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Hydrogen Fluoride (HF) inhalation is one of the industrial accidents. It causes serious damage, although it is quickly recognized. Since hydrofluoric acid leaks are under surveillance by the alarm system, and low concentrations of gas also have a distinctive smell, most accidents occur from exposure in a short period to a large amount of HF. Thus, prolonged exposure to HF is exceedingly rare in a developed country. We report seven cases of chemical pneumonitis due to HF inhalation to share clinical course and prognosis.Severe bronchial asthma is a challenging disorder to treat and can impair quality of life (QOL) under conventional therapeutic modalities. We report the case of a 52-year-old woman with severe asthma associated with eosinophilic chronic rhinosinusitis (ECRS) and eosinophilic otitis media (EOM). Although the patient was treated with a full dose of inhaled corticosteroid, leukotriene receptor antagonist (LTRA), theophylline, burst use of oral corticosteroids (OCS), her asthmatic condition aggravated, disrupting her daily life. ECRS and EOM symptoms were also getting worse despite treatment with topical application of corticosteroids to the nose and ears, LTRA, and occasional use of OCS. In addition to asthmatic symptom, the patient always suffered from intractable nasal obstruction and hearing disturbance, which contributed to the heavily impaired QOL. However, the administration of benralizumab showed rapid and remarkable improvement not only in her asthmatic conditions but also in the symptoms of ECRS and EOM within a month. These results suggest that the use of benralizumab for the treatment of severe asthma with intractable ECRS and EOM should be considered when the patient's QOL is severely deteriorated.Mycobacterium abscessus is a rapidly growing mycobacterium. It rarely causes disseminated infection or endocarditis. A 55-year-old male with a history of hepatitis C, liver cirrhosis, intravenous drug use (last use was four years ago), and chronic back pain presented with a three-week history of a right calf nodular lesion. He did not have a fever, chills, rash, dyspnea, or cough. Laboratory data showed mild leukocytosis. Computed tomography of the chest revealed bilateral cavitating nodules. Skin biopsy, sputum, and blood cultures grew Mycobacterium abscessus. Therapy with meropenem, tigecycline, and amikacin was initiated. He was re-admitted with worsening lower back pain. A lumbar magnetic resonance imaging showed destructive changes of L4 and L5 vertebral bodies concerning for osteomyelitis. Blood culture and bone biopsy grew Mycobacterium abscessus again. An echocardiogram was performed due to persistent bacteremia, which revealed large vegetation on the tricuspid valve and small vegetation on the mitral valve. Therapy was changed to eight weeks of amikacin, with cefoxitin and imipenem for twelve months based on drug susceptibility. Treatment of disseminated Mycobacterium abscessus is challenging due to antibiotic resistance. Typically, multidrug therapy is warranted with at least three active drugs. In severe valvular endocarditis, valve replacement may be required.This is the first published case report of a child with acute lymphatic leukemia developing a fatal mucormycosis during blinatumomab treatment. The patient showed multiple, systemic thromboembolic lesions with ischemia, bleeding and infarction in almost all organs. The child succumbed to increased brain pressure resulting in cerebral herniation. This case particularly illustrates the fulminant progression and huge challenges of diagnosing and treating mucormycosis in children with hemato-oncological diseases during treatment with targeted therapeutic antibodies (blinatumomab).A 72-year-old woman with an ant bite on her hand presented with anaphylaxis at the scene and chest pain in the emergency department.Electrocardiography showed a myocardial infarction with inferior and lateral wall ST elevation. She received percutaneous coronary intervention. The results revealed left anterior descending branch and right coronary artery obstruction. After stenting, she was discharged in good condition. Kounis syndrome was diagnosed. Emergency physicians should be alert to acute coronary syndrome following anaphylaxis.

On February 6, 2018, a magnitude-6.2 earthquake on the Richter scale struck Hualien, and that disaster killed 17 people and injured more than 300 people. Our hospital, the only tertiary hospital in eastern Taiwan, responded to a mass casualty incident (MCI) in two hours. Such a devastating earthquake infl uenced the health of the general population and the mental health of hospital staff. Thus, we aimed to analyze the medical problems in earthquake victims, the MCI response's operation, and the prevalence of post-traumatic stress disorder (PTSD) among healthcare providers.

We reviewed the medical records to investigate the information on the medical requirement of victims. Selleck Saracatinib Questionnaires were collected from emergency department staff regarding the operation of the MCI and the effect of regular MCI drills. For a survey of PTSD among healthcare providers, we used the Chinese version of the Davidson Trauma Scale for the psychiatric assessment.

Among the 113 victims who entered the emergency room, almost 90ts, the annual exercises play a signifi cant role. Besides, we can't ignore the mental health condition of healthcare providers after the disaster. We record this tragic earthquake's valuable experience and lessons and share them with others.

Bystander-initiated cardiopulmonary resuscitation (CPR) and the use of automated external defibrillation (AED) is pivotal in the community chain of survival, but little is known regarding the bystander experience of performing CPR and AED, and their psychological infl uence from the incidents in the Asian community. This qualitative study was conducted to explore the experiences of lay rescuers who had performed CPR and AED in public locations in Taiwan.

Lay rescuers who had provided initial CPR and defi brillation with AED in public locations across Taiwan in 2015 were selectively recruited from Taiwan Public AED Registry for a semi-structured interview.

Nine participants were included in the study, and event-to-interview duration was within 1 year (n = 4) and 1-2 years (n = 5). The major fi ndings from the study were (1) the lay rescuers possessed helping traits and high motivation; (2) the lay rescuers reported certain aspects of rescue reality that differed much from prior training and expectations, including diffi culty in the depth of chest compression, and uncertainties in real emergency situations; (3) the lay rescuers gained positive personal fulfi llment in sharing their experience and receiving positive feedback from others, and were willing to help next time, although they experienced a short-term negative psychological impact from the event.