This present article deals with the implementation of a psychology service in emergency medicine residency in 2017. The text aims to present the stages of implementation and the final work protocol that has been shown to be efficient in these four years of work. The activities of the service began with a diagnosis and work proposal submitted to the Residency Coordination, and with its implementation, the following activities were undertaken: Diagnosis of the work demand, group activities, individualized psychological listening with possible referrals, application of instruments to evaluate vulnerability to stress, informative groups, meetings with the preceptors, meetings with the coordination and administrative sector. The activities developed resulted in the improvement of the residencys functioning and, mainly, in stress management and mental health gains for the residents.

Keywords: Psychology; Medical residency; Emergency medicine.

INTRODUCTION: In 2020, Brazil faced the biggest public health crisis in recent decades. The 2019 Novel Coronavirus (COVID-19) acute infection challenged the national health system and showed many weaknesses that hindered the performance of health professionals. Thus, our goal is to assess the perception of the COVID-19 pandemic among these professionals.
METHODS: Quantitative and qualitative study, with a questionnaire carried out with the help of the Google Forms tool (docs.google.com/forms) and sent electronically to health professionals in April 2020. The following variables were evaluated: professional category, location and the region of work, safety regarding the guidelines for the use of personal protective equipment (PPE) and its availability, working conditions, the existence of training in the workplace and the psychological aspects experienced.
RESULTS: 197 forms were obtained. In the sample, 58.9% are nurses, 36.5% work in emergency rooms of Emergency Care Units or hospitals, 50.8% did not feel completely safe regarding the guidelines on the use of PPE, 64% reported not receiving the necessary PPEs, 55.3% said they were not prepared for higher demand scenarios, 40.6% of professionals reported that their health units never conducted training involving contingency plans for multiple victim scenarios and 77% of the sample felt stressed or nervous.
CONCLUSION: Health professionals were emotionally vulnerable throughout the pandemic due to the multiple factors that prevented good health care.

Keywords: SARS-CoV-2. Health Personnel. Mental Health. Emergency. Health education.

Pneumonia caused by the new coronavirus (COVID-19) has been of great concern worldwide since its categorization as a pandemic by the WHO in March 2020, becoming, one of the most substantial causes of mortality. Some risk factors have been associated with a worse prognosis or more severe clinical presentation, including advanced age, obesity and previous structural lung disease. Among some rare complications are pneumothorax, pneumomediastinum, and/or subcutaneous emphysema. In this report, we present a case of a 36-year-old woman who developed severe clinical presentation of COVID-19 with complications including extensive thoracic and cervical subcutaneous emphysema and moderate pneumomediastinum.

Keywords: COVID-19; Pneumomediastinum; subcutaneous emphysema; complication of COVID-19 disease.

INTRODUCTION: Airway management is a major challenge for emergency professionals, being the first and fundamental step in tte care of trauma victims. We may encounter situations of ptysiological and anatomically difficult VA. Tte main indications of definitive airway in trauma are: ensuring tte permeability and safety of tte same, in addition to difficulty in ventilation and/or oxygenation of tte patient. Obtaining tte best and most current tectniques bring safety to tte patient during a stage of care ttat does not allow failures, as ttey can be fatal to tte individual.
METHODOLOGY: literature review of 50 scientific articles, guidelines and book ctapters, being selected ttose publisted in tte last 15 years, ttat suit tte work objectives.
DISCUSSION: Among tte numerous stages of airway management are tte recognition and anticipation of factors ttat stow us tte possibility of a difficult airway. Several tectniques can and stould be used to obtain a safe airway, and tte individualized ctoice is based on tte numerous different situations ttat we may encounter in tte emergency department.
CONCLUSION: It stould be establisted ttat tte priorities of resuscitation of tte patient in tte emergency department are guided by tte ptysiological priorities of tte same. Airway management stould be combined witt otter stages of resuscitation to critically trauma-critical patients. Tte professionals involved stould seek anticipation of possible problems and tave alternatives for immediate resolution, to reduce tte tarm to patients.

Keywords: Intubation. Emergency Medicine. Airway Management