Multicenter assessment of impairments and disabilities associated with Beirut blast injuries: a retrospective review of hospital medical records.

Objectives: This study aims to describe the injury patterns of the Beirut blast victims and assess hospitals' disaster management and preparedness during the 2020 Beirut port blast. Methods: A cross-sectional retrospective multicenter study was conducted in two stages. Data were collected on blast victims presented to participating hospitals from August 4 till August 8, using three designed questionnaires. Stage 1 included all blast patients' records and stage 2 examined a subset of inpatient and outpatient records. Binary logistic regression was performed to assess the factors associated with death and disability for blast patients. Results: A total of 3278 records were collected, 83% were treated at emergency departments and 17% were admitted to hospitals. Among those, 61 deaths and 35 long-term disabilities were reported. Extremity operations (63%) were mostly performed. Outpatients (n=410) had a mean age of 40±17.01 years and 40% sustained lacerations (40%). 10% of those patients sustained neurological complications and mental problems, and 8% had eye complications. Inpatients (n=282) had a mean age of 49±20.7 years and a mean length of hospital stay of 6±10.7 days. Secondary (37%) and tertiary (25%) blast injuries were predominant. 49% sustained extremity injuries and 19% head/face injuries. 11 inpatient deaths and 20 long-term disabilities were reported. Death was significantly associated with tertiary concussion and crush syndrome (p<0.05). Of the 16 hospitals, 13 implemented disaster plans (87%), and 14 performed a triage with a mean time of 0.96±0.67 hours. One hospital (6%) performed psychological evaluations, without follow-up. Conclusion: Beirut blast victims suffered deaths and disabilities associated with their injuries. They predominantly sustained lacerations caused by shattered glass. Tertiary injuries were associated with death. Triage, disaster plans, and hospital preparedness should be effectively implemented to enhance patients' clinical outcomes. Level of evidence: Prognostic and epidemiological/Level III.

Emergency Department Management of COVID-19 Suspected Patients. An International Perspective.

Objectives: In December 2019, an invasive viral outbreak, the Corona Virus Disease 19 spread to the whole world. An international cross-sectional study was conducted to evaluate how healthcare workers in Emergency departments dealt with this pandemic. Methods: A questionnaire was sent to 180 healthcare workers around the world during May and June of the year 2020. Results: A total of 134 HCW from 23 countries responded with a majority of Emergency physicians (36.8%). The PCR testing is available in 72.9% of the hospitals. Different architectural strategies were used to isolate suspected cases in the Emergency department (ED). Half of the institutions would not allow visitors, while the other half, restricted visiting hours and the number of visitors. Triage for suspected patients relied in 82.8% on symptoms. Almost 98% of HCW used a combination of mask, gloves, gown and face shield. Around 65% of the HCW have a tendency to discharge more patients from the ED than what they were used to. Conclusion: The COVID-19 pandemic made a major change within the emergency departments worldwide.

HHV 6-7 reactivation causing Pityriasis Rosea and labyrinthitis: A case report.

Pityriasis Rosea (PR) and labyrinthitis are most commonly caused by viral infections. PR presents with a characteristic rash while labyrinthitis presents with vertigo, tinnitus and hearing loss. However, the coexistence of PR and Labyrinthitis remains an uncommon event. Human Herpes Virus (HHV) 6 and 7, are common infections in childhood, and their reactivation causes Pityriasis Rosea. But these viruses are not known to have any involvement with the inner ear or the 8th cranial nerve (CN).