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Introduction The surge of SARS-CoV-2-virus infected (COVID-19) patients presenting to New York City (NYC) hospitals quickly overwhelmed and outnumbered the available acute care and intensive care resources in NYC in early March 2020. Upon the arrival of military medical assets to the Javits Convention Center in NYC, the planned mission to care for non-SARS-CoV-2 patients was immediately changed to manage patients with (SARS-CoV-2)COVID-19 and their comorbid conditions. Healthcare professionals from every branch of the uniformed services, augmented by state and local resources, staffed the Javits New York Medical Station (JNYMS) from April 2020. Methods The data review reported aggregated summary statistics and participant observations collected by N.Y. State and U.S. military officials. Results During the 28 days of patient intake at the JNYMS, 1,095 SARS-CoV-2-positive patients were transferred from NYC hospitals to the JNYMS. At its peak, the JNYMS accepted 119 patients in a single day, had a maximum census of 453, and had a peak intensive care unit census of 35. The median length of stay was 4.6 days (interquartile range: 3.1-6.9 days). A total of 103 patients were transferred back to local hospitals, and there were 6 deaths, with an overall mortality rate of 0.6% (95% CI, 0.3-1.2). Discussion and Conclusions This is the first report of the care provided at the JNYMS. Within 2 weeks, this multi-agency effort was able to mobilize to care for over 1,000 SARS-CoV-2 patients with varying degrees of illness in a 1-month period. This was the largest field hospital mobilization in the U.S. medical history in response to a non-wartime pandemic. Its success with huge patient throughput including disposition and low mortality relieved critical overcrowding and supply deficiencies throughout NYC hospitals. The downstream impact likely saved additional hundreds of lives and reduced stress on the system during this healthcare crisis.

IntroductionNeurogenic thoracic outlet syndrome (NTOS) is a rare and sometimes overlooked cause of upper limb pain, weakness and disability and presents to a range of different healthcare professionals. Here we present a case of severe NTOS with characteristic clinical, radiological and electroclinical findings.HistoryA 16 year old right-handed female presented with a two year history of progressive symptoms affecting her left hand. Initially she noticed weakness affecting initially the 4thand 5thleft digits which progressed to involve the whole hand. She described a burning sensation affecting the medial aspect of her left forearm at night.ExaminationExamination of the left arm revealed decreased bulk of the thenar, hypothenar and inter- ossei intrinsic muscles of the hand, power diminished to grade 4 in the left ADM, APB, FDIO and to grade 4+ in left EDC, and altered sensation in the T1 dermatome.InvestigationsA lordotic chest radiograph revealed bilaterally elongated C7 transverse processes, a finding confirmed on retrospective review of the brachial plexus MRI, which also revealed bilateral grade 1 cervical ribs and increased signal on STIR sequence of the left C8 and T1 nerve roots. Nerve conduction studies revealed electroclinical evidence of a left lower trunk brachial plexopathy.OutcomeThe patients neuropathic pain responded to low dose gabapentin. She was assessed at the Peripheral Nerve Injuries Unit at RNOH Stanmore and recently underwent successful left thoracic outlet decompression.hamish.morrison@nhs.net