Mediterranean Journal of Emergency Medicine & Acute Care

Introduction: COVID-19 pandemic has had catastrophic effects on the healthcare system. Emergency departments (EDs) are among the most affected areas. The purpose of our study is to explore the pandemic’s effect on patients’ ED visits and admissions. Methods: This was a retrospective study using data from medical record system of King Hamad University Hospital. We examined ED visits and hospital admissions over two 12-month time spans before and during the pandemic. Monthly visits were classified according to several parameters, and ED revisits within 72 hours were also compared between both periods. Results: There was an overall decrease of 11.05% in total ED visits during the pandemic. Disproportionate decrease was seen in visits by pediatric cases under 18 years (49.54%) and patients older than 65 years (1.41%). Conversely, there was a significant increase in visits among adults. Referrals from local health centers to the ED during the pandemic decreased significantly (23.92%), while ambulance visits increased by 13.35%. Patients triaged as levels 2 and 3 decreased. Total admission rate decreased by 8.39%. The decline in admission was noted in most specialties, the greatest being in pediatrics (51.81%), while increased highest in oncology admissions (6.9%). There was an increase in discharge against medical advice rate and a reduction in the ED 72-hour revisit rate. Conclusion: Our study reveals a clear decline in the total number of ED visits and hospitalizations during COVID-19 for both pediatric and elderly patients. Further studies are needed to explain as well as evaluate the effect of such changes.

Achenbach syndrome is a rare cause of acute bluish discoloration and swelling of one or more digits, of unknown etiology. The condition is self-limited and benign but is worrisome for both patients and healthcare providers due to its emulation of peripheral ischemia. Familiarity with the clinical features of Achenbach syndrome allows for rapid diagnosis and mitigation of costs and anxiety associated with unnecessary testing and referrals. We report a case of Achenbach syndrome associated with a puncture wound, which supports a traumatic etiology for this condition.

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.