Introduction: Sudden cardiac arrest accounts for 5% to 10% of deaths among children. Survival following out-of-hospital cardiac arrest depends on quick recognition, early cardiopulmonary resuscitation (CPR) and defibrillation. In Lebanon, the survival rate of children following such arrests is low (16.7%). Consequently, this study assesses availability of automated external defibrillators (AED) and CPR/AED training in Lebanese schools. Methods: This is a cross-sectional phone-based survey study conducted using a randomized sample of 175 private, private-free and public schools - representative ..read more

The cholinesterase activity (AcCh) assay finds an important place in the diagnosis of acute poisoning by cholinesterase inhibitor pesticides, allowing the indication and the efficacy evaluation of antidote treatment with atropine and oximes. AcCh is also a biomarker of effect in occupational exposure to cholinesterase inhibitor pesticides. However, some factors may disrupt AcCh levels and distort the interpretation of the assay results. Hence, the present review aimed to summarize the factors and the variations that may have an impact on the interpretation of AcCh. Indeed, butyrylcholinesteras ..read more

In the midst of the COVID-19 pandemic, the increased risk of exposure to 1-propanol has led the United States Food and Drug Administration to issue a warning about toxicity of 1-propanol-contaminated brands of hand sanitizers. We report a mixed intoxication with 1-propanol and 2-propanol in a patient who unintentionally ingested approximately 300 mL of hospital topical antiseptic solution and who presented to the emergency department with nausea, vomiting, and decreased level of consciousness. The patient developed an anion gap metabolic acidosis without an osmolar gap, elevated serum lactate ..read more

Introduction: This study aims to assess follow-up behaviors of patients who leave without being seen (LWBS) from a hybrid point of service (POS) collection model Emergency Department (ED). Methods: A cross-sectional survey was administered to patients who LWBS from a hybrid POS collection model ED, one-week post-ED visit, at an academic tertiary care medical center in Lebanon, between June 2016 and May 2017. Results: LWBS patients were found to be young, males, and present with conditions of lower urgency and presenting mainly with a musculoskeletal chief complaint. Majority (66.8%) left becau ..read more

Introduction: Unscheduled return visits are an important quality indicator in the emergency department. We aim to compare clinical characteristics and ED resource usage of pediatric high risk unscheduled return visits (HRURVs) between the index and return visit and explore root cause of HRURVs. Methods: A retrospective chart-review study conducted between November 1, 2014 and October 31, 2015. All patients who returned to the ED within 72 hours of discharge and were admitted or died on re-presentation were considered. Results: The incidence rate of HRURV in our study was 0.96% (95%, CI:0.81-1 ..read more

Background: In the field of scientific research, it is well recognized that the starting point for such efforts necessitates a proper and thorough literature search using reliable databases. Objectives: The aim of this article is to present future researchers with a guide that provides a well-defined set of search terms (MeSH terms and keywords) for the Middle East and North Africa (MENA) region, the Arab world, and countries within them. Methods: Selecting the proper search terms for the 26 countries and COVID-19 required a systematic approach for building a search strategy. MeSH an ..read more

The management of survivors of rape in the Lebanese healthcare setting remains ambiguous. National initiatives have been established to train first-line responders to provide adequate care for these survivors; however, management often remains suboptimal. This article explores current practices and challenges faced in the management of survivors of rape and proposes recommendations for the advancement of care in this setting ..read more

Patellar tendon rupture and patellar apex rupture are established complications in patients with end stage kidney disease, however, little to no literature describes bilateral patellar avulsion. This is a case presentation of bilateral knee avulsion due to bilateral patellar tendon rupture at the level of the apexes in a patient with end stage kidney disease on dialysis. A 52 year old female presented to the emergency department for low energy traumatic event. On physical exam patient had bilateral patella alta with limited range of motion. On imaging, bilateral knee MRI was diagnostic of bila ..read more

Acute pulmonary embolism is stratified into three groups: low-risk, moderate-risk, and high-risk. Highrisk PE, also known as massive pulmonary embolism (MPE), is defined as an acute PE with sustained hypotension, pulselessness, and persistent bradycardia. Herein, we present a case of a 44-year-old female presenting to the emergency department with shortness of breath, chest discomfort, and central cyanosis. She was found to have MPE and arrested twice during which she received alteplase and Advanced Cardiac Life Support. In the ICU, she arrested for the third time, was resuscitated, and a deci ..read more

Introduction: Few scoring systems are used in the emergency department to identify critically ill patients and anticipate patients' deterioration such as National Early Warning Score (NEWS). This study aimed to evaluate NEWS in patients with acute stroke and its relationship with treatment and type of stroke and patient outcome. Methods: In this prospective cross-sectional descriptive-analytical study, all patients over 18 years of age with a diagnosis of ischemic stroke, who presented through the emergency department, were involved. The variables of interest were collected; the NEWs score was ..read more