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0[1.0, 8.9]). Other demographic and clinical factors were not associated with new-onset atrial fibrillation, including mechanism of injury, co-morbid medical conditions, drug or alcohol use, surgical procedures, and intravenous fluid administration.

Male geriatric trauma patients were at higher risk for developing new-onset atrial fibrillation. Other demographic and clinical factors were not associated with new-onset atrial fibrillation.
Male geriatric trauma patients were at higher risk for developing new-onset atrial fibrillation. Other demographic and clinical factors were not associated with new-onset atrial fibrillation.In December 2019, a cluster of severe pneumonia cases of unknown cause was reported in Wuhan, Hubei province, China. A novel strain of coronavirus belonging to the same family of viruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) was identified. In February 2020, cases began being identified in the United States. We describe a sentinel COVID-19 patient in Houston, Texas, who first presented on March 1, 2020. The patient did not meet criteria for a Person Under Investigation (PUI) as recommended by the Centers for Disease Control and Prevention (CDC) at the time. This case has broad implications for emergency department screening and preparedness for COVID-19 and other future infectious diseases.The coronavirus disease 2019 (COVID-19) pandemic has rapidly evolved and now dominates the attention and full efforts of the emergency medicine community, both domestic and abroad. Seattle is the site of the initial diagnosed COVID-19 cases and fatalities in the United States. We provide an overview of the system-level response of 6 Seattle emergency departments and the Washington state chapter of the American College of Emergency Physicians (ACEP) to the COVID-19 pandemic. Local efforts involved the spectrum of emergency response including on- and off-site triage strategies, an approach to personal protective equipment, testing and reporting protocols, early treatments, communication strategies, the impact on front-line providers, and ongoing work.Non-exertional heat stroke is a life-threatening condition characterized by passive exposure to high ambient heat, a core body temperature of 40°C (104°F) or greater, and central nervous system dysfunction. Rapid cooling is imperative to minimize mortality and morbidity. Although evaporative and convective measures are often used for cooling heat stroke patients, cold water immersion produces the fastest cooling. However, logistical difficulties make cold water immersion challenging to implement in the emergency department. To our knowledge, there is no documented case utilizing a body bag (ie, human remains pouch) as a cold water immersion tank for rapid resuscitation of heat stroke. During a regional heat wave an elderly woman was found unconscious in a parking lot with an oral temperature of 40°C (104°F) and altered mental status. She was cooled to 38.4°C (101.1°F) in 10 minutes by immersion in an ice- and water-filled body bag. The patient rapidly regained normal mentation and was discharged home from the ED. This case highlights a novel method for efficient and convenient cold water immersion for heat stroke treatment in the emergency department.E-cigarette or vaping product-use-associated lung injury is a disease process obtained from smoke inhalation with electronic delivery systems and typically presents with shortness of breath, cough, and fever, not unlike pneumonia. Our patient presented with similar symptoms, and his case went unrecognized through several emergency department visits. The pathophysiology is similar to chemical pneumonitis and can cause significant morbidity and mortality, particularly when it goes unrecognized. It often presents with a pneumonia-like picture and may be treated as such. The distinguishing and controversial treatment for this disease is systemic glucocorticoids, which are not often given in pneumonia. This case is unique for the significant leukocytosis found on laboratory testing and profound weight loss associated with his course of illness. Emergency medicine providers should be vigilant in recognizing this illness to prevent progression of this disease.The duty to report certain conditions to public health or law enforcement authorities is one that falls on all physicians and other health care workers as part of their duty to protect the public from harm. In an open society, others, such as teachers, clergy, police officers, or simply neighbors, share the responsibility of protecting individuals at risk, often by reporting them to authorities. ATN-161 molecular weight The emergency physician and others in the emergency department are uniquely positioned to identify people at risk or who pose a risk, and to report them as required or allowed under the law. In some circumstances, these duties may conflict with ethical duties such as respect for patient autonomy or to protect confidentiality. This article will examine mandatory and permissive reporting laws in various states from an ethical perspective. It will also explore emerging issues such as the reporting of suspected human trafficking.We provide a review of the assessment of suicidal emergency department patients and includes a legal and ethical perspective. Screening tools and psychiatric consultation are important adjuncts to the ED evaluation of potentially suicidal patients. Suicide risk should be assessed, and if positive, an appropriate and safe disposition should be arranged. The aim of this article is to review these assessment tools and consider ethical issues, such as patient autonomy, accountability of the emergency physician, and consultant to Emergency Medical Treatment and Labor Act (EMTALA) as well as confidentiality, privacy, and social issues.Airway management is an important intervention during resuscitation of out-of-hospital cardiac arrest (OHCA). Endotracheal intubation is commonly used by emergency medical services paramedics in the advanced airway management of OHCA, but numerous studies question its safety and effectiveness. Furthermore, there is now increasing use of supraglottic airway devices. In this review, we provide an overview of 3 recent randomized clinical trials of advanced airway management (Pragmatic Airway Resuscitation Trial [PART], AIRWAYS-2, and Cardiac Arrest Airway Management [CAAM]) and highlight new information that is available to guide OHCA airway management practices.
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