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Introduction: While the pressure points technique for proximal hemorrhage control is long known, it is not recommended in standard prehospital guidelines based on a study showing the inability to maintain occlusion for over two minutes. Main Symptom: This report details a gunshot wound to the left axillary area with complete transection of the axillary artery, leading to profuse junctional hemorrhage and profound hemorrhagic shock. Therapeutic Intervention: Proximal pressure of the subclavian artery was applied against the first rib (the pressure points technique) and maintained for 28 minutes. Outcomes: Cessation of apparent bleeding and excellent, enduring physiologic response to blood transfusion were observed. Conclusion: The pressure points technique can be life-saving in junctional arterial hemorrhage and should be reconsidered in prehospital guidelines. [ABSTRACT FROM AUTHOR]

Objective: Several reports of obstetric anesthesia management have been published since the onset of the COVID-19 pandemic. We aimed to collect high-quality broad and detailed data from different university medical centers in several European Society of Anesthesiologist countries. Methods: This prospective observational survey was performed in eight medical centers in Spain, Israel and Portugal from 1st April to 31st July 2020. Institutional review board approval was received at each participating center. Inclusion criteria: all women with a positive test for COVID-19. Retrieved data included maternal, delivery, anesthetic, postpartum details, and neonatal outcomes. Descriptive data are presented, and outcomes were compared for women with versus without respiratory signs and symptoms. Results: Women with respiratory symptoms (20/12.1%) had significantly higher mean (standard deviation) temperature (37.2 C (0.8) versus 36.8 C (0.6)), were older (34.1 (6.7) years versus 30.5 (6.6)) and had higher body mass index kg m-2 – (29.5 (7.5) versus 28.2 (5.1)). Women with respiratory symptoms delivered at a significantly earlier gestational age (50% < 37 weeks) with a 65% cesarean delivery rate (versus 22.1% in the group without respiratory symptoms) and 5- fold increased rate of emergency cesarean delivery, 30% performed under general anesthesia. A higher rate of intrauterine fetal death (3%) was observed than expected from the literature (0.2–0.3%) in developed countries. There was no evidence of viral vertical transmission. Conclusion: Well-functioning neuraxial analgesia should be available to manage laboring women with respiratory symptoms, as there is a higher frequency of emergency cesarean delivery. We report a higher rate of undiagnosed parturient and intrauterine fetal death. [ABSTRACT FROM AUTHOR]