Background: Post-intensive care syndrome encompasses physical, cognitive, and psychological impairments that persist in patients after discharge from an intensive care unit. There is considerable variation in the tools used for assessment. This systematic review aimed to summarize the consensus-based recommendations for assessing post-intensive care syndrome. Methods: A comprehensive literature search identified four consensus-based guidelines. A quality assessment carried out using the Appraisal of Guidelines for Research and Evaluation II tool demonstrated high methodological standards across all the included papers. Results: The guidelines consistently emphasize assessing cognition, mental health, and physical function as the core domains. However, there are notable differences in the specific tools recommended. Major et al. focused on physical examinations, while Mikkelsen et al. proposed a fundamental package of five tools covering the key domains. Spies et al. aimed for a pragmatic set of freely available instruments administrable within 30 min. Nakanishi et al. provided a detailed ranking of instruments for each domain. The availability of validated translations varied considerably across languages. Some tools developed specifically for post-intensive care syndrome were not considered by any consensus conference. Conclusions: Further work is needed to establish a universally accepted standard for assessing post-intensive care syndrome that considers practical implementation across diverse settings and languages.

Background: Invasive blood pressure measurement is the in-hospital gold standard to guide hemodynamic management and consecutively cerebral perfusion pressure in patients with traumatic brain injury (TBI). Its prehospital use is controversial since it may delay further care. The primary aim of this study was to test the hypothesis that patients with severe traumatic brain injury who receive prehospital arterial cannulation, compared to those with in-hospital cannulation, do not have a prolonged time between on-scene arrival and first computed tomography (CT) of the head by more than ten minutes. Methods: This retrospective study included patients 18 years and older with isolated severe TBI and prehospital induction of emergency anaesthesia who received treatment in the resuscitation room of the University Hospital of Graz between January 1st, 2015, and December 31st, 2022. A Wilcoxon rank-sum test was used to test for non-inferiority (margin = ten minutes) of the time interval between on-scene arrival and first head CT. Results: We included data of 181 patients in the final analysis. Prehospital arterial line insertion was performed in 87 patients (48%). Median (25–75th percentile) durations between on-scene arrival and first head CT were 73 (61–92) min for prehospital arterial cannulation and 75 (60–93) min for arterial cannulation in the resuscitation room. Prehospital arterial line insertion was significantly non-inferior within a margin of ten minutes with a median difference of 1 min (95% CI − 6 to 7, p = 0.003). Conclusion: Time-interval between on-scene arrival and first head CT in patients with isolated severe traumatic brain injury who received prehospital arterial cannulation was not prolonged compared to those with in-hospital cannulation. This supports early out-of-hospital arterial cannulation performed by experienced providers.

Background: Generative artificial intelligence (GenAI) tools are increasingly used in scientific research to support literature searches, evidence synthesis, and manuscript preparation. While these systems promise substantial efficiency gains, concerns have emerged regarding their reliability, particularly their tendency to cite inaccurate, fabricated, or retracted literature. The unrecognized inclusion of retracted studies poses a serious risk to research integrity and evidence-based decision-making. Whether commonly used GenAI tools can reliably detect, exclude, or transparently communicate the retraction status of scientific publications remains unclear. Objective: This study aimed to evaluate the ability of freely available GenAI tools to correctly handle retracted scientific articles during literature searches. Primary and secondary outcomes focused on accuracy, reliability, and consistency in recognizing retracted literature. Methods: In this pragmatic trial, nine widely used free-access GenAI tools (ChatGPT 4, ChatGPT 5, Claude, Gemini, Perplexity, Microsoft Copilot, SciSpace, ScienceOS, and Consensus) were evaluated. Each tool was asked five predefined, standardized questions addressing topic overview, article identification, article summarization, and explicit assessment of retraction status. Overall, 15 retracted articles (the 10 most cited and 5 most recently retracted as of May 23, 2025) were selected from the Retraction Watch database. All questions were repeated twice to assess intratool consistency. Responses were independently rated as correct or incorrect by 2 researchers. Descriptive statistics summarized performance, and comparisons between general-purpose and research-focused AI tools were conducted using descriptive statistics. Interreviewer agreement was assessed using Cohen kappa coefficient. Results: None of the evaluated AI tools consistently handled retracted articles correctly. No model achieved perfect accuracy across all question sets. ChatGPT 5 performed best, defined by the primary outcome of achieving fully correct responses to all five predefined tasks (5/5) for the highest number of retracted articles, correctly answering all five questions for 8 of 15 articles (53.3%). Research-focused tools (SciSpace, ScienceOS, and Consensus) failed to produce a single fully correct response set. Retracted articles were frequently included in topic overviews without warning, with error rates exceeding 40% in several tools. When specifically asked about retraction status, most systems failed to provide correct or complete information. OpenEvidence only reported data for a subset of our retracted articles as it is only used in health care literature. It demonstrated strong performance in topic overviews but low accuracy in identifying retracted articles. Conclusions: Freely available GenAI tools are currently not able to detect, exclude, or appropriately flag retracted scientific literature. The widespread and confident reproduction of retracted studies represents a substantial threat to research integrity, particularly in medical and evidence-based fields. Until retraction-aware verification mechanisms are systematically integrated, independent source checking remains essential when using AI-assisted literature tools.

