RESUMO
During the COVID-19 pandemic peak, the author deployed twice to an emergency Alternate Care Site in Porterville, California. The provision of oxygen to patients there, as seen from a physician's perspective, does not fully support the description in a recently published article of how the State of California approached oxygen logistics during the COVID-19 surge. To inform future planning, an adequate logistical assessment must include not only approaches for solving technical resource challenges, but also reliable numbers regarding end-user resource utilization, and non-utilization, as well as program costs, benefits, and unintended consequences.
Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , PandemiasAssuntos
Doenças das Artérias Carótidas , Doença Arterial Periférica , Previsões , Humanos , PrevalênciaRESUMO
KEY CLINICAL MESSAGE: Neurotoxic snake envenomation can result in respiratory failure and death. Early treatment is considered important to survival. Inexpensive, heat-stable, needle-free, antiparalytics could facilitate early treatment of snakebite and save lives, but none have been developed. An experiment using aerosolized neostigmine to reverse paralysis suggests how early interventions could be developed.
RESUMO
Pediatric, nursing home, and institutionalized psychiatric patients frequently receive medications covertly or against their will. Surreptitious medicating of emergency department (ED) psychiatric patients may occur but has not been reported. We discuss competing ethical, therapeutic, and legal issues in potential conflict during the treatment of an acutely psychotic patient who had homicidal and suicidal ideation and presented to a busy, urban ED. The practice of covertly medicating may not be uncommon in EDs, but fear of professional censure probably inhibits open discussion and documentation of such events. No specific statutory, ethical, or case law in the United States seems to control this type of situation.