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This study investigated, using validated computational fluid dynamics techniques, the potential infection risks to medical staff when performing endotracheal intubation in the negative pressure isolation ward during treatment of COVID-19 patients. The research first simulated the airflow distribution in negative pressure isolation ward and then examined the potential infection risks to medical staff under two different respiratory conditions of a patient (i.e. patient with endotracheal intubation and patient with normal respiration). The results revealed that medical staff have high possibility to be contracted when performing endotracheal intubation. Personal protective equipment during endotracheal intubation is thus critical to mitigate the potential infection risk to medical staff. Space position and body posture of the medical staff (e.g. standing upright and bent over) would influence the contamination risk. Higher infection risk was noted for the medical staff who performs endotracheal intubation as compared to the other who delivers assistance. A bent-over posture of the medical staff encounters more particle exposure due to a closer distance to the patient head as well as the unfavourable airflow pattern/direction. Protection by using a plastic aerosol box over the head of the patient was studied, which shows promising improvement by preventing more than 75% of virus particles from spreading around.

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Background:Migraine is the most common cause of headache patients for medical consultation to emergency department (ED). However, the management and cost of those patients are less known. Our study aimed to survey detailed diagnosis, clinical characteristics, management, and cost of migraine patients in the emergency department in ChinaMethods:We performed a retrospective study from April 1, 2014, and September 31, 2020, at West China Hospital. This study enrolled patients with migraine diagnoses and analyzed their investigations, medical treatment and cost during their stay at ED. Results:Our study included 300 patients, 77.3% were female and the mean age was 38 years. 36% were conducted cranial CT scan. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most used at ED. We found that none of the patients received triptans nor prophylaxis medicine. The mean cost of emergency room visits was 57.17USD.Conclusion:Our study found that most migraine patients who came to the ED were not receiving the evidence-based acute treatment. A timely referral system should be established to minimize the disease costs of patients.