Beirut Port Blast 2020: New Lessons Learned in Mass Casualty Incident Management in the Emergency Department.

Background: On August 4, 2020, Lebanon suffered its largest mass casualty incident (MCI) to date: the Beirut Port blast. Hospital emergency response to MCIs is particularly challenging in low- and middle-income countries, where emergency medical services are not well developed and where hospitals have to rapidly scale up capacity to receive large influxes of casualties. This article describes the American University of Beirut Medical Center (AUBMC) response to the Beirut Port blast and outlines the lessons learned.

Predictors of a short hospitalization in bone marrow transplantation patients presenting to the emergency department.

Background: Despite the advantages of bone marrow transplantation (BMT), patients receiving this intervention visit the emergency department (ED) frequently and for various reasons. Many of those ED visits result in hospitalization, and the length of stay varies.

Objectives: The objective of our study was to identify the patients who were only briefly hospitalized and were thus eligible for safe discharge from the ED.

Telepsychiatry in the Arab World: A Viewpoint Before and During COVID-19.

Purpose: Telepsychiatry, a subset of telemedicine, has been increasingly studied to meet the growing demands for psychiatric care. The utility of telepsychiatry is relevant now more than ever as the world endures the COVID-19 global pandemic. This paper describes the prior state and the changes that the COVID-19 outbreak brought to telepsychiatry in a selected group of Arab countries of the Middle East and North Africa (MENA) region.

The utility of chest X-ray vs. computed tomography in febrile neutropenia patients presenting to the emergency department.

Introduction: Pulmonary infections are not uncommon in patients with febrile neutropenia. Physicians have agreed to perform a chest X-ray (CXR) for all febrile neutropenic patients presenting with respiratory signs/symptoms. Nevertheless, they were divided into two groups when it came to asymptomatic febrile neutropenic patients (i.

A Financial Plot to Reduce the Burden of Medical School Tuition Fees.

Tuition fees for medical school are continuously and riotously increasing. This upsurge is amassing debts on the backs of students. In the class of 2018, 75% finished medical school with an outstanding balance of $196,520, on average-a $5826 increase from 2017.

Emergency Medicine Interest Groups.

Emergency Medicine Interest Groups (EMIGs) serve as a bountiful resource for students interested in pursuing a career in Emergency Medicine (EM). In this article we elaborate on how medical students can get involved as members in an EMIG, discuss opportunities for leadership through these groups, detail how to make the most out of the EMIG (including a listing of important lectures, workshops/labs and opportunities for growth and advancement), provide a framework for how to institute a new EMIG when one does not exist, and discuss considerations for international EMIG groups.

Clinical characteristics and outcomes of bone marrow transplantation patients presenting to the ED of a tertiary care center.

Background: Bone marrow transplantation is a breakthrough in the world of hematology and oncology. In our region, there is scarce literature studying emergency department visits among BMT patients, as well as their predictors of mortality.

Objectives: This study aimed to assess the frequency, reasons, clinical characteristics and outcomes of patients presenting to the ED after a BMT, and to study the predictors of mortality in those patients.

Geriatric Mental Health and COVID-19: An Eye-Opener to the Situation of the Arab Countries in the Middle East and North Africa Region.

While the detrimental ramifications of the COVID-19 outbreak on the mental wellbeing of the general public continue to unravel, older adults seem to be at high risk. As the geriatric population continues to grow in the Middle East and North Africa (MENA) region, it is essential to explore the influence of this outbreak on geriatric mental health, a topic often neglected. In this review, we depict the status of geriatric psychiatry in the Arab countries of the MENA region, exploring the variations from one nation to another.

Medical Student Leadership in Emergency Medicine.

Emergency medicine is a profession that requires good leadership skills. Emergency physicians must be able to instill confidence in both the staff and patients, inspire the best in others, have the enthusiasm to take on a surplus of responsibilities, and maintain calmness during unexpected circumstances. Accordingly, residency program directors look carefully for leadership qualities and potential among their applicants.

Research and Scholarly Projects.

The idea of doing a research or scholarly project can be very daunting, however, the satisfaction of seeing a project to its completion is very rewarding. In this article, we provide medical students with guidance on whether they should take on a research or scholarly project during medical school, and how to get started, publish, and then present their project. We also highlight how such a project can benefit an applicant applying for residency training.

Patient Attitudes Toward Mobile Device Use by Health Care Providers in the Emergency Department: Cross-Sectional Survey.

Background: Health care provider usage of mobile devices is increasing globally; however, there is little understanding of patient perceptions on this behavior in a health care setting.

Objective: The aim of this study was to assess patients' attitudes toward mobile device usage by health care providers in the emergency department and to identify predictors of these attitudes.

Methods: The study was carried out at the emergency department of a large academic tertiary care medical center in Lebanon.

Meningitis due to Weissella Confusa.

Bacterial meningitis is a life-threatening condition that should be addressed as an emergency. The typical culprit microorganisms are targeted empirically with ceftriaxone and vancomycin, in the absence of an immunocompromised state. In this case report, however, we are describing a case of meningitis secondary to Weissella confusa, bacteria inherently resistant to the two drugs commonly used to empirically treat meningitis.

The Medical School Years.

Medical school can be very challenging, especially when students are considering applying to competitive specialties, like emergency medicine. Once medical students know that emergency medicine is the field they want to specialize in, a multitude of other questions arise, including how many EM rotations should they do? How can they shine during their EM rotations? When should they schedule their rotations, electives, and sub-internships? How can they get the strongest letters of recommendation? What are residency program directors looking for? Therefore, we are going to present in the Medical Student Forum section of the Journal of Emergency Medicine a series of six articles covering this and more.

Pulmonary Embolism Can Be Nauseous: A Case Report and Review of D-Dimer Use in Pediatric Oncology Patients.

Background: Pulmonary embolism (PE) is a very common presentation in the emergency department (ED). Despite being life-threatening, PE is preventable if diagnosed and managed early, especially in high-risk patients like pediatric oncology patients. A negative d-dimer has a high negative predictive value and can rule out PE in low-risk patients; however, it does not lower post-test probability enough and should be coupled with further diagnostics in high-risk patients.

What If I Do Not Match? Scrambling for a Spot and Going Outside the Match.

Matching into emergency medicine (EM) is getting progressively more competitive. Applicants must therefore prepare for the possibility of not matching and, accordingly, be ready to participate in the Supplemental Offer and Acceptance Program (SOAP). In this article, we elaborate on the SOAP and the options for applicants who fail to match during Match Week.

Designing the Third- and Fourth-Years Clerkship Schedule.

Deciding on a specialty may be one of the most daunting parts of medical school. Accordingly, it is important for medical students to make informed decisions regarding their choice of specialty. To do so, they should start planning early by contemplating possible career choices during the first 2 years of medical school, followed by properly designing their third- and fourth-year schedules.

Clerkships in Emergency Medicine.

Planning for clerkships in emergency medicine (EM) can be stressful, prolonged, and challenging. Therefore, medical students should start planning for them early. In this article, we offer guidance regarding several issues pertinent to the EM clerkship, such as the best time to schedule one (or more) during medical school, the most appropriate institution or program to schedule it, the process of selecting and applying for the clerkship, and the number of EM clerkships to consider.

The International Medical Graduate and Emergency Medicine.

International medical graduates (IMGs) are medical graduates who have received their degree from international medical schools. IMGs must undertake a 3-step process to apply to the National Residency Matching Program match. First, they must obtain a valid standard certificate from the Educational Commission for Foreign Medical Graduates.

Management of altered mental status and delirium in cancer patients.

Delirium is a syndrome characterized by acute onset of changes in awareness and cognition, which fluctuate in severity during the episode. Altered mental status (AMS) and delirium have a high incidence rate among patients with cancer and this increases dramatically towards the end of life. Delirium is multifactorial, as cancer patients have an array of predisposing and precipitating factors: metabolic disturbances, structural lesions, in addition to medications and infection.

Uniformed Medical Students and Residents in Emergency Medicine.

"Uniformed medical students and residents" refers to medical school enrollees and physicians in training who are obligated to serve in the military after graduation or training completion. This is in exchange for 2 forms of financial support that are provided by the military for individuals interested in pursuing a career in medicine. These programs are offered namely through the Uniformed Services University of Health Sciences (USUHS) and the Health Professions Scholarship Program (HPSP).

Three- vs. Four-Year Emergency Medicine Training Programs.

Postgraduate training in emergency medicine (EM) varies in length among different programs. This fact creates a dilemma for applicants to the specialty of EM and prevents EM educators from reaching a consensus regarding the optimal length of training. Historically, EM training existed in the postgraduate year (PGY) 1-3, 2-4, and 1-4 formats, until the PGY 2-4 program became obsolete in 2011-2012.

Couples Match in Emergency Medicine.

The Match is a daunting process for everyone, but it can be exceedingly more complicated for couples. Accordingly, the Couples Match was introduced by the National Residency Match Program in 1984 and has been witnessing a steady increase in the number of participating couples over the past 30 years. The highest number of couples participating in the match, and the highest match rate among them, was recorded in 2018.

Applicants with Prior Training.

Emergency medicine (EM) has its challenges, downsides, advantages, and accompanying lifestyle. Additionally, graduates of EM residency programs have abundant job opportunities. Accordingly, there is an increased interest in residency training in EM, even among residents with prior training.