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Introduction and importance: Hydatidosis is a zoonotic condition caused by contact with the tapeworm Echinococcus granulosus metacestode. The liver and lungs are the most prominent locations for cysts. This is a rare case of pulmonary hydatid cyst (PHC) rupture in a young woman following a severe cough. Case presentation On July 9, 2018, a 20-year-old woman presented to our hospital in northern Iran with a complaint of cough with excessive sputum, dyspnea, drooling, symptoms of nausea and vomiting, itching and urticarial. Imaging findings showed evidence of a large, space-occupying mass in the right lung. She underwent a thoracoscopic wedge resection (TWR) as a minimally invasive technique, to remove the wall and contents of the cyst. Also, anaphylactic shock occurred in the patient. Due to hemodynamic disorders and heart and respiratory failure, unfortunately, the patient expired. Clinical discussion The rupture of a hydatid cyst may result in irreversible damage. PHC rupture is a serious complication that causes excessive coughing and chest pain. A rupture into the pleural or pericardial cavity is a serious and potentially fatal disease. Conclusion Anaphylactic shock should be considered as one of the serious complications of PHC, particularly in young ones. Therefore, early diagnosis and appropriate treatment are essential to prevent severe complications such as anaphylactic shock., Highlights • Anaphylactic shock due to ruptured pulmonary hydatid cyst in a young patient from Iran. • Radiography and CT scan showed evidence of a large, space-occupying mass in the right lung. • Early diagnosis and appropriate treatment are essential to prevent severe complications such as anaphylactic shock.

Introduction and importance Foreign body aspiration (FBA) in adults may be asymptomatic or symptomatic. Fever and cough are the most common symptoms of Coronavirus infection and other causes of pneumonia. Regardless of the etiology of pneumonia, the first step in the treatment of FBA-associated pneumonia is to remove the foreign body from the airway. Case presentation A 32-year-old man was referred to our emergency department on October 26, 2020 with shortness of breath (SOB) and a cough. He was referred to the medical center with clinical suspicion of Coronavirus disease-19 (COVID-19), and his disease was treated considering COVID-19. Based on the persistence of his symptoms after discharge, he was referred to the hospital again, and the presence of a foreign body was confirmed by a rigid bronchoscopy, which was then removed. Clinical discussion Our patient did not remember any history of aspirating solid particles, choking, or any other high-risk conditions associated with aspiration. Also, he had no symptoms with the exception of cough and SOB before the first admission. It means that asymptomatic FBA can be tolerated and go undiagnosed, particularly in adults, and manifests as a secondary complication, such as pneumonia. Conclusion The FBA and other causal agents may mimic COVID-19 pneumonia. Consequently, FBA should be included in the COVID-19 differential diagnosis.

Background: In the everyday life, a large number of pre-hospital emergency missions are including the injurers caused by traumatic events. Meanwhile, the immediate response to the injurers of the mass casualties is of particular importance due to their large number and also the distance to the medical centers. Using of a proper triage scale has a major role in prioritizing the injuries resulted from mass casualty events in order to treat and transfer them to health centers and also in the management of the scene and improving the quality of care of traumatic injuries. Therefore, the purpose of this study is to describe the various methods of triage in the scene, so that we can present a suitable triage scale for prioritizing injuries in mass casualty for pre-hospital emergency. Methods: This study is an overview one and is performed by using of databases and library resources and words including triage, pre-hospital emergency, mass casualty, crisis and emergency medical technician. Results: Based on the surveys, a variety of triage methods in the scene were found including Simple triage and rapid treatment (START), Jump start, triage sieve or Major Incident Medical Management and Support (MIMMS), Pediatric Triage Tape (PTT), Move, Assess, Sort, and Send (MASS), Care Flight, Sort, Assess, Lifesaving interventions, and Treatment and/or Transport (SALT), Revised Trauma Score (RTS), Pediatric Trauma score (PTS). Conclusions: In the literature, the use of different triage scales has been recommended in the crisis, the scene of the accident and trauma. By considering the context, structure and dispersion of mass casualty in the country, it isn’t known yet which one of these scales is operational and applicable. Therefore, for the patients in mass casualty, it is suggested that an appropriate and applicable triage scale should be designed for pre-hospital emergency operations. Keywords: Triage in the scene, Pre-hospital emergency, Mass casualty