://fem.tums.ac.ir/index.php/fem/article/download/1570/543

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 0 0 2026 05 06 1607 1607 Latife Jabbari Department of Emergency Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Zahra Alipour Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Reza Yazdani Department of Emergency Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Seyed Ashkan Tabibzadeh Dzfuli Department of Emergency Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Saeed Hayati Department of Emergency Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. 2025 05 24 2025 12 10 Objective: Chest pain is a prevalent and potentially life-threatening presentation in emergency departments, necessitating prompt and precise risk stratification to identify patients at high risk, particularly those with acute coronary syndrome (ACS). This study evaluates the predictive accuracy of the HEART score in stratifying short-term major adverse cardiac events (MACE) risk among chest pain patients in Bandar Abbas, aiming to enhance clinical decision-making and resource utilization in emergency departments. Method: This prospective observational study was conducted on patients presenting with chest pain at Shahid Mohammadi Hospital’s emergency department. Patients aged ≥18 years with chest pain were included, while those with STEMI or incomplete records were excluded. The HEART score was used for risk stratification, and patients were classified into low, moderate, or high-risk groups. The primary outcome was MACE within six weeks, confirmed via follow-up calls. Data analysis included logistic regression and ROC curve analysis. Result: A total of 1,501 individuals participated in the study, with a mean age of 48.99±14.71 years. Among the participants, 28.6% were diagnosed with MACE. The most common risk factors for MACE included a history of coronary artery disease (79.1%) and hypertension (77.2%). Based on the HEART score, patients were categorized into low-risk (≤ 3), moderate-risk (4-6), and high-risk (≥ 7) groups. The majority of non-MACE patients were classified as low-risk (78.3%), while 65.6% of MACE patients fell into the moderate-risk category. The mean HEART score was significantly higher in the MACE group (5.73±1.68) compared to the non-MACE group (2.31± 1.54). The optimal HEART score cutoff for predicting MACE was determined to be 3.5, with the ROC curve demonstrating strong predictive performance (AUC=0.932). Conclusion: The HEART score is a reliable tool for risk stratification in chest pain patients in the emergency department. Our study shows that a score of ≤ 3.5 indicates low risk, while higher scores predict a greater likelihood of MACE. The HEART score effectively guides clinical decisions, highlighting its high sensitivity and specificity for identifying low- and high-risk patients, making it an essential tool for patient management in emergency settings. https://fem.tums.ac.ir/index.php/fem/article/view/1607 https://fem.tums.ac.ir/index.php/fem/article/download/1607/544

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 0 0 2025 12 05 1669 1669 Marzieh Abbasi Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran. Faeze Salahshoor Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Jalili Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ashouri Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Hadi Mirfazaelian Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2025 10 15 2025 10 28 Spontaneous isolated celiac artery dissection (SICAD) is a rare vascular condition, often presenting with nonspecific abdominal or flank pain, and may result in downstream visceral ischemia. Early recognition is essential to guide appropriate management. We present a case of SICAD in this report. https://fem.tums.ac.ir/index.php/fem/article/view/1669 https://fem.tums.ac.ir/index.php/fem/article/download/1669/536

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 0 0 2026 05 06 1655 1655 Hesam Seyedin Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Shandiz Moslehi Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. Asghar Tavan Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. sajjad narimani Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. 2025 09 05 2025 12 26 Emergency Medical Services (EMS) providers are routinely exposed to mass casualty incidents, with post-crisis care traditionally focusing on mitigating psychological pathologies like PTSD through protocols such as Critical Incident Stress Debriefing (CISD). This commentary argues that while this clinical, deficit-based model is necessary, it is insufficient for addressing the profound existential crisis of meaning that many providers experience. Such crises are characterized by a fracturing of professional purpose and unanswered questions about the value of their work in the face of devastating outcomes. The article proposes a pivotal shift from mere psychological recovery to a framework of meaning reconstruction. This involves reframing success from measurable outcomes to the unwavering act of providing care itself, enabling agency by channeling experience into tangible roles like mentoring and protocol development, and legitimizing the search for meaning as a core component of occupational health. Ultimately, the goal is to help providers integrate traumatic events into their professional narrative, transforming them from passive victims into active architects of a more resilient future, thereby ensuring their sense of purpose is not extinguished by trauma. https://fem.tums.ac.ir/index.php/fem/article/view/1655 https://fem.tums.ac.ir/index.php/fem/article/download/1655/545