To map and characterize device damage and malfunction associated with dual defibrillator use in defibrillation and cardioversion, which is increasingly employed in both elective and emergency settings, and to identify knowledge gaps relevant to practice and future research. We conducted a scoping review in accordance with JBI methodology and PRISMA-ScR. PubMed, Embase, CINAHL, CENTRAL, and grey literature were searched without language or date restrictions. Regulatory adverse event databases were also searched. Eligible sources reported device damage or malfunction associated with two external defibrillators delivering shocks within one second or less of each other. Twenty-nine records from 2016 to 2026 were included: five published sources and 24 regulatory adverse event reports. Published sources comprised two randomised trials, one survey study, one case report, and one ad-hoc retrospective study. Across five published sources, eight events of lasting device damage and four temporary malfunctions were identified. In published studies, all reported damage events were reported in association with double simultaneous defibrillation or dual cardioversion. Across 24 regulatory reports, 11 records described device damage and 16 described malfunctions. Reported damage was often not recognized during the index event and was instead identified on post-use testing or later routine self-checks. Device damage and malfunction during dual defibrillator use are documented in both published and regulatory sources. Damage may remain occult until later testing, creating risk beyond the index case. Standardized prospective reporting and routine post-use device testing should be considered wherever dual defibrillator use is employed.

Blood pressure is a key vital sign in prehospital emergency care and essential for assessing the hemodynamic status and guiding treatment. In the prehospital setting, blood pressure is usually measured intermittently with non-invasive cuff-techniques. However, intraarterial blood pressure monitoring with an arterial catheter offers continuous and more accurate measurements. This scoping review aimed to synthesize and analyze the current literature on intraarterial blood pressure monitoring in prehospital emergency care. PubMed, EMBASE, MEDLINE, Cochrane Central, and CINAHL were searched on April 15, 2025, following PRISMA-ScR guidelines and Joanna Briggs Institute methodology. Studies involving adults (≥ 18 years) having prehospital intraarterial blood pressure monitoring were included. 1456 studies were screened and 24 studies finally included. The most frequent indications for intraarterial blood pressure monitoring were cardiopulmonary resuscitation and post resuscitation care. Arterial cannulation was performed by physicians in 92% of the cases. The radial artery was the most frequently used cannulation site. Arterial cannulation was successful in 82% of the patients. Major complications were very rare, with brachial artery cannulation bearing the highest risk for complications. Low agreement between intraarterial and non-invasive blood pressure measurements was reported. Actions based on intraarterial blood pressure monitoring were performed in 53% of the patients. Arterial cannulation was performed during different timepoints and had varying effects on prehospital time. Intraarterial blood pressure monitoring has been studied across a wide range of indications in prehospital emergency care with an acceptable cannulation success rate and low risk of complications. However, the included studies were mostly observational, necessitating randomized controlled trials analyzing patient-centered outcomes in defined populations.

Introduction: Although healthcare infrastructure has improved in recent years, the preoperative journey of patients is often accompanied by anxiety. Allowing patients to walk to the operating theatre is a simple, yet underexplored strategy that may enhance their sense of autonomy and reduce anxiety. As patient‐centred care gains importance, evaluating the effects of this approach on patient‐reported outcomes may be more relevant than widely assumed. Aim: In this scoping review, we aim to analyse the published literature on preoperative walking into the operating theatre and patient‐reported outcomes, such as anxiety and satisfaction. Design: This study was a scoping review that followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses, Scoping Review extension guidelines. Methods: Inclusion criteria were adult patients undergoing elective surgery and walking to the operating theatre. Data were extracted using a standardised form, and critical appraisal was performed by using ROBINS‐I V2.0, RoB2 and ROB‐E tools. Data Sources: Embase, MEDLINE, Cochrane databases (OVID) and CINAHL (EBSCOhost) were searched up to 31st January 2025. Results: Our search identified 958 articles, with seven trials included in the final analysis. The studies, published between 1994 and 2022, involved 3001 patients from North America, Asia and Europe. The interventions varied, but most patients reported improved satisfaction and reduced anxiety when walking to the operating theatre. No adverse events were reported, although patient preferences varied, with younger patients more likely to prefer walking. Conclusion: Walking to the theatre positively impacts patient satisfaction and autonomy. However, patient selection is key, as not all individuals are physically or mentally prepared for walking. Future research could explore unaccompanied walking and its effects on hospital resource utilisation. Preoperative walking is a beneficial intervention that enhances patient satisfaction and reduces anxiety, providing a feasible alternative to bed transport for many elective surgical patients. Patient or Public Contribution: No patient or public involvement.