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Among the myriad of challenges healthcare institutions face in dealing with coronavirus disease 2019 (COVID–19), screening for the detection of febrile persons entering facilities remains problematic, particularly when paired with CDC and WHO spatial distancing guidance. Aggressive source control measures during the outbreak of COVID-19 has led to re-purposed use of noncontact infrared thermometry (NCIT) for temperature screening. This study was commissioned to establish the efficacy of this technology for temperature screening by healthcare facilities. We conducted a prospective, observational, single-center study in a level II trauma center at the onset of the COVID-19 outbreak to assess (i) method agreement between NCIT and temporal artery reference temperature, (ii) diagnostic accuracy of NCIT in detecting referent temperature $$\ge 100.0\,^{\circ }{\mathrm{F}}$$ ≥ 100.0 ∘ F and ensuing test sensitivity and specificity and (iii) technical limitations of this technology. Of 51 healthy, non-febrile, healthcare workers surveyed, the mean temporal artery temperature was $$98.4\,^{\circ }{\mathrm{F}}$$ 98.4 ∘ F ($$95\%$$ 95 % confidence interval (CI) = $$[98.2,98.6]\,^{\circ }{\mathrm{F}}$$ [ 98.2 , 98.6 ] ∘ F ). Mean NCIT temperatures measured from $${1}\,{\mathrm{ft}}$$ 1 ft , $${3}\,{\mathrm{ft}}$$ 3 ft , and $${6}\,{\mathrm{ft}}$$ 6 ft distances were $$92.2\,^{\circ }{\mathrm{F}}$$ 92.2 ∘ F $$(95\%\ {\text {CI}}=[91.8\ 92.67]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 91.8 92.67 ] ∘ F ) , $$91.3\,^{\circ }{\mathrm{F}}$$ 91.3 ∘ F $$(95\%\ {\text {CI}}=[90.8\ 91.8]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 90.8 91.8 ] ∘ F ) , and $$89.6\,^{\circ }{\mathrm{F}}$$ 89.6 ∘ F $$(95\%\ {\text {CI}}=[89.2 \ 90.1]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 89.2 90.1 ] ∘ F ) , respectively. From statistical analysis, the only method in sufficient agreement with the reference standard was NCIT at $${1}\,{\mathrm{ft}}$$ 1 ft . This demonstrated that the device offset (mean temperature difference) between these methods was $$-6.15\,^{\circ }{\mathrm{F}}$$ - 6.15 ∘ F ($$95\%\ {\text {CI}}=[-6.56,-5.74]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 6.56 , - 5.74 ] ∘ F ) with 95% of measurement differences within $$-8.99\,^{\circ }{\mathrm{F}}$$ - 8.99 ∘ F ($$95\%\ {\text {CI}}=[-9.69,-8.29]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 9.69 , - 8.29 ] ∘ F ) and $$-3.31\,^{\circ }{\mathrm{F}}$$ - 3.31 ∘ F ($$95\%\ {\text {CI}}= [-4.00,-2.61]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 4.00 , - 2.61 ] ∘ F ). By setting the NCIT screening threshold to $$93.5\,^{\circ }{\mathrm{F}}$$ 93.5 ∘ F at $${1}\,{\mathrm{ft}}$$ 1 ft , we achieve diagnostic accuracy with $$70.9\%$$ 70.9 % test sensitivity and specificity for temperature detection $$\ge 100.0\,^{\circ }{\mathrm{F}}$$ ≥ 100.0 ∘ F by reference standard. In comparison, reducing this screening criterion to the lower limit of the device-specific offset, such as $$91.1\,^{\circ }{\mathrm{F}}$$ 91.1 ∘ F , produces a highly sensitive screening test at $$98.2\%$$ 98.2 % , which may be favorable in high-risk pandemic disease. For future consideration, an infrared device with a higher distance-to-spot size ratio approaching 50:1 would theoretically produce similar results at $${6}\,{\mathrm{ft}}$$ 6 ft , in accordance with CDC and WHO spatial distancing guidelines.

Introduction Acute respiratory distress syndrome (ARDS) after mild traumatic brain injury (TBI) can be associated with significant morbidity and mortality. This study aimed to evaluate the potential predictive factors of ARDS development following mild TBI in trauma patients. Methods A retrospective chart review was done for adult trauma patients with mild TBI (GCS 13-15) requiring admission at our center from 2012 to 2020. Linear regression analysis and chi-square test were utilized to identify independent predictors of the association with ARDS in adults with mild TBI. Results A total of 784 mild TBI patients were admitted during the time of interest; 34 patients developed ARDS during their index hospitalization. Patients who had ARDS were more likely to have acute kidney injury (AKI; p < 0.0001), sepsis (p < 0.01), rib fractures (p < 0.05), use of anticoagulants (p < 0.001), deep vein thrombosis (p < 0.001), transfusion during the first 4four hours upon admission (p = 0.01), intravenous fluid (IVF) resuscitation during the first four hours (p

Traumatic brain injury is responsible for over one million hospital visits, and thousands of deaths annually. The aging population is associated with an increased use of anticoagulation and antiplatelet agents which complicates traumatic brain injury. The use of antiplatelet agents significantly increases baseline risk of intracranial hemorrhage. However, routine platelet transfusion in an attempt to reverse the effects of antiplatelet agents may be detrimental. Here, we report a case of an elderly woman with mild traumatic brain injury, who suffered a tragic demise after platelet transfusion.

Clostridium perfringens (CP) bacteremia is a rare but rapidly fatal infection. Only 36 cases of CP bacteremia with gas containing liver abscesses on image studies have been reported in the literature since 1990. In this report, we describe a 65-year-old diabetic male with CP bacteremia which progressed into fulminant hepatic failure with subsequent fatal cerebral edema.