In recent years, the use of the intranasal route has been actively explored as a possible drug delivery method in the palliative patient population. There are reports demonstrating the effectiveness of nasally administered medications that are routinely used in patients at the end of life. The subject of this study is the intranasal drug administration among palliative patients. The aim is to summarize currently used intranasal therapies among palliative patients, determine the benefits and difficulties, and identify potential areas for future research. A review of available medical literature published between 2013 and 2023 was performed using online scientific databases. The following descriptors were used when searching for articles: “palliative”, “intranasal”, “nasal”, “end-of-life care”, “intranasal drug delivery” and “nasal drug delivery”. Out of 774 articles, 55 directly related to the topic were finally selected and thoroughly analyzed. Based on the bibliographic analysis, it was shown that drugs administered intranasally may be a good, effective, and convenient form of treatment for patients receiving palliative care, in both children and adults. This topic requires further, high-quality clinical research.

The Emergency Department (ED) is a facility meant to treat patients in need of medical assistance. The choice of triage system hugely impactsed the organization of any given ED and it is important to analyze them for their effectiveness. The goal of this review is to briefly describe selected triage systems in an attempt to find the perfect one. Papers published in PubMed from 1990 to 2022 were reviewed. The following terms were used for comparison: “ED” and “triage system”. The papers contained data on the design and function of the triage system, its validation, and its performance. After studies comparing the distinct means of patient selection were reviewed, they were meant to be classified as either flawed or non-ideal. The validity of all the comparable segregation systems was similar. A possible solution would be to search for a new, measurable parameter for a more accurate risk estimation, which could be a game changer in terms of triage assessment. The dynamic development of artificial intelligence (AI) technologies has recently been observed. The authors of this study believe that the future segregation system should be a combination of the experience and intuition of trained healthcare professionals and modern technology (artificial intelligence).

Introduction: Elderly patients in emergency departments (EDs) are at increased risk due to nonspecific symptoms, multimorbidity, and elevated mortality. This study compared the predictive performance of the Manchester Triage System (MTS) and the Emergency Severity Index (ESI) for hospitalization and critical outcomes in geriatric patients and analyzed symptom patterns by age and clinical course. Methods: This retrospective study included all patients aged ≥18 years admitted to a tertiary ED in northern Poland between January and June 2021. Each patient was concurrently assessed using both MTS and ESI. Data collected included triage level, age group (18–64, 65–79, ≥ 80), sex, mode of arrival, presenting symptoms, and outcomes including hospitalization and ten predefined critical events (e.g., sepsis, admission, urgent surgery). Logistic regression was used to assess associations. Results: Among 1,063 patients, 475 (44.7%) were aged ≥65. Patients aged 18–64 most commonly presented with abdominal pain or polytrauma, while geriatric patients more frequently reported dyspnea, weakness, and altered mental status. Dyspnea was nearly twice as common in patients ≥80. Weakness (OR = 1.67) and abdominal pain (OR = 1.64) were significantly associated with hospitalization. Hospitalization and critical events were more likely in older adults (OR = 2.03 for ages 65–79; OR = 3.74 for ≥80). In both systems, higher triage urgency was independently associated with greater risk (MTS: OR = 0.51; ESI: OR = 0.43). ESI showed stronger alignment with physiological deterioration and predicted complications such as ICU admission and sepsis more consistently than MTS. Conclusions: MTS and ESI show limited sensitivity in older patients, particularly with nonspecific presentations. ESI provided better discrimination of clinical urgency. Findings support revising triage systems to account for age, atypical symptoms, and geriatric vulnerability.

Given the increasing number of patients presenting to Emergency Departments (EDs), the use of effective and reliable triage tools is essential. Such systems enable rapid assessment of the urgency of medical intervention, which contributes to improved workflow, optimized resource allocation, and potentially better clinical outcomes. This study presents a direct comparison of two of the most widely used triage systems globally: the Manchester Triage System (MTS) and the Emergency Severity Index (ESI), evaluating their classification agreement and predictive value for critical events in the ED population. This retrospective study included 1,072 patients who were concurrently assessed using both systems during a transitional six-month period in which both MTS and ESI were applied in parallel at the study hospital. The correlation between triage categories assigned by each system was analyzed, as well as their association with predefined critical events. A moderate level of classification agreement was observed between the two systems (Cohen’s kappa = 0.51; Spearman’s rho = 0.49). ESI assigned over 80% of patients to priority level 3, whereas MTS distributed patients more evenly between levels 3 and 4. Both systems demonstrated a statistically significant association between higher acuity levels and an increased risk of critical events—lower category numbers (i.e., higher priority) corresponded with a greater likelihood of severe complications. The results confirm the effectiveness of both triage systems in assessing patients’ clinical condition while highlighting important differences in their classification structures. These findings may inform the choice of triage system in clinical practice and underscore the need for further research on optimization and potential integration with artificial intelligence-based decision support tools.

Background/Objectives: The increasing number and complexity of cardiac and neurosurgical procedures underscore the importance of effective perioperative care. One of the most serious postoperative complications is delirium, which prolongs hospitalization, increases treatment costs, worsens rehabilitation outcomes, and increases mortality. Identifying biomarkers that predict delirium can improve patient outcomes. The aim of this study was to assess the relationship between C-reactive protein (CRP) levels and the incidence of postoperative delirium in patients after cardiac and neurosurgical procedures hospitalized in the intensive care unit. Methods: A retrospective study was conducted on 408 patients (202 undergoing cardiac surgery and 206 undergoing neurosurgery) who underwent surgery between April 2024 to the end of August 2024. Medical records were reviewed for the occurrence of delirium assessed using the Confusion Assessment Method-Intensive Care Unit scale (CAM-ICU), its severity assessed using the Confusion Assessment Method–Intensive Care Unit 7 (CAM-ICU-7), and laboratory test results, with particular emphasis on C-reactive protein levels. CRP levels were measured on postoperative days 1 and 2. Results: Postoperative delirium was noted in both groups, more frequently in patients with elevated CRP levels, indicating an active inflammatory process. In the neurosurgical group, episodes of severe delirium occurred primarily after laminectomy, whereas in the cardiac surgery group, they were most common after coronary artery bypass grafting (CABG). Conclusions: Elevated CRP levels are associated with a higher risk of postoperative delirium. Monitoring inflammatory parameters and implementing early preventive measures may improve treatment outcomes and shorten hospital stays. Further prospective studies using standardized diagnostic tools are necessary.

Due to the increasing number of terminally ill patients in emergency departments (EDs), there is a need to provide them with appropriate care, treat end of life symptoms and support in obtaining targeted palliative care. A review of scientific articles available in global databases such as Google...