The American journal of emergency medicine
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Spontaneous pneumothorax (SP) is characterized by the escape of broncho-alveolar air into presence of air in the pleural space without preceding blunt or penetrating trauma. SP requires prompt diagnosis and treatment. SP is divided into two groups as primary and secondary. ⋯ However, late-onset SP after recovering from COVID-19 is unusual. Herein we present a case with post-COVID-19 pulmonary fibrosis-like changes and subsequent late onset spontaneous pneumothorax (SP). We also present the patient's radiological findings.
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COVID-19 spread worldwide, causing severe morbidity and mortality and this process still continues. The aim of this study to investigate the prognostic value of right ventricular (RV) strain in patients with COVID-19. ⋯ Presence of right ventricular strain pattern on ECG is associated with in hospital mortality in patients with COVID-19.
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Case Reports
Triple threat: New presentation with diabetic ketoacidosis, COVID-19, and cardiac arrhythmias.
Patients with diabetes have increased susceptibility to infection with Severe acute respiratory syndrome-coronavirus 2 and increased morbidity and mortality from Coronavirus disease 2019 (COVID-19) infection. Mortality from COVID-19 is sometimes caused by cardiac arrhythmias. ⋯ In this case report we describe two children with COVID-19, new-onset DKA and cardiac arrhythmias. These cases emphasize the importance of close cardiac and electrolyte monitoring in patients with COVID-19 infection.
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Awake intubations in the emergency department: A report from the National Emergency Airway Registry.
To describe awake intubation practices in the emergency department (ED) and report success, complications, devices used, and rescue techniques using multicenter surveillance. ⋯ Awake intubation in this multicenter cohort of emergency department patients was rare and was performed most often in patients with airway edema or obstruction. Emergency physicians performed the majority of first intubation attempts with high first-attempt success. Further studies are needed to determine optimal emergency airway management in this patient population.
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Observational Study
The prevalence and predictors of extended spectrum B-lactamase urinary tract infections among emergency department patients: A retrospective chart review.
Inadequate initial antibiotic treatment of ESBL urinary tract infections (UTI) can lead to increase in the number of antibiotics used, return visits, longer hospitalizations, increased morbidity and mortality and increased costs. Given the important health implications on patients, this study aimed to examine the prevalence and predictors of ESBL UTIs among Emergency Department (ED) patients of a tertiary care center in Beirut, Lebanon. ⋯ Out of the 886 patients that were included, 24.9% had an ESBL organism identified by urine culture. They had higher bladder catheter use within the previous 90 days, antibiotic use within last 90 days, and were more likely to have a history of an ESBL producing isolate from any body site in the last year. Antibiotic use in the last 90 days and a history of ESBL producing isolate at any site in the previous year were significantly associated with developing an ESBL UTI (OR = 1.66, p = 0.001 and OR = 2.53, p < 0.001 respectively). Patients diagnosed with cystitis were less likely to have an ESBL organism (OR = 0.4 95%CI [0.20-0.81], p = 0.01) CONCLUSION: The prevalence of ESBL organisms was found to be 24.9% in urinary tract infections. The predictors of an ESBL UTI infection were antibiotic use in the last 90 days, a history of ESBL producing isolate at any site in the previous year. Based on the findings of our study, we can consider modifying initial empiric antibiotic treatment for patients presenting with a UTI with the above stated risk factors